Continuous Collective Traumatic Stress Disorder: A New Concept from Ukraine for a World of Long Wars
Current psychiatric classifications use the term post‑traumatic stress disorder (PTSD) to describe reactions to traumatic events. It is a useful, but historically “peaceful” concept: the event happened, it ended, and now we are dealing with the after‑effects. For countries living through prolonged war, this assumption does not hold. The traumatic event does not end. It continues, changes, returns in new forms, and affects not only individuals but entire societies. To describe this reality, we introduce the concept of Continuous Collective Traumatic Stress Disorder.
Today’s Ukraine is a real‑time example of such a state. Shelling, losses, displacement, economic instability, constant anxiety for loved ones, chronic fatigue, information overload, political and social tensions — this is not “one trauma,” but a persistent background. A person does not return from “the event” to a safe environment. They live in an environment where threat and uncertainty have become normal. The same is true at the collective level: families, communities, professional groups, and whole regions are traumatized together.
Why PTSD Is Not Enough Here
Classical PTSD describes a reaction to a relatively time‑limited event: combat, an accident, a disaster, an assault. Even if the consequences last for years, the basic model assumes that there was a “before,” a discrete event or events, and now there is an “after.” Treatment is built around integrating memories, reducing re‑experiencing, and restoring a sense of safety.
In a situation of ongoing war, the key assumptions of PTSD are violated:
There is no stable “after” – the threat continues, people face new traumatic episodes again and again.
Trauma is not only individual but collective – entire families, communities, professional groups, and regions are affected simultaneously.
The baseline level of stress never returns to “normal” – the body and psyche live in a mode of chronic mobilization, which itself becomes destructive.
Triggers are not only memories but current reality – air‑raid sirens, news, fresh losses that keep unfolding.
In such conditions, the diagnosis of PTSD is not just imprecise. It can be harmful, because it creates the illusion that “the event is over,” when in fact it is ongoing. The person and the society are offered a treatment model that presupposes a peaceful background which does not exist.
What We Mean by Continuous Collective Traumatic Stress Disorder
Continuous Collective Traumatic Stress Disorder is a state in which:
Traumatic impact is prolonged over time, with no clear boundary between “before” and “after.”
Traumatization is massive, affecting large population groups.
Reactions to trauma develop not only at the level of individual psyche, but also at the level of social institutions, cultural norms, and collective behaviour.
Attempts at adaptation (individual and collective) take place in conditions where the threat does not disappear, but only changes its form.
This is not simply “a lot of PTSD.” It is a different type of process. The shift from post‑ to continuous is not a play on words; it demands a different logic of care.
Why This Opens a New Pathway for Help
If we honestly acknowledge that we are dealing with a continuous collective traumatic process, the basic goals and methods of care change.
The goal is not to return people to a “pre‑war normality” that no longer exists, but to support the maximum possible integrity of the person and the community under abnormal conditions.
Therapy cannot be only individual. We need group, family, and community formats, as well as changes in the organization of work, education, and the healthcare system.
The focus shifts from “treating trauma” to supporting a long‑term capacity to live and act: maintaining relationships, meanings, roles, small sources of joy, and a sense of belonging.
Stigma must be rethought. In conditions of continuous war, it is not a few “damaged” people but the entire fabric of society that is affected. This is not “weakness,” but a natural reaction of a system that has lived in extreme tension for too long.
In this sense, introducing the concept of Continuous Collective Traumatic Stress Disorder is not an academic gesture but the discovery of a new — and perhaps the only effective — pathway of qualified help during war. We finally name reality as it is, instead of forcing it into pre‑war schemes.
Ukraine as a Laboratory of the Future
What is unfolding in Ukraine today will soon attract the attention of doctors, psychologists, sociologists, and policymakers around the world. Prolonged wars, chronic crises, climate disasters, mass migrations — all of these create conditions where continuous collective traumatic stress may become typical rather than exceptional.
Our task is not only to survive in these conditions, but also to create language, concepts, and practices that will help others. The new term is only the first step. It must be followed by new protocols, new forms of support, organizational decisions, and, above all, a new way of relating to ourselves and to each other in a country without a rear.
You can learn more by reading our e-book or listening to our audiobook
Mykola Iabluchanskyi (Iabluchansky)
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