It is very sad to see how the once beautiful and peaceful Eastern Ukraine has been plunged into the horrors of civil war. Lives have been lost, families separated, communities destroyed. Some people are struggling for basic survival under fire, while other flee. Many of those in safety cannot sleep at night because of worrying about their family members and friends. I looked at the website of the Doneck Psychological Association, which features pictures of Freud, Fromm and Jung, and thinking “These folks cannot help you now!”
The recent developments in Eastern Ukraine have led to multiple civilian casualties, mass displacement and collective trauma. The unrest in Eastern Ukraine started in March 2014 when some regions, including Doneck, Lugansk, Slavyansk, Kharkov, Odessa and others, declared independence from Ukraine and engaged in heavy fighting with pro-governmental forces. The civilians found themselves hostages of the armed conflict and complicated international political struggle. The UN reports that hundreds of adults and children have been killed and tens of thousands have fled. The United Nations Refugee Agency (UNHCR) estimates that more than 16,000 people fled their homes in Eastern Ukraine during June alone, bringing the number of displaced within the country to 54,000. Approximately 110,000 Ukrainians have arrived in Russia since the beginning of 2014.
Non-governmental organizations (NGOs) characterize the situation as a complex emergency, with heavy fighting and artillery attacks, shortages of food and medications, limited access to basic medical care, difficulties delivering humanitarian assistance, and a lack of safety for the media. As in any civil war, collective trauma carries the inherent potential for the perpetuation of violence, tension, fears, desperation, anger, and distrust. Communities are divided, thus isolating people and limiting their access to scarce resources.
For example, rumors that the humanitarian aid had been poisoned led to a distrust of assistance efforts. And there is concern for the possibility of post-trauma radicalization (it is very human to seek revenge), which may hinder efforts for reconciliation and the bringing of peace to this war-torn country. It is expected that the psychological aftermath will be long lasting and the success of psychological recovery will, to a large degree, be determined by the community’s resilience and support.
With my expertise in global trauma, I have begun working with the psychological fallout from the crisis in Eastern Ukraine. My approach was based on the model I developed of Community-Based Psychological Recovery in Complex Emergencies. The main idea comes from the community mental health paradigm, which proposes that most individuals and communities are able to recover if there is support available. Whereas anrmed conflict destroys the psychological infrastructure, crucial support systems can be mobilized and strengthened by community players who are willing to step up to make a difference in restoring community capacity to support its members, particularly focusing on special needs groups. This model was piloted in Liberia in 2011 (with the NGO Last Mile Health) and in other countries.
In Kiev and Eastern Ukraine more than 170 psychologists, mental health workers, psychology students, social workers and pedagogues, were trained via Skype. Many of them had already started volunteering within the community. They all received training in trauma and psychological first aid with particular emphasis on the neutral role of trauma workers as a way to provide impartial psychological support and contribute to de-escalation of violence.
The plan is to continue providing remote supervision and support. Training included a module on how to reach out to the community and facilitate a sustainable and self-reliant recovery, how to identify those willing and able to help and how to educate, encourage and empower them and how to facilitate mutual support in the community with particular attention to children, disabled, persons with mental health problems and the elderly.
The participants found these trainings helpful, not only professionally but also therapeutic personally. After an initial period of demoralization, they felt that they could do something to make a difference and knew what to do in their professional capacity—“helping others is better than being a sitting duck under the bombs”. Some began organizing among themselves to support each other, while others evacuated and continue providing psychological support to fellow refugees in other regions of Ukraine and Russia.
Even if a truce is reached soon, life will never be the same and the psychological aftermath is expected to be long lasting. But the community will recover! Teachers are teaching and students are eager to return to school to work on their assignments. There is hope that life will normalize by the fall, so people continue with their lives. As one colleague wrote, “Despite everything, there is no panic. People try to go about their lives--when possible, find the occasion to celebrate, love, lough and help each other.” I am impressed by the resilience, kindness, self-determination, self-reliance, desire to help and genuine concern for the wellbeing of others among the people I was fortunate to meet.
The Ukrainian community in the United States and Canada also needs a lot of support. The psychological resources are limited and the language barrier in accessing services is significant. There are very few Ukrainian-speaking mental health providers (many seniors speak Russian), and the current tension creates challenges for forming the trust needed for therapeutic alliance.
About the Author
Elena Cherepanov, PhD, is a member of the faculty at Cambridge College (School of Psychology and Counseling, Trauma Program) and Massachusetts School of Professional Psychology (Global Mental Health Program). She is a recognized expert in global trauma who specializes in trauma-informed and culturally competent community health care, cultural trauma, violence prevention, crisis and risk management and disaster behavioral health. She has developed programs with a particular emphasis on the psychological recovery of community systems in complex emergencies. Elena worked with various NGOs in Armenia, Chechnya, Chernobyl, Russia, Kosovo, Liberia and Ukraine. She serves on the board of the Association of Traumatic Stress Specialists (ATSS) and is the author of over 40 publications.