"Many families who have survived the fighting are becoming more united"

In the new regions of Russia, up to 15-20% of children have signs of post-traumatic stress disorder, are at risk and require special attention, Olga Ulyanina, head of the Federal Coordination Center for the Development of Psychological and Pedagogical Services in the Education System of the Russian Federation, said in an interview with Izvestia. Many children survived the fighting in their hometown or village, were under fire, and there are those who still live in the frontline zone, she explained. There are similar signs of post-traumatic disorders in adults, especially in Donbas. About how doctors, relatives and the state can help such people — in an interview with Izvestia Olga Ulyanina.

"This is a risk group that requires special attention"

— Many territories of Donbass, as well as all new regions, were the scene of battles, villages and towns were systematically shelled. How did this affect the children?

— Children are most vulnerable in combat situations. Despite the severity of what is happening, many people adapt to the conditions in which they live, cope with this difficult life situation, and develop new personality traits. However, according to our professional observations, survey results, and practical work on psychological assistance, up to 15-20% of children in frontline territories have pronounced signs of maladaptation and signs of post-traumatic stress disorder. For psychologists, this is the so-called risk group, which requires special attention, organization of psychological assistance and work.

— What kind of psychological support is provided to such children and their parents?

— Today, a network of psychological, pedagogical, medical and social centers has been launched for children, which provide such assistance. An All-Russian children's helpline has been created, where psychological assistance in a remote format is provided around the clock, anonymously and free of charge. We have also developed the My Compass chatbot, which allows you to quickly assess your condition, understand what is happening to you, where to turn for help and how to help yourself.

In addition, temporary accommodation facilities have been deployed in the new territories and in the border area, where psychologists are on duty and provide the necessary assistance.

— How do children who have survived military conflicts differ from ordinary children?

— Attention is drawn to the change in the system of value orientations, which are manifested in their attitude to life, to family, to school and study. For example, many families who have experienced traumatic events related to combat are becoming more cohesive, forming closer ties, expressing support and help, and feeling empathy.

— How exactly does the change in attitude towards learning manifest itself?

— There are often difficulties here. Because when a child is faced with a threat to life and the proximity of death, the value of achieving any academic success goes to the second, third, or fourth plan. In these children, we often see reduced motivation to learn and not always a clear picture of the future with some kind of plans. The level of knowledge may vary, and we are also faced with this.

— How can we help children from the regions where fighting is taking place?

— Today, at the level of the Federal Coordination Center, we strive to assess the total number of children who suffered as a result of the fighting, to monitor their condition in an attempt to understand the severity of their condition and the consequences.

We take into account the experience of observation and the results of examinations when building a system of psychological assistance for such children. In particular, we train psychologists in all regions of the country, because there is forced resettlement. And we even work with counselors, psychologists of those health camps where children are periodically taken out for recovery and recreation.

— Is there an exchange of experience between psychologists working with such patients?

— Last week in Lugansk, an All-Russian forum was held on issues of psychological assistance to the population, including in the context of a special military operation. It was attended by leading experts in the field from different regions of Russia, who shared methods, technologies and approaches to providing psychological assistance. We try to organize such events annually both in new regions of the Russian Federation and in other regions, inviting specialists from the DPR, LPR, Kherson and Zaporizhia regions.

The All-Russian Congress of Psychologists is scheduled to be held in Moscow in June. We invite all our colleagues, including those from the new regions of Russia.

"In, the return to peaceful life necessitates transformation"

— What problems do the participants of the SVO face when returning to a peaceful life?

— Two categories of problems are the most common. The first is of a social nature. This includes the attitude of family, relatives, and friends to participate in their own activities, and integration into an already redistributed role structure within the family, at work, and among friends. That is, people have lived for some time without this person. Roles, responsibilities, functionality — they were redistributed among those who remained. And the return necessitates another transformation of intrapersonal and interpersonal relationships both among friends, colleagues, and within the family.

The second category of problems is psychological in nature. Every time the reality around a person changes, adaptation mechanisms are triggered, coping strategies of behavior are activated with the formation of new qualities, the development of new types of activities that make it possible to successfully live in a new reality. Of course, after experiencing the events in the conditions of hostilities, peaceful life is perceived somewhat differently than before. And the processes of adaptation are as painful as getting used to the conditions of combat.

Another aspect is related to the consequences of traumatic events. Here we are also talking about the effects of combat stress and acute stress reactions. And, of course, if all this is postponed for three to six months, we are also talking about post–traumatic stress disorder. All these disorders, negative psychoemotional state can manifest themselves at absolutely different levels of a person's personality. The system of value orientations is changing, and attitudes towards the importance of some kind of work or social activity may change.

There are also psychophysiological consequences associated with sleep disorders, nightmares, dietary changes, headaches, or even pain that does not have any organic disorders or medical grounds.

— What are the warning signs worth paying attention to in the behavior of a member of the SVO? What factors require contacting a psychotherapist or a psychiatrist?

— In general, any changes in standard behavior, communication, and interaction already require attention. Alarming signs range from isolation, detachment, unwillingness to communicate with someone to increased aggression in communication.

If we are talking about the emotional sphere, then it can be irritability, incontinence, impulsivity. Or a constantly lowered mood background. In the psychophysiological sphere, it is a change in eating behavior, that is, everything that is associated with a change in the standard diet. Sleep disorders, nightmares, insomnia, or, conversely, unhealthy prolonged and prolonged sleep should pay attention to themselves.

The critical signs for which it is necessary to contact medical specialists, psychiatrists, and psychotherapists are suicidal thoughts, statements, not to mention attempts. Of course, you should consult a psychiatrist if there is the use of psychoactive, narcotic substances, uncontrolled alcohol consumption.

— How is the experience of psychological support for veterans of past military conflicts used?

— It is extremely difficult to use such experience gained as a result of previous military conflicts, because the military is unique in terms of tactics of military operations, in terms of the range of effects, including informational and psychological. According to a number of complex and complex factors, this is a unique conflict. And the consequences are also very specific.

The second aspect is that we must honestly admit that during our military campaigns in Afghanistan and Chechnya, there is not much need to talk about comprehensive psychological assistance provided to military personnel or family members.

We often relied on foreign experience. We used the best practices of our colleagues, which were accumulated while working during emergencies. For example, during the Chernobyl disaster or the tragedy in Beslan. There, the teams of psychologists worked very competently and efficiently. And we take into account the experience in the format of providing emergency psychological crisis care and working with post-traumatic stress disorder and crisis states.

— What kind of psychological assistance is provided to the participants of the SVO after their return?

— Today, every Russian region has built a comprehensive system of assistance and support for its members and their families after their return. Psychological centers have been established, as a rule, interdepartmental ones. There are foundations, including Defenders of the Fatherland, which implement many significant programs and projects aimed at providing the necessary social, legal, medical and, of course, psychological assistance.