Reports of the war in Ukraine have focused on the deaths and injuries suffered by civilians, the destruction of towns and the battles fought by frontline troops. For good reasons, less has been written on the psychological cost of the war. Still, the psychological toll of a conflict of this magnitude is likely to be considerable.

A look at the physical casualties will give some idea of the severity of the fighting. In August 2023, US officials reported that the total casualties from the conflict were close to 500,000, with Ukraine suffering 70,000 killed and between 100,000 and 120,000 injured; they put Russian mortality at 120,000, with 170,000 to 180,000 wounded or sick. In October, UK Defence Intelligence analysts suggested a larger total of Russian casualties, somewhere between 240,000 and 290,000. Further, in September 2023, the UN Office of the High Commissioner for Human Rights recorded 27,149 civilian casualties in Ukraine since the February 2022 invasion, comprising 9,614 killed and 17,535 injured. Given these headline statistics, it is not surprising that levels of current traumatic illness and the persisting post-traumatic stress disorder (PTSD) once the conflict has ended are likely to be high.

We can look to psychology to give us a fuller picture. The mental health effects of wartime trauma are well-studied. So, what does the science have to tell us?

Psychological casualties of battle

In the aftermath of World War ll, American researchers studying hospital and unit records established that a positive association exists between the casualty rate and psychological breakdown on the battlefield. While factors such as morale, leadership and confidence in equipment may dampen the effect, it has been found for different nations and across time, from British soldiers in World War ll to Israeli troops in the Yom Kippur War and US forces in Vietnam.

Key studies in the 1990s looked at Israeli veterans of the conflict in Lebanon and, more recently, at US and UK forces deployed to Iraq and Afghanistan in counter-insurgency roles. This research has shown that veterans who suffer from post-traumatic illnesses often do not recover when treated with therapies that work well for civilians in peacetime. Soldiers are exposed to more trauma than civilians, and the factors that would normally protect them from trauma — such as group cohesion and a soldier’s identity — are diminished once they leave the armed forces.

It has also been shown that veterans who continue to suffer from troubling thoughts, intrusive memories of trauma and dreams of war meet the criteria for “complex PTSD.” This is a more severe and persisting form of PTSD characterized by negative self-beliefs, difficulty controlling emotions and interpersonal difficulties. The recognition of this distressing mental state has gone some way to explain why some veterans struggle with the challenge of reintegration to civilian life.

Treatments that work well for civilians suffering from PTSD often fail to resolve the symptoms of those with complex PTSD, but research is underway to find more effective interventions. Hopefully, any therapeutic gains can be offered to Ukrainian veterans.

Protective factors

While psychological casualties are inevitable, there are protective factors that will influence the final numbers.

Of importance is the fact that the Ukrainians are defending their homeland and families. Other conflicts have shown that troops fighting an invasion force often achieve success beyond their numbers. In March 1940, the Finnish Army halted a much larger Soviet invading force by inflicting heavy casualties on their infantry and destroying many tanks. In the summer of 1944, Finnish forces again defeated an offensive by superior Russian numbers before agreeing to peace terms. In Yugoslavia, partisans took advantage of mountainous terrain and dense forests, winning significant victories against larger and more experienced German forces and neutralizing the enemy’s superior equipment and air superiority with guerrilla tactics. In short, soldiers fight more effectively when they believe in what they are fighting for. Some research shows high morale may reduce psychological casualties, too.

Confidence in weapons has also been shown to protect against breakdown. There has been a progressive increase in both the quantity and range of military aid delivered to Ukraine. In June 2022, for example, the delivery of the US M142 High Mobility Artillery Rocket System (HIMARS), which enabled the Ukrainians to strike accurately from long-distance, improved their military capability. Reportedly, in the midsummer of 2022, battle fatigue among Ukrainian troops engaged in the region of Severodenetsk was significantly reduced after receiving a supply of modern artillery and missiles from Europe and the United States.

Studies of US and UK armed forces deployed to Afghanistan have shown that higher levels of unit cohesion, morale and leadership were associated with lower levels of psychological illness in high-tempo combat operations. These factors not only rely on the selection of soldiers for positions of authority but also on the creation of a military culture in combat units that sets standards of behavior.

Before the Russian incursion into the Donbas and the occupation of the Crimea in 2014, Colonel-General Henadii Vorbyov had begun to redesign the training and education of Ukrainian ground forces to move away from the traditional Soviet model. The reforms were targeted at senior sergeants and junior officers. Subsequently, individual soldier skills and battalion level operations were taught with the assistance of NATO nations to generate higher levels of professionalism.

Lastly, although conscription can lead to the enlistment of unwilling soldiers, when a nation’s existence is threatened, this is less of a factor. Conscription can add diversity and skills not normally found in regular armies. Recruitment across age groups can promote the feeling of an entire nation at war for a common purpose. Hence, there are grounds for thinking that the Ukrainian armed forces have established the foundations for a psychologically resilient fighting force.

Studies of Western nations have shown that when soldiers and veterans feel supported by friends, family and the civilian population as a whole, it protects against psychological illness and aids psychological recovery. A Chatham House survey of Ukrainian civil society in December 2022 showed that, despite economic hardships, 72% of Ukrainians had donated money to support the war effort. Whilst it is possible to exaggerate the protective effect of a “blitz spirit,” the resilience of civilians exposed to bombardment has been demonstrated in many conflicts, including the Siege of Sarajevo and air raids on Nanking in August 1937 and Barcelona in March 1938.

Ukraine may have the strength to come through, but there will be damage

Ukraine is fighting for its own existence, and history tells us that people defending their homelands often have a resourcefulness that surpasses their numbers. But there are other factors that make the war an especially challenging one from a psychological standpoint.

The Ukrainian conflict resembles World War l in the extensive use of trench systems and artillery. With little movement, the fighting has an attritional character. Because Russia has well-established defensive systems, Ukrainian forces have encountered considerable difficulty counterattacking through extensive minefields and across physical barriers. As in World War l, Ukrainian commanders face the challenge of maintaining the morale of an army faced with a lengthy frontline no immediate prospect of an easy breakthrough.

It is difficult to consider long-term outcomes while the prospect of peace remains unclear. However, the numbers of killed and wounded leave little doubt that there will be a need for psychological therapy in the post-conflict period.

In both World Wars, psychological casualties were between 5% and 30% of the wounded and sick, depending on the intensity of the fighting. Given that the Ukrainian armed forces have suffered an estimated 100,000 to 120,000 wounded, we could extrapolate that somewhere between 5,000 and 36,000 soldiers will suffer from psychological wounds.

However, as the Prussian military theorist Carl von Clausewitz argued, in war, “moral factors” are often more important than physical factors, such as weapons, logistics and terrain. By moral factors, he meant an essential spirit that governs the will to conduct military operations and was expressed through adaptability, determination, and stamina. Moral factors, for Clausewitz, were the ultimate determinants of war.

Whilst modern research has shown that these variables do not confer absolute protection against psychological wounds, they can mediate the effects of trauma. Ukrainian forces resisting and driving back a larger invasion army have provided practical weight to Clausewitz’s theories.

[Beaudry Young edited this piece.]

The views expressed in this article are the author’s own and do not necessarily reflect Fair Observer’s editorial policy.