'The first and most important way to help a child of war is to stabilise the mother. Mostly, it is the mother accompanying children as they flee; the mother who now carries the responsibility of both parents. So the best way to support a child, is to support her,' says Professor Viktoriia Osypenko, a teacher of psychology and sociology at the Bukovyna Medical University in Chernivtsi, Western Ukraine.
Although in her normal life Osypenko is an educator, since the start of the war, she's pivoted to providing crucial mental health support to traumatised and displaced families who have escaped from cities which have been the focus of the fighting, such as Kharkiv and Mariupol. As so many men have felt duty bound to join the defence efforts, the vast majority of Osypenko's patients are women. Considering UN Women outlined just last month that the effects of the war in Ukraine are causing a particular crisis among its women and girls, I sought to discover what this looks like first hand, and to speak to Professor Osypenko about what she's doing to try and reduce some of the damage.
For The Women
'As well as the horror of experiencing loss, or witnessing deaths, for women refugees their core relationships are being undermined. Often what happens is that men will bring women and children to a place of safety, and then they will go back to join the army. So the distance between families compounds the stress, hopelessness, anxiety and feelings of impotence,' furthers Osypenko on the particularities of female suffering in Ukraine.
'And - though everyone's degree of trauma is different and requires different approaches - one of the best ways to try and mitigate some of these feelings is to try and re-introduce a routine that feels familiar. Something which bridges the gap between where they find themselves and pre-war life. I ask people, "What did you like to do before the war? What did you want to do? Maybe you can do this now." Even something simple like singing in the shower. Trying to do that now might help for a minute to ease some of the tension,' she continues.
'For the more severely affected, it can be hard to say. Statistically, we know that PTSD will affect between 20-30% of civilians. We're resilient as a species, so we can expect that after two years or so, the rest of the population might be able to restore themselves mentally, if the appropriate aid, assistance and safe spaces are created for them. But for people suffering worse mental health side-effects, it depends on the type of nervous system, but those people will need extra professional help.'
In some cases, where Osypenko's patients are still in conflict zones (she also operates a telephone helpline) it's impossible to do anything much at all. 'Four days ago,' she explains, 'I had a call from a woman who was still in a basement in Kyiv. The building had partially collapsed and she couldn't get out of where she was sheltering. The right side of her body had been injured and she was immobilised. So she called me just to know that someone was there with her. And the only thing I could do was stay on the line, reassuring her that I was there.'
I ask Osypenko specifically about how she thinks the advent of smartphones has affected our recovery from traumatic events. In the wars of the 20th century, we might have relied on twice-a-day bulletins to keep us abreast of the events unfolding. Now, on the other hand, smartphones give us access to a constant stream of information, videos, even TikToks, reels and streams showcasing the war live, some of it extremely graphic, some of it fake news. It's hard to imagine what that kind of war-content total immersion might be doing for the psyche.
'There are significant risks associated with consuming information like this,' Osypenko agrees, 'For some people, they risk developing OCD (obsessive compulsive disorder), because when they keep tapped into the war, watching things seemingly live, they might develop the illusion of control - that they have control of the situation, which gives them an easily accessible dopamine hit. So though it scares them, the adrenaline and dopamine might develop into an addiction.
'When people contact me from safe places, I will often introduce the idea of an information detox. It can be a huge challenge for a person to exist without a mobile phone even for 30 minutes, which is problematic. In the short term, I ask them not to use it during consultation with me, which can last from 20-40 minutes. And then we try to develop a plan for what a woman will do to occupy herself when she puts her phone away for a period of time each day.'
For The Children
Children filthy with debris, curled up and sheltering in tube stations, or clinging to their mothers necks as they try to exit the country pramless and on foot, the scenes of little kids experiencing war are among the most gut-wrenching. It is some, if small, relief to hear from Professor Osypenko that young children have the largest propensity to bounce back from this kind of trauma, providing the circumstances are right for their rehabilitation.
'The main problem is when children are orphaned. For example, two days ago rescue workers brought 147 children aged from two to nine to the Chernivtsi region, where they now reside unaccompanied by their parents in the children's camps. We are looking for human resources and volunteers to provide for their vital needs. But when there is at least one parent present, it is a different story,' she explains.
'First, you must stabilise the mother and ensure that children are surrounded by safe people in a safe place. A child's psyche is more intelligent than any psychotherapist. It has the capacity to restore. But there are two conditions that need to be complied with. And that is a safe place, and safe people.
'After that, the work of volunteer psychologists is to bring children back to routine. Like dancing, drawing and reading fairy tales, so that children feel like they are back in touch with a pre-war normal experience.'
What Can Outsiders Do?
For so many of us, whether we're receiving refugees into our homes, or watching with dismay and donating money from a distance, it can be easy to feel powerless to make any real difference to people who have lost so much. I consult Professor Osypenko on the best ways for people like me to feel like we're doing something useful, particularly how we can help support the mental health recovery of people who have experienced war.
'Social support is crucial,' she responds. 'This is a humanity test for all of us. You don't need to be a psychologist to provide assistance. Be it an acquaintance or an absolute stranger, interacting kindly with traumatised people could keep them alive.'
'On the one hand, you need to avoid violating someone's boundaries. But on the other hand, it's easy to say: "I want to support you, how can I do that?" Talk to people, tell them you are next to them, let them talk about their fears, remind them that they are safe. In time, help them to start acting for themselves. It's easy to conflate acting as a guardian and doing things for or instead of people. It may result in them being treated as disabled. The best thing is to help people re-learn how to do things for themselves, so they feel they have agency in their lives again.'
For information about donating money and supplies CLICK HERE
For information about how you can help Ukraine's women and girls, consult UN women's dedicated page HERE
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