Nicole Tung visited some mental health treatment centers in Ukraine, and spent time with some soldiers who suffered psychological damage from the war earlier this year.
The night brought little sleep and nightmares. The day brings panic attacks and flashbacks. Everyone is tired and some are thinking about suicide. They are afraid of their own thoughts, and what they can do with those thoughts.
Vladyslav Ruziev, a 28-year-old Ukrainian sergeant, has recurring nightmares about his experience of being pinned down in his unit last winter, unable to do anything about the constant artillery fire. in Russia, the bitter freeze, the comrades he saw lost arms and legs. “Sometimes the ground is so thick with the wounded that the evacuation vehicles drive their bodies into the chaos,” he said, recalling the scenes he witnessed on the front earlier this year.
In a year and a half of war, many of Ukraine’s troops have only had a two-week break. And when they get short breaks from the front, what most of them need is treatment for psychological trauma.
That need is growing and beyond the ability of Ukraine to solve it, as a New York Times journalist found in visits to institutions that provide care, and in interviews with soldiers, therapists and doctors.
Andriy Remezov knows that suffering is too much – after 2014 to fight Russian proxy forces in the East, he returned home and entered a tailspin.
“I was addicted to drugs and alcohol, and even thought about suicide, but my colleagues saved me,” said Mr. Remezov, 34. He went to therapy, became a psychologist and got married.
He returned to the army last year. On a two-day trip to Kyiv, sipping coffee in his kitchen with his wife, Marharyta Klyshkan, he explains that every time he leaves the front, he takes some quiet time for mental review. of what he suffered “so that I may put it on a shelf. in my mind.” Otherwise, he says, “all this information could just destroy me.”
Ukraine’s mental health system can only handle a fraction of the demand, he said, and most soldiers make the mistake of trying to stabilize it themselves, as he once did.
Some centers in Ukraine treat mental trauma with traditional psychotherapy and alternative treatments: electrical stimulation, time with animals, yoga, aquatic therapy and others.
At Lisova Polyana, a hospital near Kyiv, therapists use “biosuggestive therapy,” a mixture of speech, music and touches on the head, chest, shoulders and arms. Even a haircut at the barbers can be healing — a safe encounter with a stranger, providing a sense of routine and care.
The hospital treats soldiers with psychological injuries and physical injuries, including brain injuries such as concussions. “It has become an epidemic now because Russian artillery is like rain,” said Ksenia Voznitsyna, the director. He added, “We also work with those who were tortured while in captivity in Russia.”
Tough guys can have trouble letting their guard down. For some, touch is harmful. In a group session, hypervigilant fighters struggle to follow instructions to close their eyes. One shook uncontrollably.
The goal at the moment is just to heal them to get back to the front. Long-term recovery will have to wait.
During a previous rotation from the front line, Maksym, 35, attacked his roommate at night, thinking the other soldier was an enemy of Russia. After that he insisted on having a room to himself.
The hum of bees overhead put him on alert, expecting the drones. A shooting range gives him a flashback to the war.
“We lost most of the men in my unit,” he said. “I cry sometimes. When I fall asleep, I can imagine it again.” He added, “I remember the faces of all our dead comrades.”
Maksym saw little point in the therapies in this stint, his second, at a rehabilitation center outside Kharkiv, in the northeast. But like many soldiers, he is caught between the horrors of the front line and the feeling that this is the only place where he belongs.
“Up front, I know my assignment and I know my duties,” he said. “But here, I don’t know.” He added: “Maybe one day when the war ends here, I will go to another battlefield somewhere else.”
Between therapy sessions, he sits outside, apart from everyone else, smoking a cigarette and staring into the distance, one hand clasped behind his neck. He couldn’t help but rethink his every move in battle, filled with guilt.
However, he said that he will return to the front because he cannot let his fellow soldiers down. A few days later, he joined them again.
On a sunny afternoon in Kyiv, dozens of fatigue troops gathered at the Spirit Rehabilitation Center, to do something that most have never done before: Ride a horse.
An instructor led men on horseback around a barn, had them do arm exercises, and told them to lean forward and hug their horses. A soldier, his arms wrapped around his horse’s neck, breaks into a wide smile.
“They learn to ride horses, but it also gives them attention, to be here and now, to be present,” said Ganna Burago, founder of the equine therapy program.
Afterwards, he gathered the soldiers in a circle and asked how they felt about the experience. One soldier said it made him happy, an emotion he never expected to feel again.
It was the last session of its kind. The program ended due to lack of funds.
Among the traumatized veterans, there is a common theme with great implications: that others may not understand their suffering, that they do not know how to return to a civilian world that now feels which is completely foreign.
“You don’t understand because you don’t smell it, hear the sounds, the feeling of what it’s like to kill someone,” said Maksym.
Oleksiy Kotlyarov, 36, a military surgeon, saw years’ worth of severe wounds every day in a decrepit medical station near the front, under constant shelling, with little rest. Suffering from depression, panic attacks and crying, he was diagnosed with PTSD
On the farm, with important work to do, he adjusts to the fear, he says, but in the capital, where there are more people and signs of ordinary life, he feels out of control.
Out front, “everything is gray and destroyed,” he said. “Here, people are smiling, drinking coffee. There, everyone is suffering.”
Much of the treatment the soldiers received, such as clay sculpture and physical therapy, re-introduced them to a non-threatening world, easing them into ordinary contact with others, including civilians, while occupy their bodies and minds.
“At first, the soldiers were worried about art therapy,” said Iaroslav Chabaniuk, a pottery teacher at the medical center of the internal affairs ministry in Kyiv. But, he added, it “gave them a break from their own thoughts.”
Soldiers and those who treat them say Ukraine is just beginning to face a mental health crisis that is ongoing and will last for years.
Ms. Klyshkan, the wife of Mr. Remezov, said to be happy, patient and helpful with him requires a lot of energy, a need that will not disappear soon. He thought about getting a paying job, but decided he couldn’t do both.
“The most important thing is that I don’t expect him to be the same person as he was the last time we met,” he said.
Anton Kosianchuk, 22, one of the soldiers treated at Lisova Polyana in Kyiv, pointed to a tattoo on his bicep of a screaming, demonic face.
“This is a reflection of my inner state,” he said.
Dr. Kotlyarov spoke for many soldiers when he said: “I am not the same person before this war. I have low empathy, I became tolerant of violence.
Evelina Riabenko and Anna Barsalo contributed reporting.