The persistent conflicts in the Middle East and Ukraine, among other places, shape global therapeutic practices by emphasising the importance of cultural sensitivity, trauma-informed care and a broader understanding of the interconnectedness of mental health issues worldwide. As the world grapples with increasing polarisation due to these conflicts, this article serves as an affirmation of the role mental health practitioners play in acknowledging this shared experience, on a personal and professional level.

It encourages exploration of how we can confront the global implications of war rather than letting them remain unexamined. Through these efforts, we can offer heightened support to clients affected by witnessing these conflicts from a distance, as well as to those directly impacted by war or those who have fled their countries in search of refuge. Together, our mission is to nurture empathy, comprehension and resilience in the face of this intensely emotional circumstance.

Stark contrast 

Let your imagination carry you away to a place of serenity and beauty. Picture yourself beneath the canopy of an English cherry tree on a radiant spring day. Close your eyes and feel the gentle caress of the breeze, carrying with it the scent of cherry blossoms. Imagine the warmth of sunlight, wrapping you in a soothing embrace, while the melodious songs of birds fill the air, creating a symphony of nature. As you look around, you’ll see families meandering along, their laughter and love blending harmoniously with the surroundings, like the sweetest of melodies. Just a short distance away, an elderly couple is preparing a picnic. 

This tranquil scene epitomises the idyllic beauty of a British countryside day, a moment of peace and joy that allows you to escape into the embrace of nature’s wonders. Yet, in a war-torn land, the contrast is stark. Amidst the heart-wrenching rubble of demolished buildings, innocent children find solace in one another’s fearful embrace, sheltering from the acrid miasma of destruction that lingers like a ghost. The gentle caress of breezes has been usurped by the howling tempests of violence, and the once azure skies now hang heavily with the shroud of uncertainty. Instead of the sweet serenades of birds, the air is pierced by the relentless wails of sirens and distant cries for help. Passersby, haunted by the spectre of danger, wear expressions etched with anxiety, and families flee in haste from lurking perils. In this harsh, unforgiving environment, acts of unexpected kindness are as rare as precious gems. And, amidst the turmoil, humanity grapples to endure the unyielding chaos.

Disparate worlds 

These two worlds depict vastly different realities; one graced with privilege and fortune, the other burdened by the weight of misfortune. Nevertheless, it’s crucial to understand that the fortunate existence is not shielded from the far-reaching impact of war experienced from afar. In the digital age of social platforms, we often find ourselves navigating these dual universes concurrently. While one enjoys the serenity of a tranquil countryside, the stark realities of war are just a click away on our screens. 

The paradox of global conflict can be bewildering, especially for individuals from adverse backgrounds who may struggle to fully comprehend the impact of war while living in relative peace. Various factors contribute to this, as individuals strive to reconcile personal struggles with issues associated with conflicts, causing dissonance with their own experiences. The contrast between personal adversity and large-scale global events can be disorienting – challenging hope and resilience, and potentially leading to a sense of hopelessness and bewilderment.  

Additionally, there may be an influence on identity and belonging, as individuals grapple with their sense of place and self when faced with conflict. The shifting dynamics and narratives can create internal conflicts and confusion about one’s identity and position in the world. Global conflicts cast an enduring shadow, affecting those directly thrust into the heart of war and those who bear witness to the unfolding tragedy through various media. These experiences may be distinct, yet the repercussions are profound and unique, shaping the emotional landscapes of each individual. 

For those directly witnessing the horrors of war, navigating the emotional labyrinth poses an extraordinary challenge. Fear and anxiety, born of relentless danger, leave indelible marks on the psyche. Even indirect war witnesses, who may never set foot on the battlefield, are not spared from tumultuous emotions, particularly those grappling with their own traumas. Witnessing war reignites dormant wildfires, turning past trauma into a raging conflagration.  

Parallels between prior experiences and the ongoing horrors of war intensify emotional turmoil. Witnessing war rekindles buried memories and emotions etched deeply into our being. These recollections harbour anguish stemming from past losses, enduring trauma, and lasting scars from experiences such as abuse, harassment, discrimination, racism and other forms of adversity. Amidst the chaos of war, individuals revisit past vulnerabilities, amplifying feelings of fear, anger and grief.

The emotional toll becomes an inescapable part of their journey, as they navigate the intricate web of emotions woven by the impact of witnessing conflict.

Solemn duty

As mental health practitioners, we bear a solemn duty to stand beside those affected by their struggles. We embark on a shared quest, contemplating the prospect of setting aside the divisive lenses through which we often perceive the world. As practitioners, it’s imperative for us to acknowledge and confront our unconscious biases, as these exert significant influence on our perceptions and interactions with clients. Being in personal therapy proves invaluable, especially when grappling with resistance or encountering unpleasant emotions triggered by indirect exposure to global conflict.  

This reflective process empowers us to establish a safe and non-judgmental environment, and to foster a space in which clients can freely express their narratives and emotions. Through proactive measures such as self-reflection, continuous education on diversity, and supervision, we can elevate our cultural competence. Implementing practical tools like regular self-assessment, participation in diversity training, and engaging in open dialogues about bias, supports us in navigating this process. This approach facilitates more empathetic and equitable treatment, thereby minimising the impact of preconceived notions on therapeutic dynamics. In addition, maintaining cultural competence is paramount. Staying informed about cultural nuances, tailoring therapeutic approaches to individual contexts, and cultivating continuous self-reflection on personal biases regarding war-related topics, contribute to providing unbiased and empathetic support. 

Tailored approach 

In the context of therapeutic practice, addressing the nuanced impact of indirect war exposure involves a tailored approach. Creating a safe space for clients to discuss their experiences, acknowledging their narratives and validating their feelings, are integral aspects of fostering a therapeutic environment that promotes healing and growth. Psychoeducation serves as a key element, providing information on trauma reactions, and normalising emotional responses to help clients comprehend and manage their experiences.  

Our sole aspiration is to encourage clients to openly process emotions related to their trauma, such as fears, anxieties, grief, anger, or feelings of helplessness. Cognitive restructuring plays a role in identifying and challenging distorted thoughts or beliefs connected to indirect war exposure, reshaping negative cognitive patterns. Equipping clients with coping mechanisms is essential while working with them through the process of unearthing buried emotions. The effectiveness of exploring internal conflicts and their connections to external triggers lies in identifying behavioural patterns. Key elements in this process include integrating cognitive-behavioural techniques, promoting mindfulness, maintaining a balanced lifestyle, and cultivating a supportive social network. 

To further support clients, therapists can employ a comprehensive set of strategies in their practice. These include implementing trauma-informed care and integrating cultural sensitivity into the work. Nurturing open dialogues, addressing trauma origins by untangling unconscious conflicts, and exploring any transferences that surface in the therapeutic relationship and its associations with the past and the present moment, are crucial steps in the process. This multifaceted approach enhances the therapeutic experience, fostering a sensitive environment for individuals from different backgrounds and cultures. Through these intentional approaches, we can effectively support individuals affected by global conflicts, assisting them toward healing, resilience, and, consequently, peace. 

Formative years 

My message springs from my formative years immersed in a region entrenched in conflict, where I weathered the tempests of war. Witnessing the impact of the Iran-Iraq war (1980–1988), shaped by division and strife, I gained an intimate insight into the lasting echoes that resonate through the lives of those touched by conflict. These initial encounters with adversity sculpted my personal odyssey, leading me through diverse emotional landscapes and compelling me to seek solace in humanity’s profound resilience. Bearing witness to the trials and triumphs of individuals navigating turmoil became the catalyst for my unwavering commitment to the field of mental health. 

It’s within this mix of personal experiences and professional endeavours that I discovered the profound impact of empathy when supporting clients grappling with the aftermath of global conflicts. In my practice, I’ve walked alongside individuals grappling with the turbulent emotional aftermath of conflict, where unseen wounds carve deep imprints into their very essence. These encounters emphasise the immense importance of cultivating a secure space where individuals feel empowered to voice their stories courageously, confront their traumas, and embark on their healing journey. 

I recall a client – an indirect observer of conflict – whose experiences unexpectedly mirrored aspects of my own journey. While our stories differed in specifics, they resonated on an emotional level. Through our sessions, as we navigated the fragmented aspects of my client’s self, acknowledged the divides within the internal parts, and worked through defence mechanisms shielding unpleasant emotions, we traversed through the corridors of buried emotions, confronting the haunting echoes of conflict within. Witnessing therapy’s profound ability to guide clients toward resilience and healing reaffirmed my conviction in the pivotal role mental health practitioners hold in addressing the enduring impacts of global conflicts.

Sharing these experiences, rooted in personal encounters with conflict’s profound impact, is an invitation to fellow mental health practitioners. It’s a call to acknowledge our unique vantage points and the transformative potential of our interventions when engaging with the echoes of war. By grounding our practices in the lived realities of individuals affected by conflicts, we elevate our therapeutic approaches beyond theoretical frameworks, and embrace the intricacies of human suffering and resilience. Through introspection, I endeavour to illuminate the path forward, one woven with empathy, tailored interventions, and a commitment to amplifying the voices of those touched by the far-reaching tendrils of conflict. My journey stands as a testament to the transformative power of therapeutic engagement when rooted in personal context and lived experiences.

In unity, we illuminate the complex emotional tapestries woven by these conflicts in our lives and strive for a world that embraces compassion and insight. Drawing from the well of human resilience, we transcend time and distance, offering hope for support and advocacy to all those touched by conflict. Whether we’ve personally weathered the storms of conflict’s challenges, or find ourselves as indirect observers of its aftermath, our insight into these inner dimensions empowers us to stand shoulder to shoulder with those who seek solace, offering unwavering support and deep comprehension.  

This may pave a path for individuals burdened by challenging pasts to uncover their inner strength to champion compassion and extend support to others affected by conflict. Together, we embark on a collective endeavour toward resilience, united in our shared commitment to mend a world marked by the ravages of war, and, in doing so, we sow the seeds of hope that will flourish for generations to come.