Daily Ground: Psychological First Aid for Yourself and Those Around You During Prolonged War

Introduction

1. What This Book Is For

In many places on this earth, armed conflict does not end in weeks or months. It stretches across years and decades, quietly reshaping entire generations — their bodies, their relationships, their capacity to trust, to rest, to imagine a future. The psychological wounds of prolonged war are among the least understood and most poorly served challenges in global mental health today.

This book was born in one of those places. It was written first for a Ukrainian audience — people living through the fifth year of a full-scale war with Russia, and more than a decade of conflict overall. It was written from inside that experience: not as observers, but as people who know what it means when the threat does not end, when the nervous system never fully stands down, when "after the war" remains an uncertain horizon rather than a lived reality.

Precisely because of that origin, this book carries something that cannot be constructed from the outside: the knowledge of what actually helps when prolonged danger is not a subject of study but a daily fact of life.

The authors decided to adapt and translate it into English because the experience it addresses is not uniquely Ukrainian. Prolonged conflict, chronic collective trauma, and the psychological cost of years lived under threat are realities for millions of people across the world — in the Middle East, in Africa, in Asia, and increasingly, in the form of other sustained crises, in societies that once considered themselves safe.

The Ukrainian experience is the source. The human experience is the subject. This book was written for people in Kharkiv and Kherson — and it was written for anyone, anywhere, who knows what it means to live for a long time without safety.

This book is not about heroism, and it is not about how to "always hold it together." It is about how to get through to tomorrow while still remaining yourself — outwardly and inwardly. It is about small, manageable steps of support in a reality where the large decisions and large events are largely beyond our control.

One important clarification: this is not a medical manual, and it is not a guide to self-diagnosis. It does not replace a doctor or a therapist when those are needed. Its purpose is to offer language, simple tools, and pathways toward people and services — not to give anyone a label.

2. Prolonged Trauma and the Term CPTR

International classifications recognize the terms "PTSD" (Post-Traumatic Stress Disorder) and "Complex Trauma." They describe the psychological responses that follow severe events.

But the Ukrainian experience — and the experience of many others living through ongoing conflict — is not life after an event. It is life inside an event that has not ended. For millions of people, the war has not concluded; it continues across years, changes shape, but does not disappear.

In international clinical literature, the closest recognized term is Complex Post-Traumatic Stress Disorder (C-PTSD), described in ICD-11. What this book calls Complex Persistent Traumatic Disorder (CPTR) overlaps with that concept but extends it: here the trauma is not post — it is present, ongoing, and without a clear endpoint.

We use CPTR as a human description of life under prolonged danger — not as an official medical diagnosis. It is an attempt to name the reality in which the nervous system lives for a long time in a mode of: alert — mobilize — hold on.

We will not write "you have CPTR." We will say: "what you are feeling is common among people who have been living the way you have. In this book, we use the term CPTR when..." This is a word that helps you understand yourself and others — not a label that condemns.

3. What Psychological First Aid Means During a Long War

Psychological First Aid (PFA) is humane, simple support for when someone is struggling. Not treatment, not "repairing the psyche" — just the basic steps of care:

• noticing that something is happening — in yourself or in someone nearby;
• gently calming the body and the breath;
• giving the sense that a person is not alone;
• helping to see the next manageable step forward.

This book focuses specifically on the emotional and interpersonal steps of PFA — for yourself and for the people around you: children, partners, elderly relatives, colleagues, people in your care. There are no instructions here on logistics or shelters — only on what can be done through words, presence, and small actions.

4. Different Experiences of the Same War

The front line, cities near the front, relatively quieter regions, evacuation, life abroad — all of these experiences are woven into the same fabric of prolonged trauma.

Some people have seen the front at close range. Some live under regular shelling. Some have never heard an explosion but have lost their home, their work, their familiar life. Some live in another country and every day balance between two realities.

None of these experiences "deserves" more or less support. If things are hard for you — that is already sufficient reason to look for support. If things are currently easier for you than for others — that is not guilt, it is a resource. If things are harder — that is not weakness, it is the reality you are living in.

5. How to Use This Book

This is a tool, not a novel. It does not need to be read from beginning to end.

You can open it at whichever chapter feels most urgent right now — by state (exhaustion, anxiety, sleep, loneliness) or by role (children, partners at a distance, elderly relatives, commanders, medical workers, teachers).

Choose only what feels manageable right now. If an exercise doesn't land — you have not broken anything, and nothing is wrong with you. It is simply not the right tool for this moment. You can try another, or come back later.

If you are wondering whether things are "bad enough" to ask for help — that question itself is a sign that things are hard. Reaching out is normal. It does not "take resources away from those who have it worse." It increases the chances that you yourself will not fall.

6. Spiritual, Cultural, and Community Resources

For some people, prayer, ritual, a place of worship, or a community helps. For others — books, music, volunteering, humor, art. For others still — conversations with people who have been through something similar.

This book will occasionally mention spiritual, cultural, and community practices as possible sources of support — but we are not prescribing any of them. You have the right to choose what resonates with you and what does not. Support is not always something "correct" by someone else's standards. It is whatever genuinely sustains you and causes no harm to others.

7. Red Flags

There are situations where self-help is not enough, and live people and services are needed.

Pay particular attention if:

• thoughts or plans of harming yourself appear;
• there has been almost no sleep for several nights in a row;
• panic attacks are recurring frequently;
• there is a feeling of "I am not in reality" — strong confusion or disorientation;
• there is a risk of harm to yourself or others.

In these situations, what matters is not the name of the condition — it is the step toward people:

• Say to someone nearby: "I am in a very bad place. I am afraid I might hurt myself. I need help."
• Call a crisis line, your family doctor, emergency services, or any support service available in your area.
• Do not remain completely alone, as far as your circumstances allow.

This book can suggest words and steps — but it does not replace live help. If you are hesitating about whether to call or speak to someone — do it.

8. This Is Not an Exam

This book is not a test of strength, correctness, or endurance. It does not need to be completed "properly," and certainly not all at once. If right now you have the energy only to read a few pages, stop, put it down, and come back later — that is completely fine.

If an exercise did not work for you, that does not mean something is wrong with you. It means only that in this moment you need a different pace, a different approach, or a different kind of support.

On hard days, small is enough. Sometimes it is enough not to "pull yourself together" — but simply not to stay alone, to drink a glass of water, to write to someone, to step into the light, to take one manageable step.

This book was not written to demand more from you than you are able to give. It was written so that in the moment when things are hard, you have something close at hand — something real to lean on.

More about this topic can be found in our book "Daily Ground: Psychological First Aid for Yourself and Those Around You During Prolonged War" on Our Books on Google Play.

Mykola Iabluchanskyi together with Andriy Yabluchanskiy