«I can see the assault of positions in my dreams». Why are many soldiers deprived of psychological recovery?

An enemy assault, an empty rifle mag, and one-on-one in a trench with Russian soldiers. Having miraculously escaped possible captivity, 36-year-old soldier Dmytro Holovko now sees that day in his nightmares. Yet here, at a psychological rehabilitation center in the Kharkiv region, he can sleep peacefully and distract himself from haunting memories. The two-week rehabilitation helps 95% of the soldiers, local therapists say. However, the center lacks funding.

 

36-year-old Dmytro Holovko stepped on his military path in 2016 as a mortar operator in the 72nd Brigade. After serving three years under contract during the Anti-Terrorist Operation (later Joint Forces Operation) he rejoined the ranks in 2022. He received his new call sign “Dobryi”(“Kind”) in Bakhmut during his service as a rifleman in the 44th Battalion.

 

 

“I’d give you the call sign “Dobryi” because you are calm and hard to intimidate. Why don’t you be “Dobryi”?” his comrade suggested to Dmytro. After that, “Dobryi” served in eastern Kreminna, Makiivka, and from the end of 2023 in Lyman, where he “miraculously” escaped Russian captivity.

One step away from Russian captivity 

Dmytro and his brother-in-arms with call sign “Parovoz” (“Train”) was heading to his position all night the day he was nearly captured. When he left in the evening, he got under Russian fire, suffering at least the 15th concussion in his entire service and bruising knees. Having finally reached his position, the soldier had an hour to rest before the Russian assault started. Dmytro fired off all his ammunition to hold it back. Only his comrades, who were in another dugout 30-40 meters away, had more ammo.

“There were a lot of enemies coming. Just when I ran out of ammunition. I took some from my men and returned to the post. I was just getting out to see if anyone was coming when someone tapped me on the shoulder, a hand wrapped in a white bandage. The foe,” Dmytro recalls.  

 

 

“’Sup, are you from our unit?'” he heard, and then he saw three Russian soldiers standing next to him. Dmytro still remembers every smallest detail: all three of them wore different uniforms: Ukrainian “pixel,” Russian marsh-colored camouflage, and plain green clothes. The commander had the call sign “Belyi” (“White”) on his body armor.

“Yes, I’m one of your men. Everything is fine,” Dmytro answered, instantly switching to Russian. This language has helped him lots, as he knew it since childhood. What also saved him is that he forgot to wear green armband that distinguishes Ukrainian soldiers from Russian.

“We’ll find out this, and whoever broke through the defense,” Dmytro heard from “Belyi.”

“Yeah, I wasn’t going to say that I was holding the line. I told him that it was me who broke through,” the soldier continues. 

“Belyi” sat down to rest, still pointing his assault rifle at Dmytro. 

“For a hot minute, I felt too stunned to speak. I didn’t know what to do or what was going on. I still had no ammo. If I started reloading, I would be shot down from three sides. Then I decided to run away because that was the only way to be saved. So I took this chance, and thank God I’m here,” says Dmytro. 

“Parovoz” ran along from Russian troops and waited out the assault, hiding deep in a trench.

After returning from his positions, “Parovoz” was immediately sent for medical treatment. However, he did not reach the hospital, and to this day he’s out of contact with his commanders. After that assault, Dmytro refused to return to the battlefield.

“I reported to the command that I didn’t want to redeploy. I would rather be in prison than there. That’s why they sent me to the rehab,” says Dmytro.

“I was waking up all shivered”

That encounter haunted him during nightmares for a long time. Dmytro still suffers from panic attacks, but he doesn’t mind talking about his experience. 

“I think about it all the time anyway.”

“For the first eight days, I kept dreaming that I was guarding my position. I slept for 1-2 hours during the day because I couldn’t at night. If I did fall asleep, I kept seeing the assault and myself in the trench. I could be in other trenches, but the unit was also constantly being attacked, the foes were everywhere. I would wake up all shivered, unable to figure out where I was,” says Dmytro.

After these events, the soldier got into a psychological rehabilitation facility.

Psychological recovery

After the first week of his treatment, Dmytro could sleep again, for 4-5 hours and, most importantly, at night. He has a massage every day, physical treatment sessions and goes swimming. These procedures, classes, and conversations with therapists distract him from the nightmares he sees every day.

 

 

The psychological recovery program includes exercises, such as physical therapy, swimming pool, Nordic walking, and adaptation games aimed at emotional relief and adrenaline release. The soldiers also visit physiotherapy procedures, including laser, electrophoresis, amplipulse, etc., to improve blood circulation and restore damaged tissues.

 

 

Military psychologists and doctors, like Colonel Ihor Prykhodko, PhD in Psychological Sciences, created and continue to develop the program. He says there are only a few similar centers in Ukraine. The rest are mainly engaged in rehabilitating veterans. Two-week psychological rehabilitation lets soldiers rest, relax, and then gather their strength again to continue performing combat missions.

“We have created certain conditions for them to recover so that they don’t say that everyone has abandoned them. We find the emotional support that they have, which is usually family, friends, parents,” says Prikhodko. 

 

 

About a third of the soldiers at the center are visited by their families. Here, they can stay with them for the entire rehabilitation period and spend two weeks together, away from the front and at home. Family support is crucial for the servicemen, the psychologist assures.

“When there is family support, a close connection, the soldiers stay motivated. I believe that family is the main morale driver nowadays. What is patriotism? What is the state in general? It’s actually family, friends – all our loved ones,” says Prykhodko.

«Having healthy legs and head is 90% success»

His words are approved by Volodymyr Meleshko, a 46-year-old rifleman with the call sign “Doc.” Three years ago, he lost his 17-year-old son Denys, who died from cancer. Volodymyr wears a crescent-shaped Cossack-style earring in his left ear in memory of him.

 

 

“Well, that’s life. Nowadays, many children are left without parents. Perhaps we will adopt one of them. It’s an open topic for me and my wife. We just need the war to end,” says Doc.

Volodymyr lived and worked near Myrhorod in the Poltava region. When Russia started the war against Ukraine in 2014, he was a chief veterinarian at a dairy and breeding complex and had a wife and a small child. In 2015, he signed a contract with the Ukrainian forces.

“I stood against being part of everything we tried to toss away, like Russia and the USSR. So, I joined the army for the sake of this idea and my family because I didn’t want my children to grow up in the way I did. We are not here for MPs, presidents, or anything global. The vast majority of soldiers are here to protect their families,” says Doc.

 

 

Nine years later, Volodymyr still serves to protect his family. Today, he is undergoing treatment for his legs. For the last six months, Volodymyr’s unit has been stationed near Kreminna. During this time, he says, the war has changed dramatically because of drones—now, mobility and speed are even more important for a soldier.

“For a fighter, having healthy legs and head is 90% success. I have enough morale to return to the battlefield. I just hope my legs won’t let me down,” says Volodymyr.

Reintegration into civilian life

Dmytro is not ready to return from the frontline. He is afraid that at a critical moment, he might have a panic attack that he wouldn’t cope with.

 

 

“I am quite mentally drained. While I am recovering here, obviously, everything is fine. But sooner or later, God forbid, my luck may run out. It seems to me that serving 6.5 years is the right duration. I can already say that I have paid my debt to my homeland. Should I stay there and die?” asks Dmytro.

Former ATO soldier and now an all-out war fighter, he wants to return to civilian life as soon as possible. When asked if he is ready for this, the soldier assures us that he will be law-abiding.

“I am a calm person. I have not committed any offenses, I have not been in prison, I have not broken any laws. Some people say that veterans cannot adapt to civilian life. I think they are wrong,” says Dmytro.

The soldier is convinced that he will never forget the horrors he experienced in the war. However, his reintegration into civilian life, away from the trenches and explosions, is a chance for him to get rid of nightmares, flashbacks, and panic attacks.

“All the shelling, all the contusions didn’t “poof” anywhere. When you see your comrades torn apart, you can’t get it out of your mind. No therapists can help with this. When I get back to civilian life and work, these images will certainly pop up in my head, but not as often as at the position. When I hear explosions, I can see these visions clearly,” says the soldier, adding that no one lives forever, and many soldiers need to be retired.

Morale regaining

Although psychological and medical rehabilitation is provided by psychologists or doctors, some soldiers anonymously admit to having threatened their commanders with AWOL (absent without official leave) to get here. All of them complain about the lack of rest.

 

 

“If it’s a good-witted commander, he understands that his soldier is exhausted and needs to recover, so he should either send one on vacation or to a center like ours,” says Ihor Prykhodko.

International military experience has shown that a person can stay sharp on the battlefield for 3 to 6 months without rotation. However, the studies were conducted among soldiers in Iraq and Afghanistan with less intense fighting than in the Russian-Ukrainian war. Soldiers he regularly talks to confirm this information. 

“The men say that they fight for about six months and then run out of morale. They continue either on their own spiritual strength, force themselves, or find some kind of motivation,” the psychologist says.

 

 

Acute and chronic stress, traumatic events, exhaustion, so-called “trench sickness,” etc., lead to various negative states among the soldiers. They may become anxious and aggressive, and some may experience suicidal thoughts.

From this point of view, the military are particularly vulnerable, as they fight for the first 3-4 months (adaptation period) and for 1-1.5 years. Then, as Prykhodko explains, the body exhausts its resources, and a person may reach a depressive state, which can lead to suicide. To prevent this, psychologists should start working with the military right now. Prykhodko states there is a shortage of specialists and psychological recovery centers in Ukraine.

 

 

“What we do first is de-stress the soldier and then settle him for further service. This is a completely different challenge and requires another program, unlike for the veterans. Unfortunately, Ukraine has a huge problem with the number of such rehabilitation centers. They need to be scaled up so that every frontline region has this facility. Some men are sent to Ukraine’s western regions, but this is a complicated logistics issue. One thing when they arrive here, but it takes a day to reach the place and another day to get back.”

 

 

Psychological rehabilitation helps 95% of the incoming soldiers, which is evidenced by the results of diagnostics conducted at the beginning and end of rehabilitation, and feedbacks from the soldiers.  The remaining 5%, require longer rehabilitation. The center provides recommendations, and in some cases refers them to a hospital for a consultation with a psychiatrist.

Seeking a dollar tree

Deputy Director Stanislav P. (surname withheld for security reasons – ed.), Ukraine’s National Health Service plans to boost military rehabilitation services at new medical departments. However, since April 1, the institution has limited funding. The state follows a newly approved rule by stopping paying for excess recovery services if a medical facility exceeds its rehabilitation capacity by over 30%.

 

 

“We employ 15 professional physical and rehabilitation doctors, 12 physical therapists, and over 30 therapist assistants and rehabilitation nurses. Our capacity allows us to treat 280 patients monthly while having 2.5 times more beds. If we increase our capacity by 30%, we have to pay more to a doctor who works one and a half times the rate. If we expand, we will need additional payments for treatment, food, and accommodation,” says the doctor.

The restriction, which arises from the capacity of the institutions introduced in April, applies only to inpatient rehabilitation. The state pays for the rest of the medical services for all patients but not for accommodation and meals. The institution’s chief board is forced to charge extra to ensure that all patients receive rehabilitation.

“It is not forbidden. But what should we do with the soldiers? We cannot refuse giving them help. The government may imprison me, but I will not refuse to assist. We stand still on what we have been doing since the beginning of the war.” 

Aside from the funding issue, the institution lacks medical specialists. Neglecting rehabilitation can lead to inevitable consequences, Stanislav P. reassures, citing statistics on suicides among American veterans.

 

 

“These people had no protection. They were returning from the war and the society just pushed them away. Let’s think about what to do about it. Now with the war raging, let’s treat them as equal Ukrainian citizens!” the doctor says, hoping for an understanding of the state’s healthcare system. Solving the funding problem will allow rehabilitating more soldiers, modernizing medical equipment, improving living conditions and introducing newer, more modern practices.

 

Text: Viktoriia Kalimbet; Photo: Yakiv Liashenko, Nadiia Karpova