Psychiatrist: Disillusion sets in, but Ukraine pays with blood, we only with money

Hundreds of thousands of Ukrainians fled to the Czech Republic before the war. In what mental state do you think they are?

They are frustrated, sad and worried about their loved ones. We should be prepared for the fact that, as seriously ill people often do, they vent their frustration with doctors, so that these refugees can vent their frustration with officials and others.

There are already several hundred thousand of them, so please do not exaggerate, unless a Ukrainian mother behaves as exemplary as we imagine. Let’s be generous, don’t forget that it’s not just the angels who have come here.

What can we do for them?

Refugees mainly need identity papers, basic financial support and a work permit. This has been the case for over a hundred years. And I am very happy that the Czech Republic accepts them. Then, they need to be anchored, not to live from day to day, but also to have links with other refugees.

We also need to help them take control of what they have in their power, such as daily routine, physical activity and information filtering. And this also applies to the Czechs. If we bang our knees with a hammer every hour, we can’t want to not hurt ourselves. When we listen to ten hours of war news every day, we simply shouldn’t be surprised that we don’t sleep well.

Will the enthusiasm with which people in the Czech Republic help refugees survive?

While individuals may react to stress in the first days after a tragedy with denial, anger, sadness or despair, on a societal level the reverse is true. After the impact of the catastrophe, comes a heroic phase of several days. Financial collections are created immediately and people are ready to make significant sacrifices, volunteers get involved quickly.

When we listen to ten hours of war news every day, it should come as no surprise that we cannot sleep peacefully.

It lasts several days and this phase is gradually transformed into an idyllic phase. Affected communities are coming together, mobilizing their internal reserves and the work of volunteers continues. At the time of the covid epidemic, the sewing of drapes was typical of the idyllic phase. We are now looking to help refugees before the war.

However, these emotional phases are exhausted and a disillusionment phase follows after weeks or months. Individuals are aware of their limitations as well as the limitations of the help available. The disappointment arises from the failure to meet some of the inadequate expectations, from finding the culprits and spreading conspiracy theories.

But we are already seeing trends on social media and among people questioning the need to help Ukrainian refugees, for example, because we need to think more about our own people. After all, refugees will not vote in councils. But we must not forget that in Ukraine people pay with blood, while our society pays “only” with money.

We will probably have to accept that. Or is there anything you can do about it?

It is not a law of physics, and if society were strengthened, we could advance the idyllic phase. Reinforcement can take various forms. When I served in Afghanistan, the British royal family sent Prince Harry there, which boosted the morale of the soldiers. They are personal models and examples.

We should want the same from captains, which is an old military function, and any commander knows very well that if he wants to tear down a team, he must lead by example. We do not know yet.

Why are the Czechs helping so much now, when seven years ago during the war in Syria they were so cold with the refugees?

We didn’t feel so threatened. They weren’t our neighbors, but now they are, and we see what’s happening. At that time, the gender composition was completely different, mainly males. Now it is quite clear to everyone that these are not economic migrants, although I think at the time they were also mainly refugees. Now, the image of the emigrant – mother with child – is so indisputable that it is obvious to everyone.

We are also closer culturally, we know the Ukrainians, we have a good experience with them. I understand that it is more difficult to identify with the Syrian people than to sympathize with the Ukrainian people, with whom we have long cooperated and a common state in the form of Transcarpathian Ukraine.

As psychiatrists, you probably had your hands full of covid-stressed people, and now the war has come relentlessly…

Don’t be mad that I jump on you. But I don’t think we were busy with covid. We just thought so. But unfortunately we have an economic service that calculated it for us. And he found that we had a performance of 70% compared to 2020. Some people were afraid to go to the hospital because of covid, and the day hospitals were not working either. Not that our doctors and nurses sat idle because they went to covid wards.

But it was written everywhere that the assault on the psyche was great and people needed more help from psychologists and psychiatrists.

The pressure on the psyche was certainly greater, but from the point of view of the economic service, there were fewer performances and contacts.

However, I wanted to ask you if you expect a greater onslaught from the war, be it Ukrainians or Czechs?

Despite the decline during the coronavirus pandemic, the demand for psychiatric services is growing steadily and over the long term. We can already see that our pediatricians in particular are very overwhelmed. Because Ukrainian children get sick after suffering. You can already see it in the hospital, and I have no doubt that refugees suffering from mental disorders, including depression and anxiety, will be coming in a few weeks.

You were in Afghanistan as a military doctor for a year and you also served as chief military psychiatrist. What about the morale of soldiers in Ukraine? We hear that the Ukrainian army, although weaker, less armed, is better defended mainly because of a good motivation and a good psyche. On the contrary, the Russian soldiers have the wrong motivation. Do you think there is any truth to these reports and can you describe it?

The answer is that these reports should be taken with some reserve, because the first victims of wars are always true. Each side exaggerates the enemy’s losses and also exaggerates its combat morale. Because good combat morale is important. In many war situations, fear and despair lead to more death than actual physical suffering and injury.

We are now in an information war, and this is even more important in hybrid forms of war than before. And although the Ukrainians are clearly and rightly winning the psychological war in Europe and the United States, the opposite may be true in Russia.

What can we do?

We must not succumb to comfort and passivity, but we must send clear and decisive signals, because without them we will have to send our soldiers to the front in an instant instead of a signal. Putin has made it clear that we are within his sphere of influence, and we need to make it clear to him that if he wants us, we will fight back.

The first victims of wars are always true. Each side exaggerates enemy casualties and combat morale

The media sometimes tell the stories of young people who live in Ukraine and call their parents or relatives in Russia and tell them that there is a war, and they don’t believe them. Do you think that the propaganda in Russia and the lack of information of the Russians is such that they do not believe that there is a war in Ukraine?

I have no doubt about it. I know Russians as warm and friendly people, at least those I have had the opportunity to meet. But I know that Europe and the Europeans have always been regarded with great suspicion as people who have stripped them of their empire, as people who want to steal their mineral wealth.

And I really heard ordinary peasants from the Primorsky Krai, which is in Siberia above Vladivostok, say: Well, you know, there were no computers, but the whole world was afraid of us . And that’s something that Russians sincerely missed and that Putin makes them feel now, so I’m afraid a lot of Russians really believe that.

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