Erosion of mattering and agency among displaced Gazans under ongoing genocide: A qualitative study

Background: Prolonged exposure to genocide and structural violence profoundly reshapes how individuals perceive their value, agency, and social significance. While research on trauma in Gaza has documented high levels of psychological distress, less is known about how genocide reorganizes everyday relational life, progressively narrowing recognition, participation, and voice. Objective: This study explores how displaced Gazan women and men experience erosion of mattering and agency under conditions of ongoing genocide, and how they negotiate meaning and survival within fractured social environments. Methods: Thirty displaced adults (17 women, 13 men) residing in internally displaced persons’ camps in Rafah participated in semi-structured interviews conducted in Arabic. Data were analyzed using reflexive thematic analysis to identify patterns in lived experiences related to self-worth, agency, relational dynamics, and meaningmaking. Results: Four interrelated domains emerged. First, participants described fragmented social relations marked by mistrust, emotional withdrawal, and the re-prioritization of survival over connection. Second, genocide intensified experiences of marginalization and relational non-recognition, eroding participants’ sense of personal significance within families and communities. Third, compulsory living conditions and exclusion from decisionmaking processes undermined agency and reinforced feelings of imposed powerlessness. Fourth, despite pervasive narrowing of external validation, participants actively engaged in adaptive meaning-making, drawing on familial roles, spirituality, and moral responsibility to sustain a sense of worth. Conclusions: The findings suggest that genocide restructures psychological experience not only through trauma exposure but through systematic destabilization of recognition across socio-ecological levels. Mental health responses in Gaza must therefore move beyond symptom-focused frameworks to address relational, structural, and existential dimensions of harm, centering recognition, dignity, and agency as foundational components of psychosocial intervention.