War Trauma | The Psychological Consequences of the Ukrainian-Russian war
In the last few years, the world has seen a pandemic, racism, massive fires, and now a dreadful war unfold. The trauma we faced in such a short amount of time can become overbearing. These past couple of months have been a struggle for so many people, and things are becoming even more uncertain by the day.
The thing about war is that its effects continue long after the actual battle is over. War leaves behind famine and economic collapse, but the most important thing is the devastating psychological effects. I have several friends and colleagues in both Ukraine and Russia, and I can see firsthand what this whole situation has done to them. This is a very delicate subject, and to be honest, I’m still debating whether it’s ok to do a video on this. Partly because I feel that since I haven’t experienced war myself, how can I talk about it?
But this is such a huge thing happening in the world right now that it's impossible not to address it or be moved by it. And so we must. I did my research and found some interesting studies on this topic so in post we will explore three important questions about war trauma.
The first one is WHO are the people that can be affected by the war, and it’s important to distinguish between those directly affected and those who are not directly affected but still feel the effects of it. The second question is HOW can war affect people. Here we’ll explore several categories of people and how they are affected. And lastly, we’ll talk about WHAT each category of people can do to cope with war anxiety. Here, I’ll talk about coping mechanisms that we can follow to alleviate negative feelings.
If there’s one thing I want you to remember from this blog post then this is it: That whenever someone is psychologically traumatized, there’s a part of that person which dies, like the tissue of your skin when cut. And the thing which intensifies the psychological trauma is that you cannot believe that something like that can actually happen to you. Especially when someone is inflicting trauma on you. And that’s in the nature of trauma, that you just cannot believe that something like that could happen to you.
Many of you know Jordan Peterson, he’s a clinical psychologist who has his facts right, so he says that what traumatizes people is malevolence, not tragedy. People can overcome tragedy but malevolence is this which traumatizes them deeply.
So during war, this can have two levels. The first one is the malevolence of other people doing horrible things to you. This is when you get scarred for life by the actions of others. The second level is when your own malevolence traumatizes you deeply. It’s this power that is hidden within you that makes you do horrible things during war and then you try to make sense of it but you can’t! And then you’re done. Scarred for life by your own actions.
Ok so now let’s get started with…
WHO are the people that can be affected by war?
War can affect you even if you’re in the comfort of your home, watching it from a cosy couch.. All of us on this globe have been affected by the events in our world, whether we realize it or not - depression and anxiety can strike hard when you least expect it.
But the ones that we must focus on first are the Ukrainians who one way or another, are involved in the war. The people that are the most at risk (both physically and psychologically) are the ones that live in warzones, especially in towns that are being bombed. The uncertainty they live in and the constant state of flight or fight can take a toll on anyone. Many of the repercussions will be more evident in the future when we'll see how these traumatic events will affect people in the long run. The amount of grief experienced by people that have witnessed death will be something that will require a lot of attention in the aftermath of war.
Also, people involved in combat are significantly affected by war - their trauma often manifests differently than other victims. They are most prone to develop severe PTSD symptoms and suffer from long-lasting mental health issues.
Beside those on the field, there are other groups that are directly involved - family members of the people who lost their lives in combat and received the news, spouses, children, employees of people serving, and women and children that might have their safety compromised.
Let’s move now to a group of people that we talk about less, and these are the Russians, or let’s put it better, let’s say citizens of the aggressor's side, that don't agree with what is happening and have to suffer the repercussions of their leader's decision. The shame and guilt they deal with - either individually or collectively - can carry on for a long time. The restrictions placed upon them from the whole world, the stigma they carry and will have to live with, and the aggression they receive are all things that will have a considerable impact. Not to mention how little help they get compared to other vulnerable groups.
Not every place is secure. In times of war, some of us are safe at home while others are in danger.
It is not only those directly involved or living in areas that are conscious of a crisis or suffer from anxiety about war. Some people who are not directly involved in war still might feel its effects— that includes the rest of us - bombarded by too much information about the war, driven by different political agendas, and not knowing what comes next.
This takes me to my second question:
HOW can war affect people?
As I mentioned before, war affects everyone. But let’s get specific:
Those directly involved
War trauma
If your life is being affected by war trauma, you need to learn how it can change the way you live. That's because it fundamentally changes how you feel, think about, or relate to the people around you.
War trauma is a term used to describe the mental responses to the traumas of war. Ordinarily, when people are exposed to a traumatic event, they develop stress-related disorders. Examples of this are post-traumatic stress disorder, anxiety disorders, depression, suicide, and drug/alcohol abuse.
The thing is that if you have been part of war, you’ll have immediate effects and that’s because the huge stressors of war, affects your biology.
When you experience that much stress, your stress hormones are circulating continuously. Norepinephrine, epinephrine and cortisol are circulating all the time in your body during this stressful period and they put you in a constant alarm, they suppress your appetite and they make you be more hyper vigilant, more jumpy, they disrupt your sleep and all this comes with great consequences in the long run.
It can be very difficult to identify normal versus pathological reactions to war stress, but some of the severe results may include:
Withdrawal from others. Where people affected by war are avoiding people they like and activities they would usually enjoy. This can lead to social isolation, where people may even want to avoid contact with family and close friends and just be by themselves most of the time.
Another effect might be stuttering where people may start facing problems with the flow of their speech. And their speech is disrupted by involuntary repetitions and prolongations of sounds, syllables, words, or they start speaking with long silent pauses.
Confusion, nausea and vomiting are some other symptoms people should be aware of as war violence effects.
And lastly people become overly suspicious over anything and anyone and they lose trust. And for very good reasons!
So now it’s time to talk about…
War trauma in veterans
Veterans are a particularly vulnerable group in that the experience of war leaves long-lasting traces in them - they become easily triggered by everything. At the same time, we have seen in studies that some veterans even miss the familiarity of combat and the unique bonding they experienced there.
Their trauma is often not manifested through victimization but as a hunger for more destruction - they often cope with internal dichotomies, struggling to reconcile the trauma with the longing to go back to war. They can feel torn between two worlds (war and home) and find it hard to mend that bridge. Other times, they may feel like they didn't fulfill their role as war heroes (which is often a cultural expectation).
The thing with combat veterans is that they:
Experience the highest rate of PTSD by 41.8% compared to other traumatic events [9],
are seven times more likely to meet criteria for PTSD compared to other traumas [9],
are 4.5 times more likely to have delayed onset of PTSD [9],
and have higher rates of substance abuse than others with non-combat PTSD [1] [2] [3].
I’ll put below the sources I used for these numbers from several studies so you can have a deeper look if you like.
Next we’ll speak about…
War trauma in refugees
It’s impossible to talk about the war without talking about the refugees who had to flee their countries to survive. Running away from possible death and losing their home has become their new normal, and this is if they are lucky. Many refugees have to also deal with torture, with threats for their lives and their family members lives, rape, many refugees are forced to watch other people being tortured, and usually it’s their family memebers, others are kidnapped, others are imprissoned, and even the basics like the lack of shelter or the lack of food or water are enough to traumatize someone deeply..
It’s no surprise that PTSD in refugees goes up to 86%.
And then, if you’re in that situation, what do you do? You cannot make sense of the world anymore. The scar is so deep, but then 2 things jump out as a solution to that.
The first one is to develop a very articulated philosophy of evil, cause it’s all the malevolence that you encountered that has wounded you the most, and you can’t go on in life if you don’t make sense of it. Cause you keep asking yourself “why did this thing happen to me? how can someone do something like this? And these are fair questions, that will haunt you for the rest of your life if you don’t have a logical answer. And you don't want to be a victim again, you don't want to have the same experience twice. So you need a philosophy of evil to make sense of what has happened.
And the second thing is to learn strategies on how to protect yourself next time this happens. To have some tools and resources you can use so you’re prepared! But we’ll talk about this in a bit.
So these are the main groups that are directly affected by war trauma, which brings us to..
Those indirectly involved
The rest of us. The ones who live, work, or have a connection with someone in the field of war, those people may also experience anxiety about war. People who have a fear of violence may also have a hard time coping with the situation. In other words, the closer and more aware you are to the tragedy , the more it can affect you. For example, if you live in a country close to the war, chances are you are more involved in its course.
Then the other group we’ll talk about is those who feel shame because they do not agree with their government’s aggressive actions
This is a tough one to address. In the example of the Ukraine- Russia war, there are plenty of Russians who are suffering for their leader’s actions - especially those who disagree with the war. Not to mention that the whole world is ostracising them. This hatred for Russian people will continue to unfold even after a “resolution.” of the situation.
Nobody should ever have to be blamed or punished for the place that they were born in or for the passport they hold. Unless you have some affiliation with this guy over here… (Hitler’s picture)
Russians may experience feelings of anger and shame towards their culture/nation or leader, which can, in turn, encourage collective action through feelings of sympathy towards the affected groups. This has manifested in speaking out against the decision to start a war and participating in protests.
What can those directly affected do to cope with war anxiety?
For refugees and veterans, the priority is staying alive, fighting, fleeing, and finding shelter. Coping usually comes in the aftermath of war; survival comes first.
I think that focusing on your mental health can sometimes be such a luxury. Especially when something immediate needs more attention and action. Because we often talk about coping when our lives are not in danger.
However, there are things that victims often do to cope without realising it, and I think it’s important to look at them more carefully.
Coping strategies for veterans
Veterans experience war differently - it fundamentally changes how they view life forever. That change is almost impossible to explain, mainly because they've had to normalise the atrocities they've seen and dealt with in order to survive. And often the atrocities they themselves inflicted to others.
Accepting vulnerability
Because of what they’ve seen, veterans understand their infallibility more then most people. Their world is more uncertain and paved with imminent death.
Many veterans who end up accepting their vulnerability and the uncertainties of life, by talking about them straightforwardly, expressing them through art and writing, and attaching meaning to them, end up coping better with the effects of war.
Healing can only be done on the background of acceptance - of yourself and of reality.
Art therapy
Art-focused approaches can help veterans validate their experience, foster a sense of community and encourage self-empathy.
Some of them include:
Writing memoirs or autobiographies about their experience
Improvisation and performance
Drawing and reciting poetry
Social support
Veteran centers can be beneficial for veterans after their experiences of war.
Some studies about women veterans show that social support help them feel that they’re a part of society. That’s because they often tend to isolate themselves and engage in destructive behaviors - for example, excessive spending and drug use.
The same applies to men. Support groups can offer them a sense of belonging since other veterans may be the only people that truly understand what they’ve been going through.
These shared experiences of compassion contribute to their sense of well-being, and helps see themselves as simply “humans among humans”.
Coping strategies for refugees
If we want to understand more about how refugees can cope with what they're dealing with, we can look at interviews of Yezidi women refugees for a deeper insight.
Yezidis were brutally attacked by the Islamic State because of their religion. In this context, Yezidi women suffered every abuse imaginable in the hands of ISIS - forced conversion to Islam, being sold, enslaved and raped. Because of this, they had to flee their country and find shelter. They became refugees. Here are a couple of ways in which they’ve faced these challenges:
Hope about the future
The ability to imagine a life outside of war and new horizons is essential to healing. But it's hard to do that when you have no home because there is nowhere to return. Interviews with these women show that retelling the traumatic event - even obsessively - is more beneficial than bad. That’s because integrating trauma into your life allows you to start all over. That hope for the future, even if blurred, is essential to keep going.
Practising gratitude
Practising gratitude is extremely helpful for refugees - even as much as being grateful for surviving or having a temporary roof over your head - because it fosters hope. And that can make them look forward to what they still have (like the family that is left). However, this gratitude can often be compensated with survival guilt. Yezidi women continued to cook and clean while living in their tents, even if they lived in constant dread. This made them able to make plans for the future, even if it was an uncertain one.
Finding meaning in unpleasant circumstances
It seems that giving meaning to the experience of war can foster a sense of pride for surviving and fighting. And this can be empowering. Giving meaning also means being able to find explanations in the aftermath of what happened. Yazidi women found a sense of pride from their resistance in the face of enemies and in having simply survived countless genocides.
Mourning rituals
Yezidi women greatly benefited from regularly engaging in mourning rituals. These can be prayers, rituals specific to the culture, or worship. Any kind of ritual which includes a higher power to which you are able to express your grief and sorrow. Believing in something above yourself (it doesn’t necessary have to be God, but a higher power) can be very healing, because it is yet another thing that can help foster hope. Having a belief system can help a lot with traumatic experiences.
Expressing solidarity for others in their group
Expressing compassion for those going through the same experience can be liberating. These women felt the most relief after talking with other women who have experienced the same pain. See, our deepest need, when we are in pain, is compassion; this is what helps us heal. So when you can show compassion to someone who have experienced the same pain as you, it help you develop self-compassion too. It’s like seeing your higher self as a figure on which you can rely on. And the pathway to do that is by showing compassion to others who have felt the same. I’m sure we can all learn from this.
I remember seeing this quote in a book about Mindfulness and Psychotherapy:
"Connection in the face of death and unbearable suffering can lead to the deepest healing insight and liberation. The capacity to suffer with another person, or the "shared heart of compassion," is at the core of the relational practices of parenting, marriage, friendship, ministry, and medicine."
I think that is so unbelievably true. As trivial as it may sound, expressing solidarity helps us find meaning in our struggles - even in the most grotesque of them. The ability to share compassion in a horrible life situation is essential for our very survival.
WHAT can we do to cope with war anxiety?
What can the rest of us do to fight against anxiety? By that I mean those of us who are not affected by war directly, but feel the anxiety of it. If you feel overwhelmed by stressful emotions, the following coping strategies may be helpful for you or your loved ones:
Don't watch the news all day.
Close the TV or your computer if you think you're overwatching the news. It's good to be aware of the leading affairs in the world, but you must make sure news watching doesn't become compulsive.
Engage in the same day-to-day activities as before.
As simplistic as it might sound, the best thing that most of us can do is stick to our known routine and continue with our lives. This is not to make you numb in what’s happening but it’s to protect you if you’re feeling an overwhelming stress from things you cannot control. The habits we develop in our day-to-day lives give us the stability we need, which keeps us resilient in the face of disaster.
Getting enough sleep, having a balanced nutricion might sound basic but these are the building blocks that help us keep a regular schedule.
In a time of collective turmoil, we must turn to the mundane. To feel our feet on the ground again, by keeping up with our routine and doing the same things that we used to do before - make breakfast, go about our workday, talk to a colleague or a friend, read a book or watch a movie, take your dog for a walk or cuddle with your cats.
Use social media cautiously.
Apart from actual war, there is also an informational war going on in the world. People react impulsively to every news they stumble upon - and you can't blame them. We need to look out for misinformation and disinformation - and we need to learn to tell the difference. With all the fake-news and clickbait tactics the majority of the websites employ, fact-checking is critical. Especially in times like this as the fear of uncertainty is what makes propaganda spread. And these days, propaganda comes from all sides to be honest. Here's what you can do:
Connect with other people
Connecting and talking to other people is the epitome of self-care - and the benefits are tremendous. Self-care shouldn't be an isolating experience but one in which people come together and heal. This can further help foster a sense of community and bring a sense of normality and humanity to an otherwise unnatural and inhumane situation.
You can do this by:
Talking and listening to friends, family members, or professionals
Hearing about other's experience
Engage in acts of kindness that promote well-being - like providing social support and a safe place for those involved in combat and refugees, and volunteering in organisations.
Engage in activities with loved ones
Practice mindfulness meditation
Stay in the present moment by practicing mindfulness meditation. Mindfulness has been consistently shown to be effective in reducing anxiety and depression.
You can practice mindfulness by spending time outside and noticing things around - non-judgementally and non-evaluating— by being aware of the present experience and accepting it as is.
What can everyone do?
Seek therapy
Symptoms of PTSD can be expected for people directly involved in combat and those who are indirectly affected. If the stress becomes too much for you to handle, make sure to contact a licensed professional that can help you manage these complicated emotions.
But what does therapy look like?
When you do therapy, you learn new ways to see things and discover behaviors that can reduce your negative emotions. The therapist usually encourages you to verbalize your anxiety inducing thoughts and work with you to find a resolution by changing how you approach/see your issue.
It’s important to mention that post-war therapy is usually a longer process compared to other situations. Additionally, helplines are be available for refugees or anyone affected by war. Check to see if you have one in your area.
Final words
War leaves long-lasting scars in people who experience it - so keep in mind the analogy we discussed at the beginning with a scar on your body and a scar on your soul.
Therapies focused on trauma usually reduce PTSD and depressive symptoms - the good news is that they've proven to be extremely helpful.
However, it's important to emphasize the role of context in trauma. Other factors and conditions can contribute to mental health issues, especially when it comes to refugees that have had to flee their countries. For example, unsafe living situations, few resources, and loss of support. Research shows that these daily stressors may have a more prominent role in developing (and worsening) trauma than we might have previously thought.
So what we can do after the fact matters as well as what we do during the fact.
Every tragedy brings out both the best and the worst in people. We’re shown examples of bravery, kindness, love for others, but also the most despicable behaviors. The question is: how can we make sense of this all? The information out there has mostly dealt with the harmful effects of traumatic events but this video is a message to focus on resilience or even post-traumatic growth. Stories of post-traumatic growth are somewhat anecdotal - and we hear them rarely.
I think it's essential to focus on our strengths and resources, even amidst unfortunate events. With this in mind, let’s listen to those that are affected by war, so that we can understand how to help them - and ourselves - in the process.
Till next time, stay safe and show compassion to those who are traumatised. At the end of the day, that’s all of us.