War leaves marks not only on the body but also on the mind. Returning from the front line, the experience of captivity, the loss of fellow soldiers, amputations, suicidal thoughts — these are part of the reality that mental health professionals work with every day.

Clinical psychologist Oksana Dziuba works in a rehabilitation center as part of a multidisciplinary team with soldiers, former prisoners of war, and their families. We spoke about trauma, aggression, the loss of trust in the world, and what helps a person choose life.

About the Work and Difficult Emotions

— What concerns do soldiers most often bring to you?

Most often, it is work related to combat experience: intrusive memories, flashbacks, feelings of guilt, and bursts of anger. Another challenge is adapting to civilian life — psychologically, socially, and sometimes even in everyday practical matters.

— What is the most difficult part of your work?

Working with uncontrolled aggression, shame, “survivor’s guilt,” and the loss of fellow soldiers. It is especially difficult to work with trauma while the war is still ongoing. The event has not ended, and people do not yet have a sense of safety.

Stories That Stay Forever

— Is there a patient’s story that particularly moved you?

Yes. A young man with amputations of both lower limbs. A person with incredible strength of will. He came to consultations with a smile, planned his future, bought a house, and organized renovations to suit his needs. He enrolled in driving courses for people with disabilities so he could travel independently.

During our consultations, I saw not just a patient, but an example of inner resilience. Stories like this leave a deep impression not only as a psychologist, but also as a human being.

— What moment in your work was the most emotionally powerful?

Working with a patient who had suicidal intentions. After stabilizing his emotional state and addressing his suicidal thoughts, he chose life.
Six months later, I happened to meet him on the street — he was in a hurry, planning things, living an ordinary life. At that moment, I realized how fortunate it was that I had been in the right place at the right time and that my work had brought a positive result. That is incredibly motivating.

About the Experience of Captivity

— How is working with people released from captivity different?

This is one of the most difficult areas. People lose their basic trust in the world, have a distorted perception of time, and their personal boundaries have been deeply violated.

Captivity is prolonged survival. The first stage of work is restoring a sense of safety and control. Then comes stabilization: reducing tension and bringing a person back to the “here and now.” At this stage, breathing techniques and grounding techniques work well.

A psychologist cannot erase memories, but they can help restore fundamental feelings — safety, control, and dignity.

— What kinds of trauma do these soldiers most often have?

Post-traumatic stress disorder with sleep disturbances, hypervigilance, and strong reactions to sounds and smells. Trauma of shame. Physical injuries. A breakdown of trust in the world.

These traumas are not a sign of weakness. They are traces of the fact that a person managed to survive.

Why Aggression Appears

During war, the body operates in survival mode. Aggression becomes an adaptive mechanism. It helps a person act quickly and not fall into fear.

After returning, the nervous system needs time to readjust to the mode of “it is safe here.”

— How should loved ones respond to bursts of anger?

Do not respond with aggression.
Stay calm.
Create a safe distance if there is a threat.
Do not discuss the problem immediately — allow time for emotions to settle.

If Flashbacks Occur

A flashback is a re-experiencing of trauma as if it is happening right now.

How to help:

• calmly say: “You are safe right now”
  
• remind the person that this is a memory
  
• use grounding techniques: name objects around you, sounds you hear
  
• use breathing exercises
  

Do not force the person to recall details. Stabilization is the priority.

If a Person Does Not Want to See a Psychologist

Pressure increases resistance. Loved ones can consult a specialist themselves to receive recommendations.

It is also important to support basic needs: sleep, nutrition, and social contact.

When a person sees that it is safe, resistance gradually decreases.

About Families

Families often come with feelings of helplessness, loneliness, and uncertainty about how to move forward. This is a very individual process, and each family goes through it in its own way.

The Psychologist’s Own Resources

— Do you experience burnout?

Yes. Burnout is a signal that resources are depleted.

— How do you recover?

Relaxation techniques, personal counseling, reflection after sessions, sleep, movement, time with loved ones, and nature. A psychologist must take care of themselves — this is the foundation for helping others.

The Main Rule of Support

Create a space where a person does not need to defend themselves.

Be present and allow them to speak as much as they are ready.

Being a Psychologist During War

“Being a psychologist during war means staying close to life that continues despite everything. Working with soldiers is my personal contribution to victory.”