Kate Pokrovskaya, a 39-year-old psychotherapist, was sleeping at her home in Kyiv, Ukraine, on February 24 when she and her husband were awakened by an explosion. Russia launched its invasion. “At that point, our lives stopped,” she said.
Pokrovskaya tried to help her patients cope with the stress and trauma of war. But she got through it on her own.
“We started to fall asleep; My body is tense,” she said. “The sirens are getting louder and louder, especially at night. All this is very claustrophobic, mentally and physically exhausting. “
In early March, Pokrovskaya saw on Telegram that Israeli psychotherapists were providing free assistance to their Ukrainian colleagues, drawing on their country’s war experience. She reached out for help and found something transformative. “It is very valuable to us that we can discuss our issues with such good professionals,” she said.
The Israeli group was started by Jenya Pukshansky, a Ukrainian psychologist born in Israel. Pukshansky initially posted his phone number on social media, offering to help the people of Ukraine, but was quickly overwhelmed with requests for help. Together with her colleagues, she has organized hundreds of Israeli mental health professionals to volunteer to serve them, first as crisis support for those seeking help, then as enduring guidance for therapists in Ukraine.
Now, they are engaged in a dauntingly ambitious project: to help Ukrainians deal with the mental health consequences of war, even while the war is underway.
Nurturing understanding
Most people who experience a traumatic event – clinically defined as an episode of actual or threatened death, serious trauma or sexual violence – experience a traumatic event, experts say symptoms such as nightmares, anxiety or headaches, but then recover.
A smaller subset develop persistent depression or post-traumatic stress disorder. George Bonanno, a clinical psychology professor at Columbia University who studies trauma and resilience, estimates the total to be less than 10%. In a country where millions have experienced traumatic events, that number adds up. And in some cases, the odds of people developing PTSD may be higher.
Patricia Resick, a professor of psychiatry at Duke University who has developed cognitive processing therapy, a form of trauma treatment, says one factor determines whether people develop long-term problems or not. not whether their community shares the trauma. “We see lower rates of things like PTSD after disasters than we see after individual events because of community engagement,” she said. “They’re supporting each other, and sometimes that’s an important difference.”
War can be a kind of shared experience, especially when nations unite against a common enemy, as Ukraine did against Russia.
But some types of trauma are more isolated. “When you are raped, you are raped alone,” Resick said, referring to both the typical circumstances of the crime and the stigma that followed.
Valery Hazanov, a psychologist in Jerusalem who helps lead Pokrovskaya’s monitoring team, said soldiers experience trauma but often feel isolated and ashamed about it. In the “masculine” Israeli Army, he said, the view used to be “if you go back to PTSD, something is wrong with you.”
That mindset has begun to change, especially since the 2006 war with Hezbollah in Lebanon. “Today, it has more to do with discourse,” Hazanov said. “There’s more understanding that trauma is part of what’s happening here.”
He hopes the Israeli project will help Ukrainian therapists promote a similar adjustment in consciousness. “We talked to them in person about this, anticipating and thinking about this change together,” he told me.
Pokrovskaya wants to prioritize adjusting the public perception of trauma and destiny to the concept of going to therapy. She said she wanted Ukrainians to “develop a culture of seeking help from specialists, rather than dealing with it on their own”.
Treatment and survival
For now, the fight is still ongoing, for therapists in Ukraine as well as for their clients.
Pokrovskaya was temporarily moved to a nearby town but still felt she could not escape. “There are days when the explosions don’t subside. Emotionally and physically, it was very difficult,” she said.
Over time, she marks the progression of the invasion through the changing needs of her clients. “At first, it was crisis support,” she said. “There are a lot of requirements for dealing with panic attacks.”
Then people seek help with relocation issues: conflicts with new neighbors, or between family members with distant relatives. The relationship is strained due to the stress of the mother who takes the children away while the father stays behind to fight.
Now, many patients are struggling with long-term trauma and grief as they grapple with the extent of their loss, says Pokrovskaya. “It is very difficult for them to deal with their emotions,” she says. “The realization of the scale of the damage to their families is drawing near.”
In April, she and her husband returned home to Kyiv. They hope to stay but are ready to flee at any moment. “We always have a plan in mind,” she said. “We have everything ready, emergency suitcases.”
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