|Year : 2012 | Volume
| Issue : 3 | Page : 111-116
Revolution and mental health
Department of Psychiatry, Damietta College of Medicine, Al-Azhar University, Damietta, Egypt
|Date of Submission||01-Mar-2012|
|Date of Acceptance||21-Mar-2012|
|Date of Web Publication||4-Jun-2014|
Department of Psychiatry, Faculty of Medicine, Al-Azhar University, Damietta Branch, Damietta
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Elmahdy M. Revolution and mental health. Egypt J Psychiatr 2012;33:111-6
| Introduction|| |
Volumes have been written on revolutionary human behaviour, and both historians and other scholars have addressed the subject in great detail. It has been considered not only from a socioeconomic stand point but also from a political perspective. An infinite variety of reasons have been explored, presenting both justification for revolution and purely emotional and even irrational reasons for man’s behaviour in this regard. Has a ‘gold thread’ appeared in history that can shed some light on the causes of revolts? The Latin word revolutio means to turn around, take an opposite direction, or make often drastic changes (Jones, 2011).
The Egyptians seemed to find an acceptable social structure and were able to live without revolt, except for the Amarna experience, which was short lived. The Romans and the Greeks had a social contract, but there was one revolt after another. The concept of addressing issues by force of arms was well established and continues into the 21st century. Fear of punishment or the hope of reward were the two motivating factors (Jones, 2011).
The Middle Ages taught man how to accept his anger and control it. The 19th century taught man to consider his collective power to make vital changes to circumstances. The slave revolts in ancient Rome were minor when compared with the revolt as seen today (Jones, 2011).
Revolution, regardless of how it is called, acts of rage and acts of violence are all manifestations of individuals seeking to acquire what to them is absent in their lives.
| Types of revolutions|| |
Scientific revolutions, Le Bon claims, are the most important but the least attentive of revolutions. It is as if these scientific wonders can be absorbed without consequences when they change the structure of society radically in a ‘cut and control’ phenomenon.
Beneath scientific revolutions are religious and political revolutions. ‘While scientific revolutions derive solely from rational elements, political and religious beliefs are sustained almost exclusively by affective and mystic factors’.
By the insistence of absolute truth a belief necessarily becomes intolerant. This explains the violence, hatred and persecution that are habitually associated with the Protestant Reformation and the French Revolution.
In religious revolutions no experience can reveal to the faithful that they are deceived, since they would have to go to heaven to make the discovery. In political revolutions experience quickly demonstrates the error of a false doctrine and forces men to abandon it (Le Bon, 1913).
| The revolutionary mentality|| |
Revolutionists are characterized by a restless spirit, instability and discontent and are ready to rebel against any established order of affairs. They are spurred by the mere love of revolt, and if some magic power could realize all their desires they would simply revolt again. This special mentality often results from a pecuiliar adaptation of the individual to his surroundings, or from an excess of mysticism, or adoption of certain ideals and principles; it may also be merely a question of temperament or, in some cases, may arise from pathological disturbances. Perpetual rebels are generally highly impressionable beings, whose mind is obsessed with fixed ideas. Despite the apparent energy indicated by their actions they are really weak characters and are incapable of mastering control over themselves sufficiently to resist the impulses that rule them. The mystic spirit that drives them furnishes pretexts for their violence and enables them to regard themselves as great reformers (Le Bon, 1913).
There are certain affective elements whose development during revolution contributes to modify individual or collective personalities. In particular, we can mention: hatred, fear, ambition, jealousy or envy, vanity and enthusiasm (Le Bon, 1913). Keeping aside the influence of affective, rational and collective logic, we will occupy ourselves solely with the considerable part played by the mystic elements that have prevailed in so many revolutions. The chief characteristic of the mystic temperament consists of the attribution of a mysterious power to superior beings or forces, which are incarnated in the form of idols, fetishes, words or formulae. Mystic logic constitutes the might of the great popular movements. Men who would be by no means ready to allow themselves to be killed for the best of reasons will readily sacrifice their lives to a mystic ideal that has become an object of adoration. The principles of the revolution speedily inspire a wave of mystic enthusiasm analogous to those provoked by the various religious beliefs that had preceded it.
Even in the case of science, revolutions fail to produce their full effect until they penetrate the soul of the multitude. The crowd is a manifestation of the mystic personality where the conscious individuality of man vanishes in the unconscious personality of the crowd.
Here, the collective mind dominates the unconscious in what Le Bon calls ‘collective logic’, which is marked by infinite credulity, exaggerated sensibility, shortsightedness and a capacity to slavishly respond to affirmation, contagion, repetition and prestige. The revolutionary becomes a veritable nonperson, as personal characteristics vanish in the crowd. ‘The miser becomes generous, the skeptic a believer, the honest man a criminal, the coward a hero’.
The crowd is on automatic pilot with unconscious forces dominating their collective soul, doing and saying what they would not do or say under other circumstances. ‘A crowd is in reality inaccessible to reason; the only ideas capable of influencing it will always be sentiments evoked in the form of images’. This is true in any mass movement.
| The unpredictability and uncertainty of revolution|| |
The depressed fruit seller in Tunisia who set himself on fire and touched off protests that toppled former President Zine el Abidine ben Ali has inspired copycats in recent days in Egypt, Algeria and Mauritania (Hassan, 2011).
The protesters were as astonished as they were angry. Not long before, no one had imagined that the regime was vulnerable. Now the streets were filled with millions of people marching and shouting ‘Mubarak has to go’.
For those struggling to understand what is happening in Egypt, and what will happen, the Iranian revolution of 1978–1979 is an obvious reference point. It is also handy for lazy pundits. The Shah used violent repression? Then violent repression will fail in Egypt. The Iranian revolution ultimately produced an Islamist government? Then Egypt is going Islamist.
The 25 January 2011 white revolution triumphed against tyranny in Egypt by a combination of the youth’s vision and their technological expertise, good fortune and the armed forces’ tacit endorsement of their fundamental legitimate demands for democracy, a respect for human rights and social justice.
The majority of young people congregate at websites like Twitter and Facebook; hence, when the Egyptian Revolution took to the social networks, today’s youth were given a front row seat and watched it all unfold. That reason alone makes the Egyptian Revolution particularly special and meaningful and will certainly leave a much more indelible impression on the next generation of world citizens and leaders (Kelly, 2011).
Their good fortune lay primarily in the government’s slow response to a few of their demands, coupled with Hosni Mubarak’s much delayed arrogant speeches. This led to their realization that the whole regime had to be abolished (El-Shazly, 2011).
When all of us worried that the demonstrators would suffer from exhaustion, or that the protests could fizzle out, a number of tragic events outraged public opinion greatly, namely, what we now call the ‘battle of the camels’, which left many young bright promising protesters dead and the public breakdown in tears on a TV channel of Wael Ghoneim, a Google manager in Dubai and online activist. He had just been released after being arrested and kept blindfolded for 12 days shortly after the protests began. Hence, the crowds kept streaming to Tahrir Square over the following days, but they never lost their courtesy, grace and humour (El-Shazly, 2011).
For ordinary people, the moment of crisis was both thrilling and terrifying. Being in a revolution is such a confusing time. It is a time when you do not know, literally, what tomorrow will bring. If you plan to go to a demonstration, you do not know if you are going to be the only one out there, or one in a sea of millions. Whether the police will shoot you, or join you in the streets protesting against the regime.
There was overwhelming uncertainty. Coping with it was a constant struggle. To deal with this uncertainty, people were obsessive about talking politics; they talked politics with everybody.
Protests are a game of numbers. If huge crowds turn out, there is relative safety and a greater chance of success. If not, those present are more likely to fail and die. Predicting what other people will do is a matter of life and death. People are trying to sample outside their family and friend network to find out what everyone else is going to do.
Should I go to the protest? Should I join the strike? Millions of people asked these questions every day. Their decisions depended on what they thought everyone else would do, and their decision was liable to change right up until the very moment of acting upon it. In this tense atmosphere, rumours and emotions surged through the population like electric charges. Excitement could give way to terror in an instant. Despair to hope. And back again. You cannot read off people’s attitudes from a year before, a month before, even a day before, and predict what they are going to do on any given day under these circumstances.
Even what people wanted was liable to sudden, startling change. ‘What your end goal is depends on what you think is possible. If the fall of a dictatorial government suddenly seems achievable, then that may be the most important thing in your life today. Whereas yesterday it may have seemed pie-in-the-sky and you would go about your business and not even form an opinion about the topic because it seems so unviable’.
This is precisely what is happening in Egypt now. There are many possible outcomes and no way of predicting what will actually happen. People are constantly asking where the country is going to, and no one knows correctly.
| Collective mind|| |
The stability and malleability of the national psyche is as much in question as that of the individual. Le Bon sees revolutions occurring when there is a collective sickness of the collective mind. Because of internal stress and accelerating and unanticipated demands made on it by change, it is unable to cope successfully. Sentiments, traditions and prejudices constitute this national mind, always ripe to project its missteps to others (Fisher, 2012).
When elements within society not only clash but also take on the character of half-castes, Le Bon sees the situation ungovernable and vulnerable to open rebellion.
From the moment when the Revolution descended from the middle to the lower classes of society, it ceased to be a domination of the instinctive by the rational and became the effort of the instinctive to overpower the rational (Le Bon, 1913).
The social climate festers and boils and then become increasingly chaotic and phlegmatic but will go nowhere until it finds a leader.
Ideas, leaders, armies and crowds constitute the essential elements of a revolution. Rarely does the crowd understand the revolution. The crowd is unhinged from meaning. It shouts because others are shouting, it revolts because others are revolting, it crashes into police barriers because others are, having no idea why or what caused it to be unhinged (Fisher, 2012).
Once the crowd has prevailed, the governmental ideal ‘is always the very simple, something very like dictatorship. This is why, from the times of the Greeks to our own, dictatorships has always followed anarchy’ (Le Bon, 1913).
The predominant characteristics of the revolutionary spirit reflected in the collective personality are race, religion, traditional hatred, customary fears, vanity, ambitions and envy. Out of this grows the temperament of the mystic mentality that is moved by idols, fetishes, words and formulae. It flatters itself that it alone is in possession of the absolute truth and meaning (Fisher, 2012).
| Revolution and violence|| |
Some revolutions were violent, others were not. A nonviolent revolution is a revolution using mostly campaigns of civil resistance, including various forms of nonviolent protest, to bring about the departure of governments seen as entrenched and authoritarian. In some cases a campaign of civil resistance with a revolutionary purpose may be able to bring about the defeat of a dictatorial regime only if it obtains a degree of support from the armed forces, or at least their benevolent neutrality (Wikipedia, March 2011).
An effective campaign of civil resistance, and even the achievement of a nonviolent revolution, may be possible in a particular case despite the controlling government taking brutal measures against protesters; the commonly held belief that most revolutions that have happened in dictatorial regimes were bloody or violent uprisings is not borne out by historical analysis. Nonviolent revolutions in the 20th century became more successful and more common, especially in the 1980s as Cold War political alliances that supported status quo governance waned (Wikipedia, March 2011).
The beginnings of the nonviolence movement lie in the satyagraha philosophy of Mahatma Gandhi, who guided the people of India to independence from Britain. According to the socialist Fourth International, Karl Marx acknowledged a theoretical possibility of ‘peaceful’ revolutions, but the Fourth International articles also say ‘The development and preservation of good relations with the military forces is one of the absolute priorities of preparatory revolutionary work’ (Dan Jakopovich, 2008).
Violent revolutions are those started and continued forcibly and in which was used a lot of violence to extinguish the old resisting regime – for example French, Russian, Romanian, Libian and Syrian revolutions.
| Mental health at times of revolution|| |
The WHO defines mental health as ‘a state of well being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community’.
The WPA Regional Meeting was held in Cairo, 26–28 January 2011. This scientific meeting coincided with the Egyptian Revolution for change. The guests were able to view the Tahrir Square from their Hotel in the Center of Cairo (WPA, 2011).
A psychiatrist is not a politician; however, he/she should be aware of the political system of the country. This political system can change many issues in the norms of the people and in the healthcare system used by them. An environment that protects and respects basic human, political, socioeconomic and cultural rights is also fundamental to mental health promotion. It is usually easier to say that dictators are crazy but it is more difficult to know the truth about their health (Elsayed, 2011).
Countries torn by dictatorship face higher levels of distress, and yet they are the most in need of productive, healthy citizens. Treating or reducing the psychological impacts of dictatorship and promoting resilience in otherwise physically healthy individuals are critical to helping rebuild these countries (Elsayed, 2011).
Across Egypt, when the police forces vanished, the youngsters were stationed at street intersections. Never was traffic as regulated as when they were in charge, and drivers cooperated beautifully. No driver tried to ‘burn’ a red traffic light, something unheard of for many years.
At the same time, when garbage collectors also disappeared, housewives, youngsters in their 20s and teenagers swept the streets, gathered the garbage in sacks and stacked them at street corners and also painted tramway stations and walls that had been damaged by anti-Mubarak graffiti (El-Shazly, 2011).
It seems like every individual has a story to tell – some faced death, others saw loved ones die, whereas others have been greatly affected by the violence that followed the end of the revolution. Although every individual deals with this emotional impact in their own way, experts say that there is little doubt that people will continue to deal with these traumatic events for some time.
‘I have been dealing with a lot of patients who are dealing with postrevolutionary stress’, says Anne Justus, a clinical psychologist and an assistant professor at the American University in Cairo. She notes that, even if a person watched the event only on TV, there is always a chance he or she could be traumatized or experience psychological repercussions.
Psychologist and neuroscientist Dalia Danish explains that there are three criteria that classify an event as traumatic for an individual. The first is the person’s proximity to the event. The second is assessing how severe it is. Severe events usually involve violence, shootings, wars or life-threatening disasters.
The final determinant depends on whether or not there is a social network of support to help people process these violent events and put them in context. This social support network usually consists of family, friends and even the media, although in terms of the revolution Danish believes the media has not been helpful. ‘Obviously that is non-existent because if you look at the media, they are scaring everyone and are heating up the issue instead of calming people down’ (El Tahawy, 2011).
| Has the father–children relationship come to an end?|| |
In some countries including Egypt people used to considering the leader as the father of the nation (family). However, what kinds of fathers are these leaders of their countries? Sometimes, of course, they are benign, beloved, or both. At other times they are tough and exacting, but fair. Some are tyrannical, iron-fisted. Then there are the cruel and even murderous.
It is clear that Hosni Mubarak was leaning towards the extreme end of the dictator/thug end of the spectrum. We have watched his henchmen mow down innocent protestors in the streets. We have seen his inability to give up his position at the helm of his nation, even when the nation was screaming for his removal and young people were willing to die to make him go (Fein, 2011).
In short, Hosni Mubarak was an abuser. And perhaps it is no accident that the ‘children’ of the abuser fought back, were willing to die to get him out of their lives. It is the father’s role to protect the family, care for its well-being, keep it safe. When the supposedly protective father is abusive, the children endure, often suffer in silence, may be inwardly filled with rage, or may give up.
We have seen in Egypt, and in Tunisia, that when young children dare to band together, they can fight back. They have their own ‘secret’ language on Facebook and Twitter. It does not matter if the older children do not understand them or their means of communication. It does not matter if the older children are afraid; the younger ones are not. They have each other. No longer isolated or alone, helping each other, caring for each other like siblings, they can ‘out’ the abusive father and, once emboldened, will stop at nothing to put an end to the abuse and remove the abuser (Fein, 2011).
The abuser refused to be humiliated, to give up his power, to yield to the young children of Egypt. He used threats, force and violence. He manipulated some of the older children (the police) to carry out his will. He was willing to inflict death on the young rather than cede his position at the head of the national family. He insisted he keep Egypt from chaos, that he maintain order. He hung on beyond the point when everyone thought he would go. For a moment there, near the end, it looked horrible – as though the abusive father would stop at nothing to retain control. And then, in a moment no one will ever forget, an announcement was made: the tyrant was stepping down, leaving the palace, handing over power. The abused children had won!
When Mubarak surrendered, the young people of Egypt thought that the abuser had gone and that the abuse had come to an end and that there would be no dictator after him in Egypt. Is it true, or is it just a dream?.
| Psychological challenges in the transitional period|| |
Danish says one of the most important factors affecting nearly everyone right now is uncertainty – they are living in an uncertain future that requires them to make important political decisions.
‘Not only can’t you predict (the outcome), you’re close to the events. The events are severe, but you also need to make decisions that will put your country in a different position’, she says. ‘Are we going to be (…) an Islamic state or a secular state? Everyone is confused’ (El Tahawy, 2011).
Any sense of security was shattered during the first few days of the revolution. On the night of 28 January, the police withdrew from the country, leaving the streets unprotected while allegedly opening prison doors to allow some of the country’s most dangerous criminals to escape. Gunshots rang out through almost every neighbourhood of every city in the country. In some areas, looting and burning of shops became an almost daily occurrence.
‘When the police withdrew and the thugs were roaming (the streets) of Egypt, we were all at least in a war-like situation and your life was totally jeopardized’, says Danish. ‘People were defenceless, and it was bound to affect everyone’.
With rumours of murders and thefts spreading throughout the country, many people were paralysed with fear. Justus explains that the very fact that no one was actually sure of what was true and what was a lie was even more frightening. ‘It’s very stressful when things are not transparent, when you have difficulty finding out if things are true or not’, Justus says. ‘Fear gives more strength to the rumour’ (El Tahawy, 2011).
Coping with loss
Many protestors were killed or lost, and their families are suffering considerably and asking for revenge. Families are focussing on investigating their children’s murders, and they want to know more about the people who directly killed them and how they were released from prison.
People lost confidence in authorities as they saw officers and soldiers who were accused of killing their relatives released from prison as no proof could be collected to justify their trial, which could open the door for personal revenge.
When people are grieving for someone, there are stages that they go through. One of the stages is anger, the second is denial and the last is sadness. After the stage of sadness, they are supposed to enter a stage of either recovery or depression according to their surrounding environment.
It is normal to experience stress, anxiety and other emotional reactions to the traumatic events of the revolution. According to specialists, being directly involved in the violence is a much more intense experience. Justus says that people who were in or close to Tahrir Square have significantly higher chances of developing full-fledged post-traumatic stress disorder (PTSD).
Danish explains that, in simple terms, PTSD is characterized by recurring thoughts or flashbacks related to a traumatic event. Typically, people with PTSD have nightmares related to the events. Many experience terror attacks, whereas others will typically try to avoid anything related to the event. Other symptoms include an increase in aggressive behaviour; the person might also withdraw from daily life (El Tahawy, 2011).
‘You are most likely to get post-traumatic stress if your life is jeopardized, whether you participated in it (the event) or witnessed it, or heard about it, it doesn’t matter. You don’t have to be actually there’, says Danish.
The impact of trauma can be far reaching. Danish is concerned that beyond simply living in fear many people are so caught up with what is happening in the country that they are ignoring their mental health. ‘I feel most people are taking decisions based on fear rather than based on thought’, she says. ‘Obviously you cannot have political awareness or rebuild Egypt if (you are) mentally not capable of making rational decisions’.
Given the violent and stressful events of the revolution and the ongoing uncertainty of the future, Danish feels that it is normal for people to experience mental health problems right now, noting, ‘I think psychological help is very important’.
People have to be aware of the problems and acknowledge their fears in order to help themselves. In terms of coping with daily stress, it is recommended to practise relaxation techniques such as breathing exercises. Other advices are: ‘Don’t risk your life, make sure you are in secure places, try to think rationally’. ‘If you set yourself goals for the day, you feel that you have some sense of control over your life. At that moment we don’t feel that’ (El Tahawy, 2011).
| Changes in the Egyptian mental condition|| |
For many decades Egyptians had a negative self-image: helplessness, hopelessness, loss of control on the future, inability to change governmental attitudes towards people, sense of rejection, poverty, persecution, etc.
This negative self-image underwent a change early with the 25th January Revolution, when Egyptians believed that they would be able to change the dictatorial regime within 18 days, pushing Mubarak out and putting him in jail, exerting pressure on the new authorities to perform how the people wanted them to, giving up the chronic fear they had, demanding loudly for their rights, being ready to go to Tahrir and other squares all over the country to confirm their freedom, fighting against anyone who was trying to bring them back to a dictatorial system, feeling proud about being an Egyptian patriot and so on (Elmahdy, 2011).
It is only natural that a sense of national euphoria should follow a popular uprising that has toppled a tyrant who had been in power for 30 years. However, what happens next to the country’s collective psyche is less clear.
The potential for great change exists. Many Egyptians suggest that there still exists tremendous pride and optimism, even if it is tempered with caution (Afify, 2012).
Shawky al-Akabawy, a prominent Egyptian psychiatrist, says that it would take years and a lot of work to turn the new-found positivity and national pride among Egyptians from a temporary high into a sustainable change.
‘Sudden wars don’t allow people to take their time to change. Principles will cause change, not slogans’, said al-Akabawy, urging Egyptians to stick to the principles of the revolution to dispel the negativities that decades of oppression have instilled in the Egyptian character.
Basma Abdel Aziz, a psychologist at the Egyptian Mental Health Secretariat and El Nadeem Center for Rehabilitation of Victims of Violence, describes the Egyptian personality before the revolution as passive aggressive and defeatist. Egyptians used to channel the anger resulting from their oppression in various wrong directions, she says, such as slacking at work or destroying public property, while simultaneously accepting the status quo.
Saneya Abdel Atty, a teacher, exemplifies that change. She says that she used to isolate herself in her house when she faced a problem. Now, whenever she has something to say, she heads to Tahrir Square.
Like many Egyptians, Abdel Atty’s relief is mixed with apprehension. ‘I am now living in a state of imbalance. I’m wondering whether the blood of the martyrs will pay off or go to waste?’
The triumph of the people’s will, which was crowned by Mubarak’s resignation in response to their demands, gave the Egyptian people a feeling of dignity and empowerment that many say has changed them drastically.
Al-Akabawy says that the revolution filled the people with pride, dignity and confidence after they succeeded in changing what they thought was unchangeable.
Many Egyptians had a gloomy outlook on the future before the revolution, but now a sense of hope has been ignited that Egypt and its people are headed for a better future.
‘After we were sure that there was no hope, the youth who started the revolution opened the door, and the whole population who had been suffering from corruption followed’, says Akabawy.
The removal of the fear barrier took a huge burden off the shoulders of Egyptians. Abdel Aziz says that Egyptians were finally able to speak out against their rulers, who they regarded as father figures before, making them off limits for criticism. The unrealistic expectation that some Egyptians had regarding the results of the revolution might lead to disappointment, which would halt the change in their personalities.
‘For the first time in 30 years, Egyptians are feeling that the world is looking at them with admiration and respect, which has restored the sense of national dignity that had been lost’, explains al-Akabawy.
Amira Khallaf, an English teacher, says that she is motivated by the feeling that Egypt is her country and that it is her responsibility to develop it.
Many who were depressed by the thought that Egyptians are negative and unwilling to fight for change got a huge boost when they saw millions of people participating in the demonstrations that led to Mubarak’s fall (Afify, 2012).
Akabawy says that the extent to which the people’s hopes will be materialized during the next phase will determine whether this shift in Egyptian morale will last or fade away, leaving them in a state of despair similar to that which was common before the revolution.
Abdel Aziz believes that a radical transformation in the educational system, from teaching memorization and passivity to encouraging creative thinking and initiative, is crucial to sustaining a long-lasting change in the Egyptian personality (Afify, 2012).
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