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Managing collective war trauma in Ukraine: The importance of keeping in touch

Like any Ukrainian, I spend a lot of time thinking about my mental health and that of our whole nation in these times of war. As rockets keep falling on our homes and families are sent to the frontlines, we must find balance in ourselves to withstand the current events. Which mental health solutions can help us cope?


In this blog, I have spoken to Illia Poludonnyi — a psychotherapist with 10 years of experience in Gestalt therapy (i.e. a person-centered form of psychotherapy that is focused on a person’s present life and challenges rather than delving into past experiences and taking responsibility rather than placing blame). I have supplemented it with the illustrations of Ukrainian artists, reflecting on how they are feeling.


The interview was taken on April 25th, 2022.


 

In 2015, with his co-founder, Illia created the first online platform for psychotherapy sessions in the post-Soviet segment of the Internet, Treatfield, and his clients come from over 50 countries today.

Illia shares: “All of the psychotherapists we work with are our partners, not employees. Therefore, our pool is quite small — about 60 therapists. We feel very confident about who we are working with and, in all the years of our existence, we only had two negative reviews.”


In the first days of the war, Illia created a chat called “How are you?”, managed by the psychotherapists on her platform. This is the story of that chat.


Note: as I chatted with Illia, air raid sirens went off where he was, and he moved into safer spaces, never interrupting our interview. I had left mentions throughout the text of when this happened during our chat.


“Sadness”. Anastasiia Khadzhynova, 2022

What did you do in the first days of the war?


For the first 4 days, I was busy evacuating my family. We took a car and drove to the west of Ukraine. My therapeutic specialization is crisis management and trauma, so it was a fascinating experience to understand the dynamics of the situation while going through it myself.


As my hands were still busy with the wheel, I started thinking about what I could do to help. I knew the protocol for working with a traumatic shock. It is a dissociating experience; the person gets out of touch with their body, the world outside, society, family, and friends. People often lose all of their communicative skills and report feeling like they are floating around, totally detached from everything else. As this was happening to me, it had to be happening to others; war is a collective traumatic experience.


“Ten million Ukrainians had to leave their homes, including me. An autobiographical piece”. Hanna Rybak, 2022

*The air raid siren interrupts the interview, and Illia goes to his corridor, as there are no windows that could explode and hurt him.*


See, those go off every couple of minutes; how is one supposed to feel safe? In this first phase of trauma, people are not ready to engage in therapy. When a rocket hits a house next to you, it is purely about survival. In this initial state of affect, it is essential to stabilize the person, bring them back in touch with reality, and just let them talk about their experience.


To respond to this immediate need, I created a chat called “How are you?”, managed by the psychotherapists from our pool. In Ukraine, we say that “How are you?” became a form of saying, “I care about you.”


“Do you feel it? Daily emotions: Melancholy”. Oksana Kurmaz, 2022

So how did this chat work exactly? You mentioned that psychotherapists administered it. Could they provide care to others while themselves going through the crisis?


The chat was a place of collective support, straightforward, and reflected the needs of the situation. People were encouraged not to give advice but to share their current state: to express empathy towards each other, to provide care and support. We had a core team of eight therapists who had experience with trauma and crisis management, moderating the chat.


Additionally, the therapists had a curator looking after their needs and checking for the signs of burnout and a supervisor providing support and releasing the therapists’ tensions. Everyone had to be in a green or yellow zone (i.e. In Ukraine, green and yellow zones are the territories with the least military action), so in the west of Ukraine, or abroad, because if a therapist is also afraid of a rocket flying into his house, they cannot exude a sense of calm. It was like a pyramid of professionals that could withstand the tension. Chat participants in the red zones (i.e. zones in an active phase of the war) could also refer to a chatbot for contacting a therapist one-on-one.


Again, the format was only “keep in touch”, not working with trauma. I was involved in this project, too, and I kept in touch with many people: a woman from Kharkiv leaving town under the shelling, someone living under occupation in the Chernihiv region. People told me that it gave them the power to feel like they were not alone. Someone is thinking about me, remembering me so I can go on.


“Do you feel it? Daily emotions: Anger”. Oksana Kurmaz, 2022

You mentioned that you do not think that therapy is an effective solution at this time. Why so?


Many of our Western colleagues were trying to help, but often people were naive to the severity of the situation. When you are on a call with a therapist, he recommends a breathing technique. Still, this person is sitting in a bathtub because their bathroom has no windows that could explode and hurt them, or they have been in a bomb shelter for days; it is a solution that is not matching their reality. It is a different context, and no in-depth work can be done within it.


*Air raid siren is over.*


Do these chat and chatbot exist now?


I am about to delete the “How are you?” chat and chatbot because I think they have served their purpose, and now it is time for different solutions, otherwise, the therapists will burn out. At its peak, the chat had four thousand participants and about a thousand messages per hour. After one month, people started to leave the chat. People started to understand where is the active zone, where is relative safety, and which direction their life should take. To go forward, we would need a different structure. For a few months, it was ok for people to volunteer as they received social gratitude, good feedback, and a feeling of doing meaningful work — a sufficient exchange but not sustainable long-term.


What do you think will happen after the war, and which mental health solutions will be relevant then?


I think after the war, once people recover from the shock and start processing their trauma, is when they will seek therapy. We will witness a massive growth in demand for Ukrainian-speaking specialists. People will also have financial difficulties, so creating some platforms will be very relevant, offering free mental health support.


I think it is essential to monitor the work/life balance and mental health of specialists involved in crisis management and ensure that we put as much work into building sustainable management systems and training as we would in more peaceful times.


“Painting helps me to preserve the lively, childish part of me. I am afraid that if I lose it, I will not be able to cope.” Masha Marykutsa, 2022
 

Since this interview was taken, the situation in Ukraine has escalated again. As the Ukrainian army is de-occupying more and more territories in the East, horrible crimes against humanity committed by the Russian army are coming to light. In the city of Izyum alone, over 400 bodies with signs of rape and torture were found. Hopefully, justice will be served to those who are guilty.


Like Ilya, I believe that checking in on each other and providing care and support will be a significant grounding factor, helping a lot of us to be able to engage in the day-to-day. Give a call to your Ukrainian friend, give a call to a Ukrainian mental health worker you know, and do not talk; just listen.


This is the best way to support us now.


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