The Invisible Wounds of War

Have you ever lived in a war zone? 

If you haven't, have you wondered how to best support your friends and family that have or are living in these areas?

The best place to start is to educate yourself on the impact armed conflict zones have on the people living there—physically, mentally, emotionally, relationship and spiritually.  I learned quickly when I was a mental health first responder to armed conflict zones that securing physical safety precedes any type of mental health care intervention and the importance of leaving all preconceived ideas of “what could help” at the door. 

Physical safety, food, clothing and shelter are necessary.

There is no amount of words or convincing someone to address mental wellbeing when they are not physically safe. Physical safety underpins the person's healing journey, so when 1 out of 4 people live in these zones supporting their fear of being physically harmed is a reality. The mind and body will not be able to rationalize they are safe when clearly they are not. Validating that their fear is normal, their need to survive is normal and their feeling dysregulation is normal. The trauma experience of war is not normal. And often once their physical safety is secured some of the mental health symptoms will subside.

So, how do you best support them? You can provide hope. Hope is necessary to sustain their day to day living and this is paramount, because they never know what tomorrow will bring. You can provide a calming presence, a listening ear, and an understanding heart to hold space for all of their fear, dysregulation and confusion. 

By being present and attuning to their heartache you bring hope. The hope that someone actually sees and hears them. In this presence you show them you care, and that matters. And that will help them survive the day to get to tomorrow.

If your loved one is willing to talk about their experience, follow them into the conversation (don't push them into it) and use phrases like:

1. Tell me more about your experience...
2. Would you like to keep talking?
3. How can I be helpful to you in this conversation?
4. What do you need from me right now?

Let's dig deeper and learn more about the effects of war.

Although war is a devastating force that not only affects adults, it also takes a significant toll on children particularly those living in conflict zones. According to Save the Children, 449 million children worldwide live in conflict and 1 out of 3 children in the Middle East live in armed conflict.

This data precedes the invasion of Hamas in Israel, and emphasizes how many generations of people have grown up in armed conflict, where their sense of physical safety and security are at risk every minute of the day.

The psychological and emotional trauma of war and living in armed conflict can leave deep-seated, invisible wounds that can last for years and even decades after the conflict has ended.

The science of epigenetics, how ancestral trauma is passed down through generations, sheds light on the lasting effects of war. Genetic trauma is inherited trauma. The experiences of everyone, including the children often-overlooked psychological impact on those who are not directly involved in the fighting.

The sights, sounds, smells, tastes and feels of war are felt by all involved, even as they shelter in bunkers. The impact of war on the nervous system can be significant, particularly for individuals who have experienced direct or indirect exposure to violence and trauma. 

The nervous system is responsible for regulating many of the body's essential functions, including heart rate, breathing, and stress response. Exposure to war-related trauma can disrupt the body's natural stress response system, leading to a range of psychological and physical trauma response symptoms. 

Living in a war zone is a harrowing experience that induces fear, anxiety, and uncertainty.

The constant sound of gunfire, explosions, and screams can cause severe psychological distress, leading to depression, post-traumatic stress disorder (PTSD), and other mental health problems. Civilians also face the risk of being caught in the crossfire, experiencing physical injuries, and witnessing the death of loved ones. The loss of homes, livelihoods, and basic necessities like food, water, and electricity can also exacerbate the psychological impact of war on civilians.

There is also a silent impact of war on the nervous system of those who have not experienced direct trauma. Family members and loved ones of individuals affected by war can also experience nervous system impacts, such as increased stress and anxiety. The uncertainty of not knowing if their loved ones are safe, the fear of losing them, and the grief and bereavement that follows can all contribute to the development of nervous system-related symptoms. 

When you do not have the experience of living in an armed conflict area, it doesn’t allow you to truly understand what your friends and family are going through, however, we do need people whose nervous systems are regulated providing support through listening to the experiences of those who have been traumatized. When you focus on their experience and truly see, and hear them you provide a moment of "safety" for your friend or family member. If only for that moment they are seen and heard, then hope can grow.

Also, an important note ... whenever I work with people recovering from trauma in combat or armed conflict zones I never talk about the politics of the situation. I have learned there is so much nuance and complexity to war and my job is to help this person find healing. If they want to speak about their experience from a political standpoint, I listen. But my opinion really doesn't matter as much as giving them hope.