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Letters
Published: 2022-06-15

Surviving Warfare Adversities. A Brief Survival Advice for Civilians Under War Stress

Department of Psychiatry, NYU Langone Health New York, United States
Medical psychology Stress War Psychiatry

Abstract

As the Ukrainian war rages, countless civilians are exposed to shelling, bombardments, relocation, loss of live and other modalities of war-related adversities.

Whilst much has been learned about the late psychological outcome of traumatic exposure, , for most civilians the task at hand now is to successfully survive whatever level of adversity and horror they have been exposed to; efficiently protect themselves and others around them, and ultimately emerge victorious and minimally scathed by war.

This document offers an easy-to-follow survival advice.

We start by defining war stress and its many facets, review successful and less successful ways to mitigate war stress, outline critical aspects of life that must be dealt with during war, and provide a simple self-assessment tool of one’s achievement and resilience.

Surviving Warfare Adversities. A Brief Survival Advice for Civilians Under War Stress

As the Ukrainian war rages, countless civilians are exposed to shelling, bombardments, relocation, loss of live and other modalities of war-related adversities.

Whilst much has been learned about the late psychological outcome of traumatic exposure, , for most civilians the task at hand now is to successfully survive whatever level of adversity and horror they have been exposed to; efficiently protect themselves and others around them, and ultimately emerge victorious and minimally scathed by war.

This document offers an easy-to-follow survival advice.

We start by defining war stress and its many facets, review successful and less successful ways to mitigate war stress, outline critical aspects of life that must be dealt with during war, and provide a simple self-assessment tool of one’s achievement and resilience.

War stress

War stress has an endless number of varying configurations – from stressful exposure to war news on televised media – or rumors as they emerge – to losing dear ones, destruction, forced relocation, shortage of food, exposure to cruelty, death, and shattered lives.

All war stressors have this in common

  • Major, unexpected and inescapable life change
  • Losses of many types: loss of lives, safety, belonging, social standing and status, food security.
  • Uncertainty- about what goes on, where to go for food, what happens to dear ones, how hostilities might end
  • Unpredictability regarding one’s near and long-term existence, about the next hostile events, about rules, regulations and expected behavior of hostile others
  • Exposure to grotesque scenes of death and destruction either oneself or through media. Exposure to suffering, hunger, cold,

Whilst this list is truly frightening, particularly as the war breaks in a previously peaceful society, we should not be paralyzed by it: human beings do not react to stress passively – they immediately start to fight back, adapt, and gain whatever control they can over war events and consequences. Mothers sooth babies and cajole children, people quickly attempt to inform themselves (about sources of food, safety, ways out) and societies promptly extinguish fires and transport those injured to care facilities.

All this happens without orders, spontaneously and always: It is the nature of human being to be resilient and to cope. Wherever you are and whatever happens to you, you will immediately mount a reaction which, most often will help you and others around you. Resilience and coping are in our genes.

Yet war stressors can do create unsurmountable losses and challenges, people may panic, get disoriented, surrender to strong emotions or be paralyzed by fear. Thus, although each of us has the seeds of resilience inside, these seeds sometimes need to be cultivated, activated, protected and assisted by actions, decisions and hope.

The goal of such efforts is to increase the distance between stress and distress.In other words such efforts must help us minimize the effect of war stressors on our behavior and optimize survival.

How do people survive catastrophic stress?

While there is no single answer to this question – because catastrophic stress includes innumerable modes of exposure and survival needs - some generalities are nonetheless helpful and powerful

  • People survive catastrophic stress by quickly adjusting to whatever situation they encounter. It is, indeed, unimaginable, that a peaceful life, steady work and safe homes are suddenly taken away from us. We can spend an entire life regretting, worrying or fostering anger about what we lost and the horror we saw (though most of us will not) but this is not the right time to obsess about all that. At the present we are in a new situation, face new challenges, have different needs and – most important – we are now as smart, as sophisticated as sturdy life-fighters as we were before.
  • Thus, whilst all has been taken from us – we still have ourselves – and friends, family members and just other people to support us. We thus immediately start to inform ourselves, protect ourselves (and our dear ones), orient ourselves, assess resources, consider alternatives and make decisions.
  • Sure, our options are likely narrower, uncertain and eventually insecure but as we learn and form an image – or a map - of our new reality – catastrophic as it might be (e.g., we are now in a car fleeing hostilities towards the border) we are back, fighting for survival, rather than crashed by events.
  • And the more realistic we become, the better we calibrate our expectations to what the new reality currently offer – and once some – not all of our expectations are met (e.g., “I’ll find milk in the grocery.” “People will show as the way to the next township”) we are back to a series of successes instead of just failures.
  • And just under duress, we often come to realize how important to us is our life – and that of those who we care about, and – at the first opportunity – be it the first warm shelter celebrate living.
  • Yes – fear is unavoidable at war, but it is one thing to be dominated by fear and another to dominate fear – or at least not let it control our behavior. An endless number of experiments shows that extreme fear is short lived (we just exhaust our capacity to produce the necessary ‘adrenaline’) such that we can and should expect fear to be transient and – very often – replaced by defiance and resolve.

So what do we need to pay attention to?

  • Information: Staying informed is the foundation of war stress survival. At times it can be life -saving. Other times if enables an assessment of risks and protection. Information’s accuracy and reliability are crucial whereas dramatized or otherwise distorted information are toxic. Pay attention to sources, credibility, plausibility and, most importantly, rely on what you perceive yourself and trust your own analyses and interpretation of information
  • Safety: There is little to add here. Stay safe is sometimes a vain advice because you might run into unsafe situations and plan for risky movements. Make sure that the risk that you may have to take is reasonable, given your survival goal and need for action. Communicate with others to learn from their own assessment and safety and follow rules and advice provided by credible sources.
  • Routines: Sooner or later you will reach safety or choose to remain where you are. Whatever happens, try to establish living routines including sleep (and helping your dear-one’s sleep), eating at distinct times, managing information (listening to bad news all day doesn’t help) and regularly contacting your significant others that are not with you. Getting disorganized and letting stress and worry invade all your awareness is not helping. Stay organized and as calm as situations allow. Help and sooth others around you. Abrupt war situation might seem chaotic at times, but the feeling of chaos always subsides and it’s better to fight back circumstances using all your mental resources.
  • Resources: One of the lessons of warfare is how little we actually need to survive and re-master our new life. Within such new adaptation make sure that you retain critical resources and know how to find such resources when they are depleted – from food to charging your mobile. Psychological resources include connecting to dear ones and remaining human, smart and good natured despite all the horror around us.
  • Assessment, planning and prediction: An undervalued attribute of peace time is that life is rather stable, predictable to a large extent, and does not require daily re-assessment and planning. War situations force us to adjust and frequently re-assess our situation, calibrate our predictions to what we can realistically achieve, and plan within great uncertainty. When you expect what might be realistically achieved (e.g., getting food, traveling to destination, getting news from relatives, soothing children) each achievement becomes a small victory and, instead of being repeatedly defeated you repeatedly achieve – which is a blessing
  • Attachment bonds: At war, what happens to beloved persons – family, friends or loved ones, is often as important, psychologically, as what happens to yourself. We often realize that we are not just individuals – but rather tied by a network of connections and attachment that – at times keep us alive and other times fill our hearts with worry and concerns. To the extent of possible, stay together with those whom you love and care for. When separated, make sure that you find ways to send your news and learn where others are. You may cross an entire continent, fleeing from harm, but your ties and affiliations will always be with you – so make sure you take care of them, send your news even in the midst of urgency. You can’t expect to fight a war all alone.
  • People around us: The same holds true to people around us who, most of the time, help, rescue, orient and share your sentiments. In war nothing helps more than helping others.

And how do we know that we are doing OK?

Who knows where and how the war will affect each of us and what might be the most appropriate way to cope with situations, achieve safety, carry on plans and successfully survive? We cope well – that is – our coping is efficient when

  • we effectively perform whatever there is to do – get food, find transportation or write a memo documenting our new realities.
  • even though we could be overwhelmed by emotions at times, we are not entirely and constantly controlled by our emotions (sadness, panic, fear, anger).
  • Although some of our calculations could have gone wrong and our plans and attempted actions did not bear fruits, at time, we do not vainly blame ourselves and maintain a positive view of who we are and what we stand for.
  • Finally, we maintain the capacity to feel the warmth and the meaningfulness of our contacts with others, that is, smile to a good joke, hug and cajole our kin, and feel their warmth and fondness. If that’s where we are then, regardless of geography and relocation we are OK and, when the stark winter of war ends, we will emerge – perhaps with scares – but not with bleeding wounds. Peace enables us a reasonable survival. War offers honorable survival, and it is reachable and within us to obtain.

How to Cite

1.
Shalev AY. Surviving Warfare Adversities. A Brief Survival Advice for Civilians Under War Stress. PMGP [Internet]. 2022Jun.15 [cited 2022Aug.8];7(1):e0701357. Available from: https://e-medjournal.com/index.php/psp/article/view/357