A World Of Conflict

Wherever there are people, unfortunately, there is the potential for conflict. Add into the equation, strong differing opinions and that has the potential to escalate to the highest level, and this can result in war.

In this wonderful world, there are wars either breaking out or have been continuing for many years. At sixty years plus, the civil war in Burma (Myanmar) is currently the longest ongoing civil war in the world.

War is defined as a state of armed conflict between different countries, or in the case of civil war, different groups within a country.

There will be many adverse effects resulting from conflict, arguably the most devastating long-term one being, severe psychological damage to the mental health in huge numbers of oppressed peoples.

It’s hard to think of wars as having rules but there are the following according to the IHL, International Humanitarian Law:

Protect those who are not fighting, such as civilians, medical personnel, or aid workers.
Protect those who are no longer able to fight, like an injured soldier or a prisoner.
Prohibit targeting civilians.
Recognise the right of civilians to be protected from the dangers of war and receive the help they need. Every possible care must be taken to avoid harming them or their houses, or destroying their means of survival, such as water sources, crops, livestock, etc.
Mandate that the sick and wounded have a right to be cared for, regardless of whose side they are on.
Specify that medical workers, medical vehicles, and hospitals dedicated to humanitarian work cannot be attacked.
Prohibit torture and degrading treatment of prisoners.
Specify that detainees must receive food and water and be allowed to communicate with their loved ones.
Limit the weapons and tactics that can be used in war, to avoid unnecessary suffering.
Explicitly forbid rape or other forms of sexual violence in the context of armed conflict.

To contravene these legally recognised conventions of International Humanitarian Law constitutes war crimes. Impunity destroys the social fabric of societies and perpetuates mistrust among communities, consequently undermining any lasting peace. War crimes can and should be investigated by the International Criminal Court supported by the Human Rights arm of the United Nations.

Whereas the vast majority of wars currently taking place in the world are non-international armed conflicts, sometimes referred to as civil wars such as in Somalia, what we are seeing happen in Ukraine is legally classified as an international armed conflict, a conflict between States, because hostilities have broken out between their armed forces.

This means that the Geneva Conventions are fully applicable, as are the IHL laws; whereas the latter applies only in times of armed conflict, human rights law applies at all times, in peace and in war. There are additionally important frameworks providing legal protection to the victims of conflict & refugees.

It is hard to imagine the hardships and terror suffered by people subjected to constant shelling, devastating loss of their homes and annihilation of infrastructure, shortages of food, water, and the basic dignity of everyday life, besieged populations needing to escape to safety whilst being forced to leave their homeland.

Apart from the unthinkable mental trauma being inflicted on millions there are so many more widespread effects from war, like a pebble being dropped into a pond.

With the displacement or forced migration of millions, comes many problems, we will never fully comprehend the psychological impact for a refugee seeking sanctuary elsewhere, for example even a car back-firing will take them immediately back to painful memories and post-traumatic stress disorder (PTSD) will be the order of the day for millions.

While PTSD, depression, suicide, and anxiety are some of the trauma effects; death, injury, sexual violence, malnutrition, illness, and disability are some of the most threatening physical consequences in any conflict.

Each night the News programmes would, and still do, reduce me to tears; one report I read was about a young man now in a catatonic state because his traumatised brain could no longer process or cope with all that his body had encountered; mothers desperate to protect their children; new mothers bringing babies into the world, into their own country; now one of devastation & heightened tension, with persistently diminishing hope for their futures; children having seen sights no child, or human, should ever have to witness.

People’s minds will be fragile in the extreme, some may never mend. Acrid smells of explosives pervading innocent nostrils, artillery, burning houses & sights of war crimes.

Rehabilitation for many will not be possible. All the five senses, sight, sound, smell, taste, and touch will have been on high alert resulting in amygdala being fired up. (this is a part of the limbic system in the brain responsible for emotional and behavioural responses) this fight or flight response can be controlled by the frontal lobes (the front part of the brain responsible for reasoning) however, something called an “amygdala hijack” can occur, the amygdala will respond to stress and disable the frontal lobes, disabling rational reasoned responses, releasing chemicals (cortisol & adrenaline – These are stress hormones) due to this stress hormone, the experience can lead to –

Rapid heartbeat
Sweaty palms
Clammy skin
Goosebumps
‘Irrational’ or ‘inappropriate’ behaviour

The body will react unconsciously to the perceived threat, operating in this fashion for weeks, months or even years on end, affecting increasingly fragile people to a degree none of us can comprehend.

How to help someone experiencing an “amygdala hijack”-

Deep Breathing – Help them become aware of their breathing (if they’re breathing rapidly) assist them by demonstrating how to take slow deep breaths. Taking slow deep breathes can help calm down the nervous system and allows us to make thoughtful decisions in stressful situations.

Being Aware of the body & mind– You can help them to understand what they’re thinking and feeling by simply asking “What are you thinking about at this moment”? And “What are you physically feeling right now? Tight chest, dry throat, increased energy, etc?”Asking these questions can help them become aware of what they’re feeling and can help create an emotional distance from the emotion itself to reduce the “weight” of it – (this is because we’re consciously re-engaging the prefrontal cortex by making them aware of their thoughts & feelings)

Identify the Emotion – Identifying the emotion they’re feeling and saying it out loud can help disrupt the amygdala & decrease the emotional reactivity to negative events or interactions.

The sense of touch may have been the most important thing to many physically clinging to their loved ones as the only thing real in a shattered existence, equally physical touch could be a reminder of the physical torture they experienced – therefore you can ask them “would you feel better if I held your hand?”

I weep for the helplessness of the civilian community, desperate to do what little I can to help, with the realisation that whatever it will be is a drop in a vast ocean. I feel guilt at having, by comparison, inconsequential worries at home like making a pension elastic enough to withstand soaring living costs, while having my life, my health, albeit ageing, but still having ‘survived’ the ravages of Covid and several lock-downs.

When we go to sleep at night and close our eyes for slumber, think of those for whom the mere act of closing their eyes will cause them to relive terrors unimaginable.

Buildings flattened into heaps of smouldering rubble with smoke and dust hanging in the air, dead bodies still unclaimed lying broken in pools of their own blood, mothers murdered with their arms tightly shielding their children still clinging to them to the end.

With the displacement of so many millions, many skillsets will be lost making rebuilding a balanced community challenging beyond belief. Destruction of cultural goods is also part of psychological warfare.

We should focus on nurturing people’s wellness and recognising their tremendous resilience. Our level of understanding has to be empathetic and has to be raised as a collective, paying special attention to the unique needs of individuals – their experiences of trauma, loss, and separation from family and friends.

Listed below are a few tips on how we can support individuals experiencing trauma (being mindful, everyone reacts differently to trauma) and stress –

Listen – It’s important to truly listen to them, with compassion and empathy, without being judgemental and asking too many questions, allowing them to speak at their own pace. Use the same words they use to show understanding and Active Listening.

Ensuring Confidentiality – It’s important to respect every one’s privacy. Please don’t disclose their shared information with anyone else unless they’ve given you permission to do so. (This is extremely important when working with individuals from different cultural backgrounds, where seeking mental health and emotional support could be stigmatised and discriminated against, amongst members of their own community.)

Unless they are threatening harm to themselves or others (then there is a duty of care) to continue the trust they have placed in you; tell them you will have to share this (unless you feel this would put you or someone else, including them in immediate danger)

Understand their triggers – It might be helpful to ask if any specific situations or conversations could trigger flashbacks or difficult feelings. For example, they could get particularly distressed by loud noises, yelling or sirens passing by. Understanding and being aware of their triggers could help you to avoid these situations in the future and feel more prepared when they have reactions such as flashbacks.

Understand Flashbacks –A flashback is a vivid memory of a past trauma that may feel like it’s taking place in the current moment. It could be hard to know how to support someone through a flashback, but it may help if you –

Try to remain calm
Gently let them know they’re having a flashback
Encourage them to take slow deep breaths
Encourage them to describe their present surroundings
Remind them, they’re safe

Grounding Techniques – These coping strategies can help someone step away from negative thoughts, unwanted memories or worries and re-focus on the present moment when experiencing flashbacks, or anxiety. Using the 5-4-3-2-1 technique, we can help someone focus on the present moment with the assistance of their 5 senses.

Professional Support – Encourage them to seek professional support by
presenting them with the available resources.

Look after your own well-being – It’s important to establish healthy boundaries and to focus on your self-care as well. As much as we want to help sometimes this can leave us with ‘burnout’, it may be difficult at times to say no (through feelings of guilt or sympathy) but setting your own boundaries demonstrates self-care.

Conclusions:
All I can do is to write, to raise awareness to all of us living so comfortably.
Whilst working with companies to help prepare for our refugees, facilitating the acquisition of electronic translators, and working with therapists whose services will be so necessary for the repair of damaged minds.

Determining reasons why any particular war breaks out is never straightforward. Some are internal civil wars due to deep rooted tribal differences; some may be religious in nature (ironically many wars historically have been wars of religion, sometimes also known as holy wars, primarily caused, or justified by differences in religion).

There is no doubt that the populations (soldiers, & citizens alike) in war and conflict situations should receive wide-ranging mental health care as part of the total relief, rehabilitation, and reconstruction processes (In some way, shape or form, we’re all victims in the rage of war).