Traumas as Social Interactions

By: Dr. Sam Vaknin

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("He" in this text - to mean "He" or "She").

We react to serious mishaps, life altering setbacks, disasters, abuse, and death by going through the phases of grieving. Traumas are the complex outcomes of psychodynamic and biochemical processes. But the particulars of traumas depend heavily on the interaction between the victim and his social milieu.

It would seem that while the victim progresses from denial to helplessness, rage, depression and thence to acceptance of the traumatizing events - society demonstrates a diametrically opposed progression. This incompatibility, this mismatch of psychological phases is what leads to the formation and crystallization of trauma.


Victim phase I - DENIAL

The magnitude of such unfortunate events is often so overwhelming, their nature so alien, and their message so menacing - that denial sets in as a defence mechanism aimed at self preservation. The victim denies that the event occurred, that he or she is being abused, that a loved one passed away.


The victim's nearest ("Society") - his colleagues, his employees, his clients, even his spouse, children, and friends - rarely experience the events with the same shattering intensity. They are likely to accept the bad news and move on. Even at their most considerate and empathic, they are likely to lose patience with the victim's state of mind. They tend to ignore the victim, or chastise him, to mock, or to deride his feelings or behaviour, to collude to repress the painful memories, or to trivialize them.

This article appears in my book "Malignant Self-love: Narcissism Revisited"

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Summary Phase I

The mismatch between the victim's reactive patterns and emotional needs and society's matter-of-fact attitude hinders growth and healing. The victim requires society's help in avoiding a head-on confrontation with a reality he cannot digest. Instead, society serves as a constant and mentally destabilizing reminder of the root of the victim's unbearable agony (the Job syndrome).


Victim phase II - HELPLESSNESS

Denial gradually gives way to a sense of all-pervasive and humiliating helplessness, often accompanied by debilitating fatigue and mental disintegration. These are among the classic symptoms of PTSD (Post Traumatic Stress Disorder). These are the bitter results of the internalization and integration of the harsh realization that there is nothing one can do to alter the outcomes of a natural, or man-made, catastrophe. The horror in confronting one's finiteness, meaninglessness, negligibility, and powerlessness - is overpowering.

Society phase II - DEPRESSION

The more the members of society come to grips with the magnitude of the loss, or evil, or threat represented by the grief inducing events - the sadder they become. Depression is often little more than suppressed or self-directed anger. The anger, in this case, is belatedly induced by an identified or diffuse source of threat, or of evil, or loss. It is a higher level variant of the "fight or flight" reaction, tampered by the rational understanding that the "source" is often too abstract to tackle directly.

Summary Phase II

Thus, when the victim is most in need, terrified by his helplessness and adrift - society is immersed in depression and unable to provide a holding and supporting environment. Growth and healing is again retarded by social interaction. The victim's innate sense of annulment is enhanced by the self-addressed anger (=depression) of those around him.


Both the victim and society react with RAGE to their predicaments. In an effort to narcissistically reassert himself, the victim develops a grandiose sense of anger directed at paranoidally selected, unreal, diffuse, and abstract targets (=frustration sources). By expressing aggression, the victim re-acquires mastery of the world and of himself.

Members of society use rage to re-direct the root cause of their depression (which is, as we said, self directed anger) and to channel it safely. To ensure that this expressed aggression alleviates their depression - real targets must are selected and real punishments meted out. In this respect, "social rage" differs from the victim's. The former is intended to sublimate aggression and channel it in a socially acceptable manner - the latter to reassert narcissistic self-love as an antidote to an all-devouring sense of helplessness.

In other words, society, by itself being in a state of rage, positively enforces the narcissistic rage reactions of the grieving victim. This, in the long run, is counter-productive, inhibits personal growth, and prevents healing. It also erodes the reality test of the victim and encourages self-delusions, paranoidal ideation, and ideas of reference.


Victim Phase IV - DEPRESSION

As the consequences of narcissistic rage - both social and personal - grow more unacceptable, depression sets in. The victim internalizes his aggressive impulses. Self directed rage is safer but is the cause of great sadness and even suicidal ideation. The victim's depression is a way of conforming to social norms. It is also instrumental in ridding the victim of the unhealthy residues of narcissistic regression. It is when the victim acknowledges the malignancy of his rage (and its anti-social nature) that he adopts a depressive stance.

This article appears in my book "Malignant Self-love: Narcissism Revisited"

Click HERE to buy the print edition from Amazon (click HERE to buy a copy dedicated by the author)

Click HERE to buy the print edition from Barnes and Noble

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People around the victim ("society") also emerge from their phase of rage transformed. As they realize the futility of their rage, they feel more and more helpless and devoid of options. They grasp their limitations and the irrelevance of their good intentions. They accept the inevitability of loss and evil and Kafkaesquely agree to live under an ominous cloud of arbitrary judgement, meted out by impersonal powers.

Summary Phase IV

Again, the members of society are unable to help the victim to emerge from a self-destructive phase. His depression is enhanced by their apparent helplessness. Their introversion and inefficacy induce in the victim a feeling of nightmarish isolation and alienation. Healing and growth are once again retarded or even inhibited.



Depression - if pathologically protracted and in conjunction with other mental health problems - sometimes leads to suicide. But more often, it allows the victim to process mentally hurtful and potentially harmful material and paves the way to acceptance. Depression is a laboratory of the psyche. Withdrawal from social pressures enables the direct transformation of anger into other emotions, some of them otherwise socially unacceptable. The honest encounter between the victim and his own (possible) death often becomes a cathartic and self-empowering inner dynamic. The victim emerges ready to move on.

Society Phase V - DENIAL

Society, on the other hand, having exhausted its reactive arsenal - resorts to denial. As memories fade and as the victim recovers and abandons his obsessive-compulsive dwelling on his pain - society feels morally justified to forget and forgive. This mood of historical revisionism, of moral leniency, of effusive forgiveness, of re-interpretation, and of a refusal to remember in detail - leads to a repression and denial of the painful events by society.

Summary Phase V

This final mismatch between the victim's emotional needs and society's reactions is less damaging to the victim. He is now more resilient, stronger, more flexible, and more willing to forgive and forget. Society's denial is really a denial of the victim. But, having ridden himself of more primitive narcissistic defences - the victim can do without society's acceptance, approval, or look. Having endured the purgatory of grieving, he has now re-acquired his self, independent of society's acknowledgement.

Sundry Observations on Trauma and Post-Traumatic Conditions

Trauma imprints everything and everyone involved or present in the stressful event, however tangentially. Places, people, smells, sounds, circumstances, objects, dates, and categories of the above, all get "stamped" with the traumatic experience.

Trauma imprinting is at the core of PTSD (Post-traumatic Stress Disorder), CPTSD (Complex PTSD), and triggering. Triggers are places, people, smells, sounds, circumstances, dates, or objects that are reminiscent of the same classes of stressors involved in the original trauma and evoke them.

Many exposure and retraumatization therapies (including, most recently, the treatment modality that I developed, Cold Therapy) make use of trauma imprinting to generate new, less stressful and less panic- or anxiety-inducing associations between extant triggers and thus to induce integration of the haywire emotions involved in the primary situation.

Major traumas can lead to either of two opposing outcomes: regression into infantile behaviors and defenses - or a spurt of personal growth and maturation. It all depends on how the trauma is processed.

Faced with devastatingly hurtful, overwhelming, and dysregulated emotions, personalities with a low level of organization react to trauma with decompensation, reckless acting out, and even psychotic microepisodes. Major depression and suicidal ideation are common.

In an attempt to restore a sense of safety, the individual regresses to an earlier - familiar and predictable - phase of life and evokes parental imagoes and introjects to protect, comfort, soothe, and take over responsibilities.

In a way, the trauma victim parents herself by splitting her mind into a benevolent, forgiving, unconditionally loving inner object (mother or father) and a wayward, defiant, independent, and rebellious child or teen who is largely oblivious to the consequences of her actions.

More balanced, emotionally regulated, and mature persons reframe the trauma by accommodating it in a rational, evidence-based (not fictitious or counterfactual) narrative. They modify their theories about the world and the way it operates. They set new boundaries and generate new values, beliefs, and rules of conduct (new schemas). They process their emotions fully and are thereby rendered more self-efficacious. In other words: they grow up, having leveraged their painful losses as an engine of positive development geared towards the attainment of favorable ling-term results.

Abuse and attachment, trauma and bonding form parabolic relationships: up to the vertex (the low point of the parabola), one member of the pair (abuse, trauma) sustains and enhances the other (attachment, bonding). Beyond that point, the former weakens and undermines the latter.

The exact location of the vertex depends on individual experience, personal history, personality, cultural and social mores, peer input, and expectations.

To simplify:

Up to a point, people - men and women - are attracted to abusers. When the maltreatment reaches the traumatic vertex, the emotional reaction flips and the hitherto victims are repelled by the gratuitous cruelty and are, therefore, ejected and catapulted out of the dyad, couple, or bond.

This means that good guys and decent women don't stand a chance in the sexual and relationship marketplace. They always amount to distant and unattractive second or rebound choices.

Nice guys and solid, stable gals are there to pick up the pieces, relegated to the unglamorous role of the sanitation workers of lopsided romance.

They are rarely anything more than pedestrian providers and co-parents or, if they luck out, intimate companions in between their spouses's extramarital affairs with other, more abusive and, therefore, more thrilling and appealing others.

Cold feet: the remorse that accompanies a - usually major - decision (like getting married or acquiring a home). It often leads to passive-aggressive, reckless, immoral, or destructive behaviors intended to undermine further action and reverse course.

The recipient of such mistreatment is traumatized: he feels rejected or abandoned or betrayed or cruelly and unjustly abused or damaged. Trust is shattered.

But cold feet have little to do with the target: the jilted fiancee or the dumped lover or the defaulted seller. Cold feet represent complex inner dynamics of avoidance, repetition compulsion, prior traumas, low self-esteem, a labile sense of self-worth and inadequacy, fear of the unknown, and emotional dysregulation (being overwhelmed).

However, if you keep attracting into your life people who get cold feet, there could be a problem with your selection criteria - or with you. It behoves you to look into why you keep choosing the wrong folks - or what in you gives them cold feet.

"Triggering cascade" is when a seemingly minor trigger results in vastly disproportional trauma.

Painful memories, replete with the attendant negative emotions, are walled behind mental barriers: combinations of dams and firewalls.

Sometimes even an innocuous mishap or a merely unpleasant event rupture these defenses and decades of hurt are released in an avalanche that, at times, can be life threatening.

Narcissists and psychopaths are dreamwreckers: they are particularly adept at provoking triggering cascades by aggressively and contemptuously frustrating both individual and social expectations, cherished and life-sustaining hopes, deeply held beliefs, and ingrained fantasies and values.

Their lack of empathy, innate, goal focused cruelty and ruthlessness, absent impulse control, and mind boggling recklessness create a whiplash of shock and disorientation coupled with agony and a pervasive feeling of being existentially negated. Intolerable angst is the inevitable outcome.


I am in the throes of reconceptualizing pathological narcissism as a post-traumatic condition or even a role play of sorts. If this be the case, the False Self may be reconceived as a dissociative fragment, the outcome of repeated traumas that had been sliced off and repressed. A kind of godlike alter

This view renders NPD not a personality disorder, but a private case of DID (Dissociative Identity Disorder, formerly known as Multiple Personality Disorder)

More about the False Self

Narcissistic Personality as Multiple Personality


When, as an outcome of extreme or repeated trauma, the personality/identity fails to integrate (Dissociative Identity Disorder or DID), some of the resulting fragments (alters or parts) may be possessed of personality or even psychotic disorders. If one of the alters is a psychopath, his antisocial and dysempathic, impulsive m, and reckless conduct creates a set of severe, irreconcilable dissonances (axiological, emotional, deontic and cognitive) with the core personality.

The psychopathic alter (an introject of an abuser, probably) emerges in situations involving unbearable stress and trauma in order to fight back and protect the individual. The core (host) then tries to safeguard its integrity and to avoid shattering ego-dystony (feelings of shame, guilt, fear, and anxiety) by firewalling the psychopathic alter behind dissociative amnesia which sometimes amounts to a fugue state. Consequently, the psychopathic personality (the "badass protector") will have no awareness of the core. Even when conscious of time lost or of blackouts, the psychopathic fragment will erroneously attribute them to substance abuse or other external or medical circumstances.

In the footsteps of Colin Ross's "trauma theory" of the origin of mental health disorders, I suggest that narcissism is a post-traumatic private case of DID and that psychopathy (Antisocial Personality Disorder) is when an alter is walled off from the core to avoid permanent psychosis (though dissociative psychosis may still occur). Another way of looking at it is like a theatre production: an ensemble role play with social inputs. This is reminiscent of the Internal Family System approach. It would explain, for example, why narcissists behave completely differently in prison: they adopt a different role.


About 1.5% suffer from extreme dissociative conditions, notably DID. Many narcissistic and psychopathic behaviors may actually reflect this lack of inner cohesion and failed integration of identity and self.

Consider triangulation.

When DID sufferers are romantically rejected and abused, their dysregulated negative emotions overwhelm them. They begin to prepare the ground for switching to a protective alter (a psychopathic slut or an antisocial bully, as examples). Such spurned parties then scan for an alternative to the rejecting party (hypervigilant phase): a rescuer-savior type of man or a motherly-salving mother figure.

Having spotted the candidate, the host (core) personality signals its readiness for intimacy, including sex (flirts). Once the signal is reciprocated, the host makes way for the protective alter (part) to emerge.

The inevitable sex act itself usually involves dissociative amnesia as the promiscuity-averse core defends itself from dissonance. The whole episode is sliced off and is denied vehemently.


The alter remains out for as long as the triggers that caused the switching are on.


We form memories in familiar settings and based on habits: daisy chain of memories which incorporate schema.

When we are deprived of the familiar – places, people – we compensate by dissociating (like living inside a movie), we freeze, or we try to form new familiarity.

New familiarity constricts the world: lockdown restrictions PLUS takes time to construct new habits and the initial space and number of objects incorporated in it is limited.

Drop in self-efficacy, dissociation (including depersonalization, derealization, and amnesia), disjointedness (discontinuity), confabulation and identity diffusion = psychotic disorder, confusion between internal and external objects and hyperreflxion (hyperreflexivity).

Discontinuity, hyperreflexivity, dissociation are at the core of NPD and BPD. This is why I suggest that NPD is an attenuated form of DID bordering on psychosis (BPD is failed NPD, so FARTHER from psychosis, not NEARER).


Structural Dissociation – part of Cold Therapy together with other approaches to trauma and retraumatization.


Dissociation: integrative deficit, not defense (child has few active defenses), symptoms (psychoform and somatoform). Integration and adaptive behavior depend on synthesis (association of all components of experiences and functions into meaningful coherent mental structures both episodically and across time) and realization (analysis and assimilation via personification and presentification – bring past and future to bear on present, mindfulness and reflexivity).


Depersonalization is failure in personification (semantic not episodic memory, see my vid). Trauma reduces integrative capacity. In premorbid personalities with low integrative capacity, may lead to dissociation.


Action systems (inborn, self-organizing, self-stabilizing, and homeostatic emotional operating systems): 1. Guides daily living and survival of the species 2. Physical defense under threat (4 Fs) 1+2 = social defense against abandonment and rejection (haywire in BPD) and interoreceptive defense against mental content (=defense mechanisms, primitive like splitting or sophisticated like passive-aggression).


Charles Samuel Myers 1940 in acutely traumatized war veterans: AS1 linked to ANP (apparently normal parts) AS2 linked to EP (emotional parts of the personality). Myers called them “personalities”, but today we call them “parts”.


EP contains vivid trauma recall (FLASHBACKS) and vehement negative emotionality (fear, horror, helplessness, anger, guilt, shame – or listless, non-responsive, submissive – or derealized and depersonalized). They are linked to body dysmorphia and separate sense of self.


ANP represses traumatic memories and avoids triggers via amnesia, sensory anesthesia, restricted emotions, numbness, depersonalization.


ANP conditioned to fear EP and reacts to intrusion by altering or lowering consciousness, substance abuse, addictions, compulsions, self-mutilation (to silence inner voice of EP), phobias or mental action, of dissociative parts, attachment and intimacy, attachment loss, normal life and change, evaluative conditioning (associating neutral stimuli with negative or positive outcomes and feelings owing to prior association with negative or positive stimuli), diversion, estrangement.


Individual can have one of each (Primary SD), one ANP and two or more EP (Secondary), or multiple ANP and EP (Tertiary).


Both ANP and EP have rudimentary sense of self (“I”) and exclusive access to some memories (=identity, see my lecture to Rostov students).


Dissociative parts vary in degree of intrusion and avoidance of trauma-related cues, affect regulation, psychological defenses, capacity for insight, response to stimuli, body movements, behaviors, cognitive schemas, attention, attachment styles, sense of self, self-destructiveness, promiscuity, suicidality, flexibility and adaptability in daily life, structural division, autonomy, number, subjective experience, overt manifestations, dissociative symptoms (negative like amnesia, numbness, impaired thinking, loss of skills, needs, wishes, fantasies, loss of motor functions or skills, loss of sensation; or positive when mental content or functions of one part introduce on another part’s – psychotic/schizophrenioa like voices, nonvolitional behaviors, tics, pains; psychoform or somatoform=conversion symptoms).


Betrayal trauma and betrayal trauma blindness (Jennifer Freyd et al.) in BTT (Betrayal Trauma Theory): when you cannot or are not allowed to express your experience of trauma and abuse, breach of trust, negative emotions, and profound betrayal by someone you depend on in any crucial way.


Such denial and repression lead to dissociation and a host of long-term mental health disorders.


"Emotional flashbacks" is NOT an accepted construct in clinical psychology. Flashbacks are dissociative (cut us off from the world), they are like time travel: they recreate fully and faithfully all the sensa of a part traumatic event. To experience a flashback is to be transported into another time and another place in the fullest way. Emotions and memories never recreate or even represent the past accurately: they reimagine it creatively, on the fly, and never in the same way each and every time they are evoked. Flashbacks sever us from the present reality - emotions and cognitions do exactly the opposite: help us to connect with reality (external and internal) and make sense of it.


Differentiating terminology: ‘‘involuntary autobiographical memories’’ (an everyday memory phenomenon), ‘‘intrusive memories’’ (involuntary memories with repeated and usually distressing content, generally associated with psychological disorders), and ‘‘flashbacks’’ (involuntary memories involving re-experiencing distressing events in the present, thought to be specific to PTSD). These are not used interchangeably (Kvavilashvili, 2014).


I propose that, from an early age we relate to the world (external objects) and regulate internal objects using three processes, not two: dissociation (to cope with traumas), cognitions, and emotions are arranged in contextualized narrative memories: traumas overwrite cognitions and emotions with new content (Schnider’s silencing).


Traumas and dissociation are as frequent as emotions and cognitions.


Traumas and the language of dissociation comprise the unconscious. Psychological defenses are associated with cognitions (rationalization), emotions (denial, projection), trauma (repression). That children dissociate and can be traumatized proves that these are fundamental features of the mind: not acquired but congenital.




There are four paths of trauma release and reactance involving three etiologies:

Fear of abandonment and rejection (in BPD)

Narcissistic injury and mortification (in NPD)

Frustration (AsPD, HPD)

All the above cause reactance.

There are four forms of release:

Cognitive release:


Catastrophizing or flashbacks (re-experiencing)

Intervention: controlled catastrophizing via imagery

Emotional release:


"Triggering cascade" is when a seemingly minor trigger results in vastly disproportional trauma.

Intervention: chair-based (chairwork dialogs), mindfulness, reframing (CBT), DBT, Gestalt, Scema

Behavioral release:


Total reactance characterizes Psychopaths, Borderlines, trauma victims (PTSD and CPTSD), and people with mood disorders and impulse control issues. They escalate every conflict, however minor or imaginary, to the level of nuclear, apocalyptic, all-annihilating warfare and make disproportionate use of every weapon in their arsenal simultaneously.

Defiance, posturing, hostility, aggression, recklessness, and abuse are part and parcel of these recurrent pitched battles with one and sundry: all bridges are burnt and relationships are shattered hurtfully and irrevocably.

Intervention: alliancing, self-efficacy agencing, reinforcement, DBT

Somatic release: conversion symptoms, somatisation

Intervention: dream work, psychoanalysis, psychodynamic psychotherapies

Narcissists and psychopaths are dreamwreckers: they are particularly adept at provoking triggering cascades by aggressively and contemptuously frustrating both individual and social expectations, cherished and life-sustaining hopes, deeply held beliefs, and ingrained fantasies and values.

Their lack of empathy, innate, goal focused cruelty and ruthlessness, absent impulse control, and mind boggling recklessness create a whiplash of shock and disorientation coupled with agony and a pervasive feeling of being existentially negated. Intolerable angst is the inevitable outcome.


Double rejection, double trauma model:

The 1st rejection is birth: Mother rejects and ejects the child.

This 1st trauma involves a shift in point of view.

The 2nd rejection is separation-individuation: the Child rejects his mother.

The 2nd trauma is about the emergence of selfhood.

During the 1st phase, external and internal objects are unitary.

Frustration (bad breast) leads to withdrawal: narcissistic investment in introversion (Jung) and a Constellated Self.

This results in a non-unitary universe with privileged object and all other objects: a schism (Kierkegaard, Buber’s encounter I-thou: eternal thou is God and psychotic, hence religion, including secular religions; and the experience of I-it, of objectifying others, is narcissistic, hence materialism)

Selfhood is traumatic and entails a loss of control, alienation from the world, estrangement from oneself, and the formation of a persecutory object.

Eros and Thanatos: libidinal and destrudo/mortido investment, cathexis. It reflects two types of mother: fully dead (Andre Green) and partly dead (Winnicott: good enough mother, both a safe base and dead).

The dead mother only rejects (death only).

The good mother enough also accepts (death and life).


Dead parents traumatize their children and create narcissists, codependents, and even borderlines and psychopaths who fail to distinguish internal from external objects.

We apply these very same schemas also to objects (both self and others) and to collectives:

Dead objects (inertial, materialistic) generate confusion, disordered, disorganized personalities.

Good enough objects result in mentally sound personalities.

The key difference: relationship between external and internal objects.

Still, even if objects are good enough, we cannot tell the distinction between external and internal objects

Meaning is safety. What renders reality intolerable? Fuzziness of boundaries between external and internal.

We go three successive phases in an attempt to create a meaningful narrative replete with either of three organizing and hermeneutic principles:

Psychotic hyperreflexivity (Borderline, Codependency) involves expansive identity diffusion (we are the world)+dissipated self (diminished self-affection or self-presence)+conflation of internal and external

Narcissistic grandiosity (Existentialists, Descartes, Frankl) is comprised of deflationary identity diffusion (l’etat ce moi)+inflated (false) self+conflation of internal and external

Nothingness is a mix of suspended identity+calibrated self+boundaries (this is where I cease to be and the world/you begin)

Human history is equally post-traumatic and unfolds like individual psychohistory:

Evolutionary embryology and vestigial structures

Collective unconscious and archetypes

Psychotic phase (religions both divine and secular)

Narcissistic phase (the Self usurps God: Descartes's cogito observer usurped God's role and this culminated in fusing Creator with observer in QM Copenhagen interpretation)



Ukraine’s PTSD Epidemic: Time to Prepare is NOW (Brussels Morning)


The world – and more particularly, Europe - need to prepare for a tsunami of mental health issues in Ukraine, most notably of acute stress reaction such as Post-traumatic Stress Disorder (PTSD) as well as complex trauma (cPTSD). It is safe to assume that at the very least 3 million people, including 1 million children, will be affected.


The war is internecine: there are many mixed marriages between Ukrainians and Russians, an intertwined history, and Cain and Abel-like sibling rivalry. The wanton brutality and barbarity of this total war have been disorienting, shocking, and unexpected, exceeding even the Yugoslav wars of succession.


Women were raped, volunteer soldiers were shell-shocked, children orphaned, 16 million people – 40% of the population – were or are dislocated as refugees or internally displaced persons (IDPs). In magnitude, this is comparable only to the civil war Syria.


Trauma is a systemic affliction. It affects every human function: cognition, the ability to communicate, to trust others, to maintain a positive self-perception, to believe in a better future (to not catastrophize), to empathize, to sustain relationships, even to sleep. Suicidal ideation is common in trauma survivors and so is suicide (around 4-6% of those affected). It is a health emergency.


Trauma also causes a host of symptoms such as intrusive thoughts, rumination, flashbacks, nightmares, anxiety, aggression, emotional numbing (reduced affect display), and depression.

Those touched by trauma develop dysfunctional coping behaviors such as substance abuse, truancy, delinquency, or inability to hold a job or to maintain a marriage. Trauma lasts months, even years.


The traumatic reaction can be delayed: it is a slow acting poison. In children, it affects personal development. Most personality disorders, for example, are attributed to adverse childhood experiences (ACE). Antisocial behavior in later life is also more common in children who have endured traumatic events.


This calls for a plan of action and we are already a year too late. We need to start to work on it now, in collaboration with the authorities in Kyiv and the Ukrainian community of mental health practitioners.


Yet, Ukraine does not have the requisite number of therapists, psychologists, and psychiatrists that is required to cope with this looming manmade catastrophe. The country needs to make mental health a national priority and involve all its denizens in the effort.


Trauma is a communal event: the social fabric is rent apart. Trauma victims lose their social connections, familiar geography, habits, relative positioning, peers, reference points – in short: their very identity. People are set adrift, plucked out of context.


Ukraine needs to reestablish communities digitally, if not in real life. The WHO guidelines are a good start. The population registry should be leveraged in this process of reconstruction and reconnection of erstwhile neighbors, now dispersed all over Europe. Mental health practitioners will serve as mediators and facilitators of these virtual healing portals.


Some people are resilience leaders: they remain relatively untouched by traumatic events.


They need to be identified and recruited to provide the traumatized with the succor that they require in order to recover and, later, heal. The shared harrowing experiences of everyone involved guarantee better outcomes.


Ukraine needs to create a mental health peace corps akin to the international brigades during the Spanish civil war. Volunteers from all over the world with expertise and experience in treating war time trauma among soldiers and in the civilian population will donate their work for a few weeks or months in Ukraine, train and supervise domestic practitioners, and treat people across the language barrier.


Budgets are an issue, of course. Ukraine would require dollops of international aid to mount the war after the war. But neglecting this problem will cost way more in the long run. It makes good economic sense to start to prepare now.


Another conundrum is the absorption capacity of the country: its infrastructure is devastated. An influx of volunteers can stretch local capacities beyond the breaking point. The solution is telehealth and mobile mental health field units. Agility to counter fragility: this should be the motto.




Also read:

Psychology of Torture

Back to La-la Land

Mourning the Narcissist

Surviving the Narcissist

The Three Forms of Closure

How Victims are Affected by Abuse

Post-Traumatic Stress Disorder (PTSD)

The Malignant Optimism of the Abused

Spousal (Domestic) Abuse and Violence

Verbal and Emotional Abuse - Articles Menu

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