Psychologist Serhiy Titarenko speaks on military rehabilitation

In 2014, while performing tasks in eastern Ukraine, a man came under enemy fire, his helicopter fell from a height of 100 meters. Unfortunately, Serhiy Titarenko was seriously injured, his spine was broken. Serhiy remained confined to a wheelchair. However, he became a psychologist and now helps Ukrainian defenders to cope with the traumatic experience of war.

Espreso TV reporter talked to the psychologist about the psychological rehabilitation of the military and whether our society and state will cope with new challenges.

“We must understand that we are not born to kill our own kind, but we have to protect ourselves, so we must learn to do it right. From the psychological point of view”

Serhiy, touching upon the topic of psychological rehabilitation, it is difficult not to draw a parallel with American veterans and the problem of their socialization. In films, for example, we often see veterans on the streets, without homes, money, family, with destructive behavior and addictions. Why is this happening, and does Ukraine face a similar situation?

This is a very complex issue and it is not quite appropriate to compare the Ukrainian system with the American one. Why? Because the American system is built on the insurance component. And in most cases, when US veterans find themselves on the street and lead a respective lifestyle, it is their choice. Because of such things as solitude, a heightened sense of justice, and confrontation with the system, they encourage them to do such actions. Indeed, their rehabilitation system is very structured. For example, if a fighter returns from combat, he must undergo psychological screening. If he does not pass, he does not receive appropriate treatment, rehabilitation, etc. Screening is a priority. Psychologists give characteristics in which sphere a veteran can develop further in life. This regards cases when a person leaves the military. Those who refuse such help often end up on the street because they do not want to receive treatment from the system. This is not always the case, but it happens.

“Our psyche is like a bodyguard for the body. In order not to go crazy, it encapsulates certain traumatic events”

So what can we expect?

I do not want to be a fatalist, but probably we will face an even worse situation. Our people have not yet developed the habit of paying attention to mental health. Most of the war victims do not want to receive mental help, because it is supposedly a manifestation of weakness.

The human psyche works like a Swiss watch mechanism, its processes are mandatory and inevitable. 93% of people who have been to the war zone are now in a state of altered consciousness or altered perception. As the expression "war changes everyone" goes, this is exactly it. Our psyche is like a bodyguard for the body. In order not to go crazy, it encapsulates certain traumatic events. Without seeking help, this capsule with trauma will lie quietly only until a certain time. Then the psyche realizes that the person has returned to normal life and wants to get rid of this burden. This is to put it simply. Then it "swallows" the person. It can be antisocial, destructive behavior like addictions, which is one of the ways of avoidance. Often events may trigger. It can be sounds, smells, time of year, basically anything. Triggers start the process of retraumatization.

Are specialists ready for such a serious challenge?

Are we ready for it? No, we are not ready. So far, we are only preparing, but quite efficiently. Psychologists are actively studying issues and methods, adopting the experience of other countries, such as Israel and the United States, Canada, and Norway. That is, specialists are preparing. The only thing is that there is no promotion of the need for such assistance among the population. It should be understood that not receiving help can lead to the development of mental disorders. What awaits us, in my opinion, can be a disaster.

“In Ukraine, the PTSD diagnosis is made 6 months after a traumatic event”

Considering what you have said, is there a need for a mandatory psychological assessment of a soldier after combat?

If you objectively look at all these things, I will answer yes. It should be an appropriate structure, which has not yet been built at the state level. But it exists at the level of enthusiasts. There are psychologists, military psychologists who understand this. What do I mean? First of all, preparation for combat operations as a preventive measure. We must understand that we are not born to kill our own kind, but we are forced to defend ourselves, so we must learn to do it correctly. From the point of view of the psyche. Because no matter how noble our goal is, it does not reduce the feeling of guilt. And add traumatic events from civilian life, which most people have suffered at some point in life, to that mixture.

What will a soldier most often have to deal with? I mean, what would be the most common disorder, is it PTSD?

PTSD is something we have all heard about. Yes, this is the name of the disorder and it has its own symptoms. In Ukraine, PTSD is diagnosed 6 months after a traumatic event. To make this diagnosis, 6 or 7 main groups of symptoms must be examined, most of which must occur over a longer period and simultaneously. These symptoms include maladjustment, aggressive or apathetic manifestations, sleep disorders, eating disorders, psychosomatics. Very often veterans have agoraphobia, fear of society, and crowds. Is it PTSD? No, it is not. But it is definitely a problem that needs to be worked on. That is, not everyone will have PTSD, but it will not change the whole picture.

Do I understand correctly that the problem is not so much in the mental state of people with the traumatic experiences of war but in the fact that they do not consider it necessary to seek help in time?

Yes. There should be educational work in this regard. In addition to the perception of addressing a specialist as a weakness, there is another problem: stereotypes. A veteran does not want to go to a female psychologist, because he thinks she would not understand him. And there are more female psychologists in the field. This is a problem. But, summing up, I will say that when we have a toothache, we do not care what gender the dentist is, as long as they do their job properly.

The second part of the conversation with Serhiy Titarenko about physical rehabilitation will be published on the website Espreso TV later.