A close person returned from captivity and closed in on himself. How to help him return to normal life? Important and sensitive instruction

Ghanna Mamonova
Yuliana Skibitska
A close person returned from captivity and closed in on himself. How to help him return to normal life? Important and sensitive instruction

Ангеліна Коткова / «Бабель»

Since the beginning of the full-scale invasion, almost two thousand Ukrainians have been returned from Russian captivity. How many people are still in prisons on the territory of the Russian Federation is unknown, Russia is hiding the information. The prisoners are kept in terrible conditions, they are tortured and humiliated. But even when they return home, the problems do not end. It is difficult for them to adapt to the usual life, they often cannot find a common language with relatives — all this leads to new psychological injuries. "Babel" correspondent Ghanna Mamonova spoke with the deputy director of the Ukrainian Center for Mental Health and Rehabilitation of Veterans and their Families "Lisova Polyana" Tetyana Sirenko, the head of the public organization "Blue Bird" Hanna Mokrousova, the head of the psychological support hotline of the "Ukrainian Veterans Fund" Olena Lashko and teacher mathematician Victoria Andrusha, who was held captive by the Russians for half a year. Together, they compiled instructions on how former prisoners and their loved ones could go through the adaptation period together and understand each other.

How should a family prepare for the first meeting with a loved one who has been released from captivity, and is it necessary to prepare?

Special preparation isnʼt necessary. Immediately after the exchange, those released from captivity are hospitalized. If the health condition isnʼt serious, they will stay in the hospital for two or three weeks. During this time, they will pass the necessary tests, undergo a course of treatment, restore their passports and testify to the law enforcement officers about what happened in captivity. A medical examination also includes a consultation with a psychologist or psychiatrist. This is comprehensive primary assistance provided by the state.

Problems usually start at home. The first days after release, people are in a state of shock, there may be euphoria or confusion. At this time, many donʼt feel pain and any threatening symptoms. In the future, the attention and care of the family, which must have the strength for this, is important. That is why there is no need to exhaust yourself in advance with special preparations for the meeting, or spend the day and night near the hospital in the first two weeks.

What health problems arise after captivity?

There are many of them. People remain in captivity for a long time, the conditions of detention are terrible, as a result of which chronic diseases worsen and new ones appear. Torture leaves scars, bruises, swelling, and injuries to various parts of the body. The captives return with amputations and brain injuries, popularly called “contusion”.

Among women, infectious and hormonal disorders occur, menstruation disappears. Many suffer from inflammation of the kidneys due to frostbite and beatings. There are cases of critical exhaustion of the body — when people lose up to 40 kilograms of weight because they didnʼt eat well or starved for a long time. Almost all those released have problems with their teeth due to poor housing conditions, lack of hygiene, and bad water.

What happens to the psyche in captivity and after release?

In captivity, the protective mechanisms of the psyche are activated, which help to survive. However, the problem is that after liberation, a person continues to trust these mechanisms, which interfere with normal life.

Those who have been tortured may lose a basic sense of trust in the world and their surroundings. They have a high risk of developing post-traumatic stress disorder (PTSD). Released from captivity can lose the sense of time and space, because they were isolated for a long time and didnʼt know where they were. It is as if their internal chronometer is collapsing. It is difficult to understand what half an hour is, how long an hour is, how long it takes to get from home to some place.

It can be difficult to take responsibility — they are used to being punished for any choice they make. This is called the dilemma of choice. The released, on the one hand, are intolerant to not having a choice. On the other hand, it is difficult for them to make decisions. There is also a paradox of control, when a person doesnʼt tolerate being controlled by someone, because for him/her this is a sign of falleing into addiction again. But, at the same time, he or she tries to control the environment — itʼs scary to lose control, because it seems that something terrible will happen. Often, ex-prisoners withdraw into themselves and avoid everyone, because they think that this way they will heal faster. In fact, this is a big myth. Such injuries can be overcome only in contact with other people.

Another important point is that now a part of society is trying to heroize those released from captivity. For us, they are people of extraordinary will and strength, because they survived in conditions in which it is impossible to exist. But the prisoners donʼt feel like heroes. In captivity, they were humiliated, tortured, forced to watch others being tortured. They were in situations where they did not behave as they would have liked. For example, Russians torture a lot with electric current, and this is an unbearable condition that exhausts the body, affects blood vessels, and causes excessive anxiety. During such torture, something could happen that makes a person feel ashamed. Likewise, various body reactions occur during beatings. And this is normal, because there is a psychological and physiological limit when everyone can control themselves. But the released people are ashamed of this experience. Embarrassment can be overcome by explaining that they could not control their reactions at the time. There are no people who can endure torture indefinitely.

There are specific consequences of contact with the body. It is a witness to a traumatic experience, and therefore there are difficulties in treatment or medical examination. For example, when it is necessary to tell the doctor where the injury came from, the patient feels a wave of excessive anxiety. He or she can react aggressively to medical procedures — drips or injections, because many in captivity were injected with something, and under the influence of substances, people behaved inappropriately or did not remember what they did. Doctors have to explain several times why they are now giving injections, that this is a medical procedure. After being tortured with electric current, a former prisoner may refuse to have a cardiogram because it resembles torture. MRI and CT can also be a trigger because they are performed in a closed space.

Video of the American public organization "Boulder Crest Foundation", which is engaged in the rehabilitation of veterans and their family members.

How should the family respond to these conditions and communicate with the former prisoner?

The family must understand that their loved one has been isolated for a long time, without control over his or her life. This cannot pass without consequences. Your relationships may change, but you shouldnʼt treat the dismissed as sick. They need a family that gradually gives a person back control over his/her own life. Therefore, do not decide anything for them and do not face the fact that you have already planned everything, what will happen next.

Do not unexpectedly hug or touch the released person. In captivity, they were touched without warning — and now it can be frightening. In general, physical contact helps, especially hugs. But do it predictably, making sure that the loved one sees you and understands that you want to hug.

In captivity, everyone has to give up some of their identity in order to survive. Therefore, for some time after dismissal, do not focus on past experience. You donʼt have to say: “You always loved it.” You have to ask: “What do you want?”

It isnʼt necessary to ask what happened in captivity. If a person wants, he or she will tell and do it when the time comes. Also, you yourself must be ready to hear what happened in captivity. It is a difficult experience for everyone.

Maybe there are phrases or words to avoid? I want to support, but I donʼt know how.

Universal advice — respect other peopleʼs boundaries and use elementary rules of etiquette in communication. Phrases like “Iʼm so sorry for you” or “youʼre such a poor thing to have gone through all this” can offend. Better tell us what your feelings were while your loved one was in captivity, what happened to you, your family and the country during that time. Then a person will gradually put together the puzzle of the whole story, because in captivity there were no information about anyone.

It is important not to devalue the experience of captivity with the phrases “everything will pass” or “you look beautiful.” This is not taken as a compliment, it seems as if you are accusing a person of something.

Do the families need to adapt to the rhythm of life of the released persons? Maybe accompany them to treatment, change their daily routine, suggest going somewhere to distract themselves?

If you start doing this without asking permission, be prepared for an unpleasant conversation. Usually, those released from captivity ask their family to mind their own business, and they themselves will figure it out and adapt to everyone else. Do not try to surround your loved one with hypercare. If you see that he or she canʼt calculate the time for the trip to the hospital or some meeting, or gets lost in the days, ask permission to help — give a ride, go with the released or remind that itʼs time to go out. The main thing is not to press.

What should the family pay attention to in the behavior of the person released from captivity in order to understand whether there is progress? And if it gets worse, which specialist is better to choose — a psychologist, psychotherapist or psychiatrist?

Alarming symptoms can be painful memories, when a person falls into them and doesnʼt realize where he or she is. Systematic night terrors and sleep disorders, when sleep is broken, with constant awakenings. If a month or two has passed since the release, and the person reacts aggressively to anything and cannot control him- or herself. Lack of appetite or, on the contrary, inability to stop eating and gaining excess weight.

A very alarming sign is if a loved one avoids anything resembling captivity. Families pay the least attention to this symptom, because we have such a tradition of “not reminding”, pretending that nothing happened. In fact, this means that a person blocks off memories and cannot cope with them, and then they overwhelm him or her. In all these situations, a person needs to see a doctor.

You can turn to a psychologist, psychotherapist or psychiatrist for help. It doesnʼt matter to whom you come for the first consultation, all specialists work in tandem. If the psychologist or psychotherapist sees that the help of a psychiatrist who will prescribe medication is needed, he will refer to him. And vice versa, psychiatrists refer patients to psychologists, because medication alone will not help.

We constantly suggest that a loved one consult a psychologist in order to overcome the experience of captivity. But what to do when he/she refuses?

Not all those released from captivity will need psychological help in the future. We must always believe in the resources of a person, thanks to which he or she survived captivity and is now able to cope with this experience.

If you are very worried, you can hang, for example, the phone numbers of specialists on the refrigerator. A person will see, remember and contact if he or she feels the need. An unobtrusive way of conveying information can work, because one does not always have the strength to openly admit that a psychologistʼs consultation is needed.

If you see that the released from captivity has problems sleeping, he or she reacts aggressively to everything or is constantly apathetic, talk to him. Explain that a mental health professional can help with these problems. The main thing is to explain the meaning of communication with a psychologist so that it is clear what it is for: you will start to sleep better, you will be able to control yourself, painful memories will disappear, etc. It is also worth asking to share the experience of someone who was in captivity and turned to a specialist. Usually, families ask siblings or stepsisters to do it.

I feel that I cannot bear the load. Itʼs a shame to admit this, because it is more difficult for those who were captured than for me.

Family members of ex-prisoners may also experience secondary trauma. It comes from knowing that their loved one has suffered. Even if you are not told anything about the events of captivity, you still get this terrifying experience. You need help if you start lashing out at children, react angrily to some phrases or actions, sleep poorly, have obsessive feelings that something bad will happen, or nervous states when there is a desire to control everything. And remember — if you donʼt take care of yourself, you wonʼt be able to help someone close to you. Your well-being is extremely important for the adaptation of the ex-captive. Often, released persons ask psychologists to help not them, but family members, because they see how they lose their strength.

How long will it take to adapt to life after captivity — half a year, a year or longer?

It is impossible to predict. After captivity, someone can recover for several years, because he or she received severe physical and emotional injuries. And the other wants to return to fight already a few months after the release. Everything depends on who the person was before the Russians captured him, and what happened to him or her in captivity.

Translated from Ukrainian by Anton Semyzhenko.

The war left its mark on each of us. But there are people who need care a thousand times more, and we will provide it as long as we have enough strength — support the psychological help hotlines.