A postcard from Belgrade

By Ivan Kos, PhD

During a recent visit to Belgrade, April 24 to May 4, I not only had the unsettling experience of bombings, an earthquake and electrical blackouts but witnessed the traumatization of the civilian population by NATO's bombing.

The result of the first week of bombing was acute stress, expressed by intense fear, helplessness, depersonalization, derealization and "being in a daze."

When air raid sirens began sounding, fear-based physiological symptoms were reported: extreme trembling of hands, legs and voice; frequent urination and diarrhea; intense and sudden attacks of chills; tightness and dryness of the throat that interfered with speech and led to chronic sleeplessness. People urgently sought news updates from TV or radio.

Togetherness was also important. Citizens gathered out of concern for safety, but also to be close emotionally and physically to their families and neighbors. Many were drawn to the basement bomb shelters for the latter reason, and out of fear of the unknown. Psychological relief came in sharing the common misfortune--the bombing--and through participating in common activities, such as cleaning basements, exchanging candles and communicating news and other useful information.

In the second month of bombing, chronic psychological symptoms of distress included hypersensitivity to sound, edginess, loss of concentration and memory, anger, extreme fatigue and prolonged sleep, exhaustion, stomach pain and cessation of menstruation. Fear-based friction-argumentativeness around logistics and noise in the shelters, as well as bickering over the general situation led to lessened usage of basements and shelters. Close relationships were kept only with family and friends with similar opinions and beliefs.

After the second month, boredom became a problem. Most citizens spent their days waiting for bombs to fall. Outside movement became restricted only to the close proximity of one's home. The telephone, a tool against isolation, loneliness and fear, was the most commonly used source of social interaction. Throughout this three-month period the common sentiment among citizens was a feeling of being caged and trapped while being bombed. Since most family members were not working and children were not attending schools, psychological problems rose. Smaller children who spent most of the time in shelters were more traumatized than children who stayed at home. Also, children who were separated from their parents and sent to other relatives in safer areas, as well as children whose fathers were mobilized, were more adversely affected than children whose families were able to stay together.

Older children and adolescents were the most vulnerable group. They watched the news and understood the severity of the situation. They feared for their parents and themselves, but did not know how to cope. Further trauma was caused by the clash of the two parallel worlds in which they lived: Through the media they felt strong identification with the Western culture, particularly with the United States, while at the same time the bombs and death were coming from the NATO airplanes.

Such conflicting beliefs create a cognitive, moral and emotional rift. Their reactions were divided: denial of the existing situation; strong supportive feelings towards their own people and hate directed toward the West; hate directed toward their own people and a desire to move to and live in the West; and feelings of isolation, loneliness and fear in the face of everything they did not comprehend.

The adults' biggest concerns centered on taking care of their children all day long. Fearful of daily bombing, many elderly parents moved in with their children. This stressed all family members. Many families were facing financial difficulties from unemployment, significant salary decreases, irregularity in receiving pensions and reduction of daily living standards.

Men, as a second most vulnerable group, felt hopeless and frustrated over being unable to protect their families from the bombs, to earn any or enough income, and to serve effectively as soldiers since the enemy was high above and out of reach. Women were affected by the same psychological stressors, but were also stressed by their husbands' or children's unhappiness and pain. Many took on the role of providing emotional support to raise family morale.

The elderly population was prone to depression, heart attacks and suicidal gestures. Their apathy and lack of desire to live were reinforced by experiences and memories from World War II and were fueled by disappointment that their old allies were now bombing them. Many couples experienced emotional as well as ideological conflicts, and some even drifted apart emotionally.

I have great concern for the future emotional state of the whole population of Yugoslavia--especially children and the elderly--and the further psychological consequences that may occur as the peacekeeping phase begins.

Ivan Kos is president of International Psychotherapy Associates in New York City and an editor of International Psychology Reporter, the publication of Div. 52 (International).



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