The mental health of children is severely compromised by war and
consequent displacement. Nations have a duty under various UN
agreements to alleviate the effects of war on children’s mental health.

Professor William Yule

UNICEF recently estimated that over 80% of the victims of todays Warfare is women and children. Children who are a vulnerable group have suffered severe traumatic events during the Eelam War. Children of the North as well as of the South have experienced many anxiety related conditions as a result of the 25 year armed conflict in Sr Lanka. They are traumatized children and have various behavioral problems. They are at a high risk of developing numerous psychological ailments. As Ana Freud & Burlingham stated in 1943 Children are always the most vulnerable and generally more exposed citizens in countries where declared and undeclared wars rage.

There has been many research world wide that indicate children of the war zones undergo severe psychological trauma. The research in Gaza, Rwanda, Mozambique and Cambodia reveal children who were exposed to war and atrocities are at a high risk of developing PTSD. Abdel Aziz Mousa Thabet of Gaza Community Mental Health Programme and a Senior Lecturer in Child and Adolescent Psychiatry, University of Birmingham did a study to estimate the rate of Posttraumatic stress reactions in Palestinian children who experienced war traumas, and to investigate the relationship between trauma-related factors and PTSD reactions. The sample consisted of 239 children of 6 to 11 years of age. 174 children (72.8%) reported PTSD reactions of at least mild intensity, while 98 (41%) reported moderate/severe PTSD reactions.

Organized and institutionalized violence like war can affect children in many ways. The effects of traumatic events on children are even greater when that trauma is due to modern warfare. In Sri Lanka a large number of children have been exposed to war trauma. There are numerous case examples which show the occurrence of anxiety reactions among the affected children.

Little K was nine years old when she became a victim of a cross fire between the armed forces and Tamil militants in the North. She sustained a gun shot injury to her left arm. She underwent a traumatic amputation of the left hand. The doctors were compelled to perform this operation in order to save her life. After the operation she was taken to an orphanage in Mulangavil in Killinochi district. She has fear feelings, night terror, bed wetting, hyperarousal and alienation. Traumatized war- zone children like little K carry the psychological scars throughout their lives.

Children who have experienced or been exposed to war trauma may have numerous symptoms including trauma based behavior. They often have anxieties and insecurities that can cause them to perceive every aspect of the world as being unsafe and frightening. The grow up with a generalized fear and hostility which affects their future lives. Trauma is often associated with intense feelings of humiliation, self-blame, shame and guilt, which result from the sense of powerlessness and may lead to a sense of alienation and avoidance. Therefore the initial trauma could become a vicious cycle.

Following case study gives a crude assumption of the longitudinal effects of psychological trauma on children which can affect their later lives.

Master S was 12 years old when 1983 communal riots erupted. His family was hiding in a nebhouring house to evade the mob attack. The attackers burnt their house while Master S and his kid sister hiding under a bed in their Sinhalese nebhour s house. He could hear the shoutings of the mob and the schreemings of the victims. Master S had fear feelings and he thought that the mob would kill him. These fears lasted for many years as he grew older.

Following day their kind nebhour with the help of the Police took them to the refugee camp at Bambalapitiya Kadirashan Kovil . Before going to the camp Master S had a quick glance at their house which was completely destroyed by the fire. He felt sorry for loosing his books and toys.

After spending several months in the refugee camp his father was managed to get asylum in West Germany. For many years S had a nostalgic feelings of his lost books and toys also fear that a group of people would come and attack him unexpectedly.

After coming to West Germany S underwent a prolonged cultural shock and frequently felt a misfit in the Western society. He became more isolated and neglected his studies. As a teenager he became more and more hostile and frequently had conflicts with the parents. After spending 12 years in West Germany S moved to Canada and got married. But he always felt the empty space and became emotionally numbed. On some occasions he could not control his temper and engaged in domestic violence. His violent outburst resulted an injury to his wife and S was charged by the Canadian Authorities. Today he is serving a prison term.

Children who had witnessed the war trauma and atrocities can have diminished cognitive abilities. They frequently have learning difficulties at school. Some have behavioral disorders. Most of them do not receive proper psychological therapies and rehabilitation. Jensen and Shaw (Jensen PS, Shaw J: Children as victims of war) indicated that there is conflicting and controversial literature on children’s reactions to war-related stress. They suggested that children’s cognitive immaturity and adaptive flexibility may mitigate the anticipated stressful effects.

As the researcher Osofsky, 1995 indicates the differential response to trauma depends, in part, on the child’s age and level of psychological maturity. Children vary in their reactions to traumatic events. Some suffer from fears and memories immediately after the event, which dissolve with time and emotional support. Other children are more severely affected by trauma and experience long-term problems.

Children of the war zone may exhibit regressive behaviors such as bed-wetting, thumb-sucking or fear of the dark. They may have increased difficulties separating from their parents. Also they can have attention problems and learning difficulties at school. Many of these affected children can have somatic complaints, irrational fears, sleep problems, nightmares, irritability and angry outbursts. They may appear to be depressed and more withdrawn.

Adolescent (ages 12 to 18) responses are more similar to adults and they are at increased risk for problems with substance abuse, peer problems and depression.

Child soldiers have been exposed to events beyond the normal boundaries of human experiences. This is a story of a child solder whose pseudonym is SE .

SE was 11 years old when he was forcefully recruited as a child soldier by the LTTE. During the training period he was beaten and threatened to be killed if he did not obey the orders. Once he saw a killing of a rival member by the LTTE. Along with other children he had to take part in a number of attacks against the Sri Lankan Army. They were called the members of the Baby Brigade. The Baby Brigade was a support team for the adult fighters. They never had the opportunity of going to school after they became child soldiers. Instead of books they carried AK 47 and grenades. Their childhood had been stolen.

Little SE witnessed a number of horrific events which changed his psychological makeup drastically. He was forced to observe torture, then forced to induce it on victims. Today SE is in a rehabilitation center but his horrendous psychological scars have not left him completely. He has intense rage , suicidal urge and alienation. Once a bright and innocent student now has become a victim of the Eelam War.

Exposure to war traumas can deleteriously affect children’s social, emotional, and cognitive development and pose significant problems into adulthood if left untreated. Exposure to war situations children lose predictability in their lives. They become far a way from daily routine and daily habits which provide security for them. It affects their psychosocial development negatively.

Master P was terrified when air attacks took place in Jaffna. During this attack his neighbor’s house was destroyed and some were critically injured. They were taken to the Jaffna hospital. Master P becomes anxious when he hears aircraft sounds. He has startling reactions, intrusive memories of the air attacks and sometimes nightmares.

Children’s well-being and development depend very much on the security of family relationships and a predictable environment. Miss L was 13 when the LTTE attacked their village in the North Central Province of Sri Lanka. The attackers shot the adults and killed the children and women with knives. She was lucky to be alive. When the village was attacked she managed to escape with her uncle. But her parents and the younger brother got killed. Miss L couldn’t continue her education after the tragedy. She became more depressed and had constant feelings of being threatened, nightmares of the attack, and psycho somatic ailments.

During the Eelam war some of the Sinhalese and Tamil children witnessed the deaths of their parents or other family members. They have experienced loss of loved ones, loss of property etc. These children have undergone severe grief and some have developed pathological grief reactions. These children carry the psychological scars of these past traumatic events. Obviously the majority of them have not received adequate treatment and rehabilitation; they will become adults with the unhealed trauma. Their anger will be sublimated to the society and this is going to be a vicious cycle.

Master D (10 Y) was a bright student who suddenly showed learning difficulties and behavioral problems when his father died in the Rivirasa operation. He became aggressive and started bed wetting. He lost the interest in social activities showed positive features of Paternal Deprivation Syndrome. He was not a happy child after his fathers death.

Living with a father who is affected by the combat trauma is another predicament faced by some children. Little B was an eight year old boy who was beaten by his PTSD father an ex combatant with sudden rage. The boy was hospitalized and received treatment for his physical injuries.

Miss M (15Y) and master L (12Y) are sister and brother of the same family. Many days they had to spend the nights at neighbor’s house when their father became aggressive and went into tantrums. He is a combatant suffering from PTSD. When he experienced combat related flashbacks he became extremely violent. Their mother left the house following continuous physical aggression by the father.

In recent years, since 1990, nearly 49 wars have been waged, and 46 have been fought with small weapons. Over 40 million men, women, and children have been forced into refugee status due to war violence.A situation of war, frequently experienced by refugees, has a disorganizing and traumatizing effect on the entire family. The Eelam war caused displacements of civilians at large. Many are still living in refugee camps. Master M (9Y) and his family had to flee from his village with the other neighbors when the LTTE ordered the Muslim people to leave the North. Their family came to Puttlam and lived in a small hut without basic facilities in Alankuda- Kalpitiya. Master M became more isolated and showed positive features of anxiety and depression. He was nostalgic about his native village in Mannar. His education was disrupted and today M works as Three Wheel driver in Puttalam town. M feels himself as an alien in Kalpitiya .He is addicted to cannabis and has no long term life plans.

During the Eelam War the LTTE launched a number of suicide bombings sometimes targeting civilians. Master N (15Y) was a psychological victim of the dreaded Central Bank Bombing by the LTTE. When the blast occurred they were in a motor car. They sustained minor injuries, but master L was psychologically shattered. He had fear feelings, startling reactions, intrusions, nightmares for nearly a year.

How to heal the wounds occurred due to the armed conflict ? These children need medication, psychotherapy, psycho social rehabilitation and long term monitoring. In Sri Lanka there is a big scarcity of experts in this area. Very often traumatized children grow without psychosocial support. Unhealed traumas affect their cognitive and personality development.

Time does not heal the trauma. Therefore active measures are highly needed. Social support should be given to the children who were exposed to war trauma. Children’s resiliency to traumatic events is influenced by the degree of social support and positive community influences (Garbarino et al., 1992).

To minimize the psychological damage the children need effective care. Parental support is highly essential to heal the emotional scars experienced by the war-zone children. As the experts point out children with adequate family cohesion manifest less stress in reaction to trauma and are better able to recover from the initial impact of the trauma.

Cultural factors and traditional healing systems play a vital role. Community ideology, beliefs and value systems contribute to resiliency by giving meaning to dangerous events, allowing children to identify with cultural values, and enabling children and adults to function under extreme conditions (Melville and Lykes, 1992). In treating war zone children family therapy, group therapy, Cognitive-behavioral therapy (CBT) , art therapy, music therapy, EMDR and school and community interventions have been used. Also they are helped with coping skills.

War trauma in Sri Lanka has created a dilemma situation. A large number of children have been affected by the prolonged armed conflict in Sri Lanka. This has become one of the crucial problems that would affect our future. Consider a significant numbers our next generation are traumatized and unhealed. The vicious cycle of war will deal with them once they become adults. Therefore this fierce cycle has to be dealt with effectively and professinally.

(the author who was the Focal Point — Mental Health in Puttalam District at the Health Ministry now offering his services to a Canadian Community Services Association in Ontario gives a balanced and unbias view of War Trauma and how it affected Sri Lanka Children )

Gen George S Patton – US Army 1942

The U.N. Security Council, chaired by Hillary Clinton, as the United States holds the revolving presidency, unanimously passed a resolution in a bid to stop sexual violence during conflicts and to end impunity, Hillary Clinton remarked that rape was used as a weapon in the Sri Lanka during the armed conflict with the LTTE. As a matter of fact she has forgotten the sexual violence caused by the US Army since the WW 2. This article reveals some of the thought provoking factors related to Sexual Assault and Rape in the U.S. Military.

War and Sexual Violence

Although rape has been closely linked with the history of warfare and some view sexual violence as an inevitable concomitant of war in the present context it is a war crime. The term rape refers to forcible sexual intercourse with an unwilling partner. Rape involves varying degrees of physical and psychological trauma. Rape is extremely traumatizing. All rape victims suffer physical and psychological aftereffects. The persistent practice of rape in war is evocative of the misogyny of war as an extension of masculine hegemony.

US Army and the Sexual Violence During the World War 2

For World War II, comprehensive statistics of prosecutions of American military personnel are available for the European theater of operations. Those statistics indicate that rape was extensive. US servicemen were accused of raping French women and when the numbers were surging it alarmed the Overall Commander Gen. Dwight D. Eisenhower and he issued a directive to U.S. Army commanders announcing his “grave concern,” and instructing that speedy and appropriate punishments be administered.

Rapes in Vietnam

In Vietnam, from 1 January 1965 to 31 January 1973, twenty army personnel and one air force man were convicted of rape, and fourteen army personnel were convicted of attempted rape or assault with intent to commit rape. In Vietnam (1970–73), one navy serviceman and thirteen Marine Corpsmen were convicted of rape. However, these conviction numbers in no way reflect the actual number of incidents. Among these atrocities most horrific incident occurred in August 1967. A 13-year-old Vietnamese child was raped by American MI interrogator of the Army’s 196th Infantry Brigade. The soldier was convicted only of indecent acts with a child and assault. He served seven months and sixteen days for his crime.

The Persian Gulf War

During Persian Gulf War twenty?four female American military personnel were subjected to rape, attempted rape, or sexual assault by American military men, according to official records. During the last Gulf war, 8% of women sent overseas were sexually assaulted or raped, according to a study by researchers for the Department of Veterans’ Affairs.

Rapes within the Establishment

According to Lucinda Marshall US feminine activist there were 2947 reports of sexual assaults in the military in 2006, an increase in reports of 24% over 2005. More recently, there have been the well-publicized cases of Lance Cpl Maria Lauterbach who was murdered after accusing another Marine of rape, and Jamie Leigh Jones who says that she was gang-raped while working for Halliburton/KBR in Iraq. Jones claims that after she reported her rape, the company put her in a shipping container and warned her that she would lose her job if she left Iraq for medical treatment. Beth Jameson, a major in the US army reserve, who was assigned to a large staging area in Kuwait. She was raped on March 20 2003, the first night of the war, in the shower block during an alert for a feared chemical attack.

More than 200,000 women now serve in the US military, with at least 15,000 stationed in Iraq. The US Miles Foundation had received credible reports of rape or sexual assault (in the period August 2002 to August 2003) from 243 women serving in the US military in Iraq, Kuwait, Bahrain and Afghanistan. The data suggests that nearly 1,400 women reported being assaulted and raped by their fellow soldiers, in some cases by their commanding officers. The Pentagon has released new reports in which one-third of military women say they’ve been sexually harassed.

Torture of POWs by the Pvt Lynndie England of US Army

Lynndie England, a young female soldier from a poor town in West Virginia,became a notorious symbol of sexual violence. She was found guilty of sexually and psychologically abusing the POW s of Abu Ghraib prison.

Pvt Lynndie England was a United States Army reservist who served in the 372 nd Military Police Company. She was one of eleven military personnel convicted in 2005 by the Army courts martial in connection with the torture and prisoner abuse at the Abu Ghraib prison. In Baghdad during the occupation of Iraq.

The case of Abeer Qassim Hamza

14-year-old Abeer Qassim Hamza lived with her family a few miles north of the Iraqi town of Mahmoudiya. On the 12 th of March 2006 three US soldiers went drinking and then changed out of their uniforms in to dark clothes. They burst in to her house. According to the affidavit, Steven Green, a private in the US Army, took Abeer’s family -her mother, Fikhriya Taha; her father, Qassim Hamza; and her 5-year-old sister, Hadeel Qassim Hamza — into a bedroom and killed them. He came out, blood on his clothes, bragging about what he’d just done. Then he and another soldier took turns raping Abeer. When they were done, they shot and killed her. Then they set fire to her body.

Steven Green , former US Soldier was convicted of the rape and murder of 14-year-old Abeer al-Janabi and the killing of her mother, father and six-year-old sister in Baghdad in 2006. In his trial Steven Green said “ you all can act like I am a Psychopath or a sexual predator or whatever….But if I had never gone to Iraq I would never have got caught up in anything like this. ”

Article By Dr Ruwan M Jayatunge M.D.

Anarkalli Aakarsha Jayatilaka (born July 11, 1987) is a Sri Lankan film and teledramaactress. She was crowned Miss Sri Lanka 2004 and represented Sri Lanka at the Miss World 2004 beauty pageant.

Jayatilaka’s first public opportunity to act came when Somaratne Dissanayake and Renuka Balasuriya, who directed and produced the teledrama Iti Pahan in 1995, were in search of a little girl who was fluent in English. In the drama, she performed the role of “Daisy Susan” beside renowned actress Vasanthi Chaturani.

After a nearly seven year hiatus, she returned to acting in 2003 when, at 15, she was cast in a lead role in Pissu Trible.Subsequently, she performed in several successful movies, and received acclaim in teledrama performances with her roles as “Inoka” in Sihinayak Paata Paatin and ‘Tanya’ in Santhuwaranaya.

Jayatilaka also works as a model, brand ambassador, presenter and often makes appearances in song visuals.

Anarkalli will contest for the Galle District for upcoming Southern Provincial Council Election, says United People’s Freedom Alliance(UPFA) General Secretary.

drrumj@gmail.com

The Holocaust was the attempt to exterminate all the Jews in Europe. Racially based genocide plan killed more than 6 million Jews including two million children and 5 million others during 1941 to 1945. The Holocaust was not a randomly conducted atrocity which resulted on high emotions. It was systematically and meticulously planned for years. The Nazis built concentration camps for the purpose of forced labour and gassing victims.

Holocaust and the German People

Hitler came to power in 1933. He did not seize power. Hitler was elected by the votes of the German people. Many Germans at that era considered Hitler as the savior of the Germany. Hitler was obsessed with racial hygiene. His speeches became very popular and people responded positively to his theory of racial supremacy. Hitler’s Mein Kampf became one of the popular and admired books in Germany. Hitler believed that Aryan superiority was being threatened particularly by the Jewish race. Many of the German people grasped this idea without contesting. Hitler’s ability to arouse in his supporters emotions of anger and hate often resulted in their committing acts of violence. The Holocaust was the ultimate culmination of his violence, terror and brutality.

For 12 years Germany was ruled by the Nazi Party and opposition had no place to survive. No one was dare to challenge Hitler. A frightened society was forced to obey unimaginable orders. Hitler’s campaign of extermination of Jewish people was camouflaged from the German Public. The average Germans knew nothing about the horrors that took place in the Concentration camps. The NAZI Propaganda Minister Joseph Goebbels constantly reported that there were no mass extermination of Jews in Germany or in the occupied territories. Despite the governing Nazi iron fist German humanitarians like Oscar Schindler helped to save the lives of 12,000 Jews.

Kristallnacht

When Hitler came to power over 500,000 Jews lived in Germany. They were Germanized and had no major conflicts with the rest of the population. Anti Semitic propaganda of the new Nazi regime changed the racial harmony. On November 9, 1938 the Nazis unleashed a wave of attacks against the German Jews which was called Kristallnacht, (Christal Night) or the “the Night of Broken Glass.” The gangs of Nazi youth roamed through Jewish neighborhoods breaking windows of Jewish businesses and homes, burning synagogues and looting. Joseph Goebbels was the chief architect of the Kristallnacht, attack on the German Jews, which historians consider to be the commencement of the Nazi violence culminating in the Holocaust.

Final Solution

The Final Solution was Nazi Germany’s plan to exterminate Jews in Germany and in the occupied territories. Final Solution evolved between 1933 and 1941. Heinrich Himmler and Adolf Eichmann were the chief architects of the plan.

Adolf Eichmann who was responsible for Jewish affairs helped plan and implement the Holocaust. The Nazis decided to exterminate Europe’s Jewish population. Eichmann was appointed to coordinate the identification, assembly, and transportation of millions of Jews from occupied Europe to the Nazi death camps. Himmler the chief of SS was in charge of the mass destruction that killed 11 million people, including six million Jews.

Adolf Hitler publicly announced annihilation of the Jews in many occasions. When dealing with the Western powers Hitler threatened to use the Jews as hostages.

In Mein Kampf Hitler wrote “If at the beginning of, or during, the war 12,000 or 15,000 of these Jewish corrupters of the people had been plunged into an asphyxiating gas…the sacrifice of millions of soldiers would not have been in vain.”

Holocaust Action Plan

In the beginning of the systematic mass murder of Jews, Nazis used mobile killing squads. In September 1941, the Nazis began using gassing vans–trucks loaded with groups of people who were locked in and asphyxiated by carbon monoxide. These vans were used until the completion of the first death camp, Chelmno, which began operations in late 1941. Nazis established 15,000 camps in the occupied countries. In these extermination camps attempts were made to utilize the fat from the bodies of the victims in the commercial manufacture of soap.

Auschwitz was the biggest death camp. A large number of prisoners died as a result of starvation, executions, disease , torture, and criminal medical experiments. four million people were exterminated at Auschwitz.

In 1933, there were approximately 9 million Jews in Europe. By 1945, the Nazi’s had reduced that number to about 3 million. The conditions in the concentration camps were horrific. Colonel Gerald Draper, a British military officer recalled the state of the survivors at the time of liberation in the following account:

“Men and women clad in rags, and barely able to move from starvation and typhus lay in their straw bunks in every state of filth and degradation. The dead and dying could not be distinguished. Men and women collapsed as they walked and fell dead.”

Holocaust denial

Holocaust denial is an anti Semitic propaganda movements to develop to deny or minimize the established history of Nazi genocide against the Jews. The Jewish organizations blame Holocaust deniers to minimizing the human cost of Holocaust and deliberately manipulating historical evidence as part of an ideological and racist agenda. In several countries, including Israel, France, Germany and Austria, “Holocaust denial” is against the law. Once a Holocaust survivor expressed that a person who denies the Holocaust becomes part of the crime of the Holocaust itself.”

Psychological Impact of Holocaust

The Holocaust was both individual and collective to the Jewish people. The survivors faced catastrophic stress situations and had adjustment difficulties to integrate in to the society. They were overwhelmed by  feelings of fear, avoidance, guilt, pity and anxiety.  Many survivors showed   apathy and hopelessness. Their  second   generation  too were affected for some extent. The  collective trauma  associated with heightened sensitivity to anti-semitism and persecution.

Holocaust changed the face of the Jewish people and their political vision. The Holocaust of World War II united the Jewish Diaspora and focused international attention on the plight of persecuted Jews. There can be no doubt of the connection that exists between the Holocaust and the establishment of the State of Israel.

The conflict between Israel and Palatine has the historical roots as well as the effects of Holocaust. Some view Israel atrocity against the Palatine people as a form of a Freudian defense mechanism which is called projection or   attributing uncomfortable feelings to others. Today Gaza strip has become the   Guernica of the Spanish Civil War.

Holocaust and its Significance

The significance of the Holocaust is that it was the greatest act of hate and atrocity committed against humanity in the last thousand years or more. Holocaust shows the savage part of human nature which proved what human beings are capable of. Holocaust represent a human enigma. It taught a humankind a lesson  how  a bunch of extremists could tern a civilized society in to a killing ground.

Binninmadaya or Schizophrenia is a brain disorder that distorts the way a person thinks, acts, expresses emotions, perceives reality and relates to others. Schizophrenia has an altered perception of reality and there are considerable numbers of patients in our community. Dr Jayatunge has written this book in simple terms and in a reader friendly manner. Therefore it is an useful book to the Mental Health Workers as well as to those who look after the Schizophrenic patients. Also this book emphasizes the importance of drug therapy and psychological management of the illness and psychosocial rehabilitation which is beneficial to the patient.

Mano Vishleshana Prathikara (Psychoanalytic Therapy) which was introduced by Dr Sigmund Freud has a clinical significance. Psychodynamic perspective sees the roots of human behavior as residing in the unconscious and it is an unique therapeutic system that can treat anxiety and various stress related disorders. Dr Ruwan M Jayatunge explains Freudian theory in an uncomplicated language and gives numerous clinical examples. It also emphasizes the importance of Psychoanalytic Therapy as a mode of medical management.

EMDR Sri Lankan Experience is a book on trauma management. Eye movement desensitization and reprocessing (EMDR) is a recently developed psychotherapy procedure that has been reported to dramatically increase efficiency in the treatment of traumatic memories. EMDR is one of the most researched methods of psychotherapy used in the treatment of trauma and was discovered by Dr. Francine Shapiro in 1987. EMDR facilitates the accessing and processing of traumatic memories to bring to an adaptive resolution. The author who was trained in EMDR at the Coatesville VA Philadelphia under the renowned Psychologist Dr Susan Rogers explains how EMDR can be used to treat Sri Lankan patients without any cultural barriers.

Sri Lanka, a country which is affected by an armed conflict and the Tsunami disaster has generated a large number of victims of trauma. These people suffer from Depression, PTSD (Post Traumatic Stress Disorder), Somatoform Disorders and many have gone in to a vicious cycle of negative stress coping methods like alcohol abuse, domestic violence and social aggression. An effective psychotherapy like EMDR would help to heal the psychological repercussions.

These three books are published by Sarasavi Publishers and are now available to the general public.

Dr R.M.S.K Ratnayaka
Regional Director Health Services Puttalam District

At the approach of danger there are always two voices that speak with equal force in the heart of man: one very reasonably tells the man to consider the nature of the danger and the means of avoiding it; the other even more reasonable says that it is too painful and harassing to think of the danger, since it is not a man’s power to provide for everything and escape from the general march of events; and that it is therefore better to turn aside from the painful subject till it has come, and to think of what is pleasant. In solitude a man generally yields to the first voice; in society to the second.
Leo Tolstoy (War and Peace)

According to E.M Forster, Leo Tolstoy’s War and Peace” (Voyna I Mir) has been the greatest novel ever written. It’s a novel that runs through time and space. Over four hundred fictional and historical characters are illustrated in this unique novel. War and Peace narrates Napoleon’s invasion of Russia and the post war period. In War and Peace Tolstoy argued his own idiosyncratic theory of life. He was struggling between with his Christian ideals and his conflicts with lust and the hypocrisies. War and Peace is a question paper submitted to the reader. Tolstoy puts a question how to lead a perfect life in an imperfect world? His struggles with his passions and his spiritual conflicts made him to write the greatest book in the history of literature.

Character analysis is exceptional in this great novel. There are several central characters that keep the narrative live and distinctive. Pierre Bezukhov and Prince Andrey Bolkonsky two fictional characters appear throughout the novel are remarkable for their static nature. They often regarded as being reflections of Tolstoy himself.

Leo Tolstoy’s life was full of contradictions. He wanted to renounce wealth but until his old age he could not make a precise decision. He preached that the money was evil yet he enjoyed luxuries, he said people should detach from their wealth and look after the poor. However in real life he had to arrest three poor peasants who illegally cut timber in his state and later to prosecute them. He was trapped in an unhappy marriage for a long time. At a time he was an egoless lover and the next time he was jealous of his wife. Leo Tolstoy’s shifting emotions are well documented in his novels and many are reflected in his masterpiece War and Peace.

Tolstoy lost both of his parents at the small age. But their warmth and spiritual touch lived with him. He immortalized their memory by creating two fictional characters in War and Peace. Nikolai Rostov (young brave Army officer who is a passionate lover fond of gambling and leads a reckless life later turns in to a responsible man) and Maria Bolkonskaya (who is a loving and a religious woman) were based on Tolstoy’s own memories of his father and mother.

Pierre and Prince Andrei bear much resemblance to Tolstoy himself. Tolstoy was struggling with his passions and his spiritual conflicts were expressed via Pierre Bezukhov’s character. According to the novel Pierre Bezukhov is an illegitimate son of Count Kirill Bezukhov. Pierre is described as an ill-mannered non attractive socially awkward man who is fond of women, wine and gambling. This portrait is much similar to young Tolstoy.

Young Tolstoy had a passion for gambling and had exhausted the family wealth. Like Pierre Bezukhov he found it difficult to integrate into the Petersburg high society. Tolstoy admitted himself as a non attractive ugly man. Likewise Pierre Bezukhov is narrated as a huge bear like person. Pierre was ignored and rejected by the high society until he inherits his father’s fortune. Once he becomes rich and famous Pierre was forced to get married to a woman named Helen. Consequently he was trapped in an unhappy marriage and searching for meaning in his life. One time debauch now becomes a philosopher. Pierre Bezuhov represents much of Tolstoy’s philosophy.

The character of Platòn Karataev is relatively small but very inspiring. As the book describes Platòn Karataev is a peasant with simple and true qualities which Tolstoy admired most. The author becomes a prophet and a moral reformer who speaks to the reader directly. Platòn Karatheave becomes his mouthpiece.

One time Leo Tolstoy was an ambitious young officer who served in the Crimean War. There he witnessed horror and despair and as a result of battle stress he gradually experienced a personality change. The climax of this personality change occurred many years after the war when he was traveling to buy an estate. He had to stay in a motel and in the middle of the night he walked up with a mortal fear. This could have been a sever anxiety attack and this incident made distinct changes in him. He experienced persistent sorrow and emptiness which he described in his autobiographical book Confession….

I cannot recall those years without horror, loathing, and heart-rending pain. I killed people in war, challenged men to duels with the purpose of killing them, and lost at cards; I squandered the fruits of the peasants’ toil and then had them executed; I was a fornicator and a cheat. Lying, stealing, promiscuity of every kind, drunkenness, violence, murder – there was not a crime I did not commit…Thus I lived for ten years.”

Prince Andrei Bolkonsky mostly represent Tolstoy’s military period. Prince Andrei was a cynical man tired of his wealth and family glory goes in search of a new life adventure. He wants to make history and to be a large part of it. He was looking forward to find his greatness in the Battle of Austerlitz. When Andrei was wounded in the battle he sees the blue sky which implies the emptiness. Andrei’s NDE (Near Death Experience) makes him more matured and finally he realizes military glory, encounter with his former hero Napoleon, making history etc all were insignificant empty attempts. He realized the true meaning of human suffering. But he becomes more syndical and alienated.

Later in life Count Tolstoy formulated a stereotype unique philosophy. Although he was criticized by the clergy and even excommunicated by the Russian Orthodox Church Tolstoy believed that philosophic principles can only be understood in their concrete expression in history.

Tolstoy discussed the free will in War and Peace. War and Peace reflects Tolstoy’s view that all is predestined.. He wrights no one controls events not even Napoleon or Kutuzov Commander-in-chief of the Russian forces or the Tsar Alexander I.
In his own words Leo Tolstoy states

“In historical events great men – so-called – are but labels serving to give a name to the event, and like labels they have the least possible connection with the event itself. Every action of theirs, that seems to them an act of their own free will, is in an historical sense not free at all, but in bondage to the whole course of previous history, and predestined from all eternity.”

This philosophy was later grasped by many novelists and film directors. For instance in the movie Wind and the Lion (Staring Sean Connery) the nomad leader of the desert Raisuli compares his place in the universe as a pawn in the chess board which he has no control . Tolstoy once said man lives consciously for himself, but is an unconscious instrument in the attainment of the historic, universal, aims of humanity.

Against horrors so chilling, the spirit was willing
But the flesh was too weak to withstand.
Was it really a sin for a man to give in?
Could I better resist each demand?

Edward Alan Brudno
American POW captured by the North Vietnamese in 1965

Former POWs of the Elam War undergo a range of mental health problems. The Elam War which lasted for about 20 years in Northern Sri Lanka has caused numerous physical and mental health ailments among the survivors. The LTTE or the Liberation Tigers of Tamil Eelam has captured a considerable number of servicemen during the war and some of them were executed. The remaining POWs were handad over to the ICRC (International Red Cross) and now they are free. Many former prisonors have dreaded memories of their POW days. Most of them suffer from PTSD.

To become a POW is a traumatic experience although the Geneva Conventions protect POWs from maltreatment and assures them of certain basic needs. The words can hardly explain the physical and mental agony experienced by former POWs. They are like living dead. The psychological impact of being taken as a prisoner of war is devastating. POWs cope with utter difficulty. Although they are free they constantly live in fearful intrusions and spending their lives in dispar.

There were a large number of soldiers who became POWs during WWII, Korean War, Vietnam War and the Gulf War. There are many reports to confirm that the POW’s have been subject to frightening forms of torture and unimaginable psychological warfare such as starvation, physical mutilation, humiliation, sexual degradation, electrocution, and severe sickness. There are many recearched studies of the POWs of the Korean and the Vietnam war in the West. Farber Harlow delineated the DDD syndrome in 1956 after detailed study which he did with the former Korean prisoners of war. DDD syndrome consists of debility, dependency and dread which filled with chronic fear. Unfortunately there are very few researched studies done with the POWs of the Elam War.

Following case studies reveal the physical and mental trauma experienced by former POWs of the Elam War. Among them Lance Corporal P’s story is more horrendous. Even though he is a free man today he is still suffering from the ramifications of the POW experience. Lance Corporal P was captured by the LTTE in 1993and endured the next five and half years in prisoner of war camps. He was deeply traumatized and his psychological wounds were a direct result of his being in the LTTE prison camp. He is a casualty of war, strained by the emotions that had haunted since 1993. When he came home guilt and anger and helplessness built up. He struggled with depression.

Lance Corporal P joined the Sri Lanka Army in 1991 as a signalman. After his basic training he was sent to the operational area. In 1993 he was posted to Welioya Senapura camp. He was working in the signal room. During this period the LTTE launched a massive attack against the Senapura camp. He was wounded and captured as a prisoner. This is how he describes the horrific events of his life.

“When the LTTE attacked our Camp I was in the signal room with a Lieutenant. We wanted to send a message and ask for reinforcement. The signal room was attacked with a RPG. Our radio and other equipment were destroyed by the attack. Then a group of LTTE members broke in to our signal room. They grabbed the Lieutenant and killed him with a mammoty. His eyes were taken out. I was wounded and lost the consciousness. When I opened my eyes I was in a LTTE vehicle blindfold and my arms and legs were tightened. Then I realized that I was a prisoner. I was anxious about my future. A number of times I asked from my self are they going to kill me? I could not escape and I was helpless.”

First few weeks they interrogated me. They thought I was an officer in disguise. They wanted to get our classified signal cords. They tortured me and threatened to kill me. The first few months I was unbreakable and told them nothing. Then they put me in isolation. For seven months I was in a small dark room. My biological clock was disrupted. I did not know it was day time or night. I was given food three times a day. That was the only time I saw somebody. I was sleeping in a dirty rough prison cell fearfully waiting for my tormentors.
This was the worst part of my POW experience. That was a frightening and disorienting event.

“After seven months I was daily taken for interrogations and everyday they asked same set of questions. For any slightest incompatibility I was savagely beaten and sometimes electrocuted. They crushed my genitals, also used to put chillie powder in to my foreskin. I was in pain and agony. No one was there to save me. I was abandoned by my people and I knew this was my end.”

They threatened to kill me a number of times. Each time I was oozing with fear and helplessness. Once they took me to a deserted area where they execute prisoners. They shot an EPRLF prisoner who was belonged to a different militant group. But they did not kill me that day perhaps they wanted to bargain my freedom with the Government.”

The Guards were extremely brutal in their handling of prisoners of war. Interrogators as well as the prison guards administered the torture. He was tied up for interminable periods into painful positions. He was not able to resist the torture without cooperating with his captors. He was subjected to psychological manipulation and blackmail. Following the long term repressive conditions, the torture and degradation under which Corporal P suffered resulted PTSD. Lance Corporal P further explains his horrendous experience thus.

“I was a POW for nearly five years. All these years I was tortured and humiliated. Every single day I prayed for my life. Finally me freedom came unexpectedly. I was released in 1998 September after the intervention of the ICRC. I came home. There was no welcome ceremony. I went on leave for few weeks. My family members were happy to see me. But I could not feel the happiness. I was always on guard. I had fear feelings that the LTTE might capture me again. Some nights I was troubled by nightmares and I could not sleep.”

“After my brief leave I went to my unit. People were suspicious about me. They thought I was collaborating with the enemy. Only if they knew what I underwent they would have realized the trauma that I experienced. What do you expect from a POW when you are surrounded by the enemy? Perhaps they expected me to act like Rambo.

“When you are a POW you have no choice. You become a number or insignificant tool of your tormentors.”
“One officer was harsh to me and said now your vacation is over so ready to go to the next operation. I was shocked. All these years I was in a LTTE prison and he calls it vacation. I wanted to ask, Sir if somebody put chillie powder in to your penis or to your anal cavity do you call it vacation? When the enemy electrocutes you how does it feel. Feel like in vacation? I could not speak. No one will ever understand the agony I went through.”

“When I was ordered to join the Operation Jayasikuru I had fear feelings. I did not want to go to the battle. I thought I would again become a POW. I remembered my past events. My head started aching and I was fainted. When I regained my consciousness I could not speak. My voice has gone. I have become aphonic.

Lance Corporal P was untreated and undiagnosed for many years. When he was finally referred to the Psychiatric unit in 2000 he had full blown symptoms of PTSD with psychogenic aphonia. He had a deep suspicion. He believed no one. After treating him for many months finally he started trusting his therapists. Then he opened more.

He had nightmares. Frequently he gets up in the middle of the night, perspiring with a severe heartbeat thinking that he is still among the LTTE. When he realizes he is safe, again he goes back to sleep. But he can not sleep. All these POW day intrusions come to his mind. The rest of the night he is awake.

Sometimes he used to get flashbacks. Then he relives the event. His mind is preoccupied with past horrific events; he thinks hours and hours about the past incidents. Then rage comes to his mind. He can not tolerate any noise. If somebody interrupts or speaks loudly he often gets angry.

Lance Corporal P exhibited severe avoidance. He was fear of military vehicles, uniforms and conversations regarding the LTTE. He could not feel happiness. He was emotionally numbed. With utter depression several times he tried to take his own life. Once he tried to kill himself by beating his head against the wall.

Lance Corporal P underwent medication and psychotherapy He was treated with SSRI, Art Therapy, Relaxation Training and EMDR. The Art Therapy was a real catharsis for him. He expressed vivid events of his POW life in a form of art. After every session his overwhelming stress has been reduced to a considerable level. It helped to lift his spirits. With the relaxation training he became calmer. His hyper vigilant reaction became minimal.

Lance Corporal P underwent 8 sessions of EMDR (Eye Movement Desensitization and Reprocessing) or Reprocessing Therapy. Then his improvement was significant. Today he can sleep without night terror. His severe depressive feelings are subsiding. Gradually he started enjoying his life; playing with his sister’s little son. Now he has fewer fears about becoming a POW again. Progressively he is regaining his voice. But he knows he would never be the same person again after spending 5 years in the LTTE prison.

Lance Corporal U is another POW who faced many horrors. He became a POW in July 1991 during the Balawegaya operation. He was wounded during the battle and taken as a prisoner. Until his release in March 1995 he was subjected to inhuman treatment. He was deprived of sanitation, light and proper medical treatment. He was kept in a small cell with 40 other prisoners. They had no enough space and practically every prisoner developed skin infections. The sick and wounded were left in their own excrement for many days. Someday they were given rotten food and while they were having meals the guards used to disturb them with loud noises etc. They were not allowed to take a bath for months. Finally they decided to go on a hunger strike. He struggled with depression. He had always been angry at his captors. Lance Corporal U often refused to eat the food he received. After continuous interventions by the ICRC the LTTE agreed to release him with a group of other prisoners.

After coming home Lance Corporal U started to work again. Gradually his sleeping pattern and the appetite have been changed. He felt more alienated. He had loss of interest and pleasure in ordinary activities, multiple somatic complaints, loss of libido and repeated thoughts to commit suicide. He was diagnosed with Depressive Disorder. Although he was treated with medication his condition was aggravating. He subsequently developed intrusive memories, emotional numbing, nightmares, startling reactions and avoidance of reminders. In 2003 he was diagnosed with PTSD.

Lance Corporal U describes his difficulties thus.

“Although I came home I felt my soul is still in that prison cell. My life was wasted. I came home as a sick person. I have fear feelings which I can not explain. My wife does not understand me. She thinks that I am a cold irritable person. Very rarely I have sexual contacts with her. My interest in sex has been diminished. I have no one to explain my pain. I can work in Colombo, but I cannot go to the North. I am afraid to become a POW again.

Last month I went to the Police Station to get a police report for my lost identity card. When I went there I saw the cell where they keep people in detention. I had flashbacks. My mind was occupied with POW events. I had a headache and without finishing my work I came home.

Lance Corporal U was treated with Beck’s therapy and EMDR. With the psychotherapy sessions his distress has been reduced to a grater degree. Today he does not experience nightmares, he has no suicidal ideas. He gradually readjusted to life and struggling to live a happy and productive life.

Mr. N became a POW when the LTTE attacked the Poonareen camp in1993. He was a civil cook. He was kept with other prisoners in a harsh condition. In the prison camps he spent 9 years being tortured as a prisoner of war. For many years he was an unacknowledged POW. First he was pronounced dead to his relatives. After his release in 2002 Mr. N constantly complained of headache and somatic pain which had no medical basis. He had suicidal ideas and sometimes manifested occupational incapacitation, paranoid reactions and aggression. He was treated with cognitive behavior therapy and exposure therapy under controlled conditions. He gradually readjusted to life and was able to live a productive life.

Maltreatment and suffering can be a part of a prisoner of war experience. Combatants find extremely difficult to cope in a POW situations. . It is a terrible and frightening experience that one can hardly imagine. Some POW s had vivid experiences as part of coping. POWs deal with their captures in a way that may change the outcome of their fate. There were very few successful coping strategies. As a part of survival they collaborate with their tormentors like in the Stockholm syndrome. The Stockholm syndrome is the case in which a hostage begins to identify with their captors and at times then join them. This was noted in Stockholm after a bank robbery when hostages were held in a bank vault.

Being a former prisoner of war often means that ones life has changed sometimes beyond repair although the human spirit is resilient. It is true that many POWs of the Elam war never had happy lives after coming home. Many are still hounded by their past memories. In most cases the permanent psychological damage the POWs suffered as a result of surviving long term torture and degradation has never been examined properly. Returned prisoners of war were not treated as war heroes whose patriotism is beyond question. After many years of torture former POWs, are openly questioning whether or not they can really forgive and forget.

Dr Ruwan M Jayatunge M.D.

Viragaya novel is a turning point in Sinhala literature. Literary genius Martin Wicramasinghe vibrantly portrays Aravinda s character in Viragaya digging in to the inner psyche. Therefore Viragaya can be considered as one of the first and best psychological novels in Sinhala literature. Aravinda was a virtuous character trapped in biological instincts and cultural pressure. The complexity of Aravinda s character reveals the inner world of a man who was brought up according to the Buddhist village traditions and how he struggles to fulfill his hidden desires leading to a dramatic transformation.

According to the mundane eye Aravinda was a failure. His ambition to become a doctor and apparent haematophobia and aversion to dissect dead bodies prevented him from pursuing his goal. The untimely death of his father and subsequent financial problems forced him to engage in a petty job and to lead an insignificant life. When his girlfriend Sara offered her love and gave her consent to live with him Aravinda faces a moral dilemma. His Indecisiveness jeopardized the relationship and he becomes lonely for the rest of his life.

Aravinda s loneliness makes him to get close to Bathie. His unusual love for the adopted girl Bathie makes him a jealous man. It was a fatherly love which gradually transformed in to a hidden desire without any physical intimacy. He becomes furious when Bathie finds a young lover. The sociobiological perspective agrees that men tend to react more strongly to sexual indiscretion while women tend to find emotional infidelity more distressing. Hence Aravinda s reaction concurs with this idea.

Aravinda was an outlandish character who repressed his sensual desires due to ethics and moral pressure from the society. Psychoanalytic notion of ethics serves philosophical, religious, and moral causes. In Moses and Monotheism Freud showed that ethics originates in “a sense of guilt felt on account of a suppressed hostility to God”. He further states thus.

Analyse any human emotion, no matter how far it may be removed from the sphere of sex, and you are sure to discover somewhere the primal impulse, to which life owes its perpetuation. … The primitive stages can always be re-established; the primitive mind is, in the fullest meaning of the word, imperishable. … Mans most disagreeable habits and idiosyncrasies, his deceit, his cowardice, his lack of reverence, are engendered by his incomplete adjustment to a complicated civilisation. It is the result of the conflict between our instincts and our culture.

Freud argued that people have always known that at one time they had a primitive father and that they put him to death. The resulting “nostalgia for the father” reflected an insatiable need to appease a sense of guilt by changing the father’s prohibitions into ethical obligations. This idea was represented in Aravinda s character.

Aravinda struggles between morality and biological instincts which leads to a generalized melancholic condition in him. This could be a universal feeling. In the Republic; Plato undertakes the most famous integration of morality and mental health. Mike W Martin Professor of Philosophy at Chapman University argues that moral values are inevitably embedded in human conceptions of mental health. In the end, he shows how both morality and mental health are inextricably intertwined in pursuit of a meaningful life. Nevertheless Aravinda fails to fulfill his heart desire. No one can claim that he was a loser. Hence Aravinda had a meaningful life in the existential point of view.

He was alienated from the society and critical about the social traditions. He was personally free and able to criticize the social values of the world around him. This is more similar to Jean-Paul Sartre s Philosophy which offers an account of existence in general, including both the being-in-itself of objects that simply are and the being-for-itself by which humans engage in independent action. Throughout his life Aravinda wants to find self and the meaning of life through free will.

According to the Western chronological records the first patients of PTSD were recorded in 1666. These records were based on Samuel Pepy’s diary which describes the bizarre behavior pattern of the survivors of the Great Fire of London. Samuel Pepy vividly portrayed the nightmares, intrusions and flashbacks experienced by these survivors. In 1876 American Civil War doctor Mandez Da Costa published a paper diagnosing Civil War veterans with PTSD like symptoms which he called Irritable Heart. During the World War 1 military psychologist explained a combat related stress feature called Shell Shock. In 1980 the word PTSD (Post Traumatic Stress Disorder) was delineated by the American Psychiatric Association after series of research work with the Vietnam veterans.

Although the Western World recorded PTSD in 1666 the King Seethawaka Rajasinghe the 16th century monarch of Sri Lanka believed to be suffered from combat related PTSD. King Seethawaka Rajasinghe (born in 1580 AD) was a great warrior who came to the battle field at the age of 16. He fought against the Portuguese invaders and witnessed many deaths and destructions. He was a fearless fighter who used effectual war tactics and overpowered the fully equipped and fully trained Portuguese war machine. Following the long years of combat he was exhausted and definitely suffered from battle fatigue.

In the later years the King Seethawaka Rajasinghe showed outburst of anger, irritability, deep mistrust, alienation, emotional numbing and various other PTSD related symptoms. There were clear personality changes in him. With these changes the great liberator launched a chain of terror against his own people creating a deep void in the hearts and minds. Hence the King Seethawaka Rajasinghe lost his due respect in the history. But no one can argue his courage and tactics which he demonstrated in the battle field. The invincible 16th century super power was in the verge of a defeat in front of his sward.
But what went wrong? Was he affected by the combat related PTSD?

PTSD or Post Traumatic Stress Disorder is an anxiety disorder which can follow psychologically distressing events like military combat. PTSD denotes intense prolonged and sometimes delayed reaction .The typical symptoms of PTSD occur after a traumatic event and the sufferers have persistent avoidance of any reminders of the event, numbing of general responsiveness and increased arousal. PTSD associated with impairment of the person’s ability to function in social and private life.

The history shows that the King Seethawaka Rajasinghe experienced a number of PTSD symptoms. On one occasion he gathered 100,000 soldiers and attacked the Portuguese Fort in Colombo. The Portuguese were desperate. Fear and famine fell upon them. Despite the attacks the Portuguese were able to get external naval support from Goa. The battle was a fiasco and the King became furious. He suspected most of his Generals and assassinated them one by one. King Seethawaka Rajasinghe poisoned his right wing man Wicramasinghe Maha Senevi then Weerasundara Bandara. These Generals helped him in numerous battles. He was under a deep suspicion and believed in a conspiracy theory.

He acted as a tyrant and used brutal methods to punish people. He never felt any remorse or compassion. The King Seethawaka Rajasinghe even killed his own father Mayadunne which can be interpreted as a reaction following emotional anesthesia. Emotional anesthesia or emotional numbing is a distinctive feature of PTSD. In the later years he turned against the religion (which can be interpreted as avoidance also a cardinal symptom in PTSD). He embraced Hinduism and murdered thousands of his subjects who refused to follow Hinduism. The King Seethawaka Rajasinghe destroyed Buddhist temples and killed Buddhist monks by drowning.

His emotions were unstable. Very often he acted with sudden rage. Gradually he made him self alienated. He had no close associates and the King became an isolated and a broken man. After many battles he was physically and mentally worn out. Many aristocrats had left him because they could not stand his false accusations and outrageous behavior. The Great warrior had become another victim of combat stress.

His final battle took place in Kandy. He had to face Konappu Bandara ails the King Wimaladharmasurya the son of Weerasundara Bandara. One time Weerasundara Bandara was King Seethawaka Rajasinghe s faithful supporter. Weerasundara Bandara helped King Seethawaka Rajasinghe to fight Portuguese. But King Seethawaka Rajasinghe unreasonably suspected Weerasundara Bandara and killed him. The battle was atrocious. The King Wimaladharmasurya proclaimed that he would take the revenge for killing his father.

King Seethawaka Rajasinghe lost the battle. While retreating he fell down from the horse and sustained an injury. A bamboo prick pierced his leg and after a few days he died may be due to tetanus or septicemia. Thus a legend came to an end. He was called the Lion of Seethawaka who brought fear to the Portuguese invaders. He was a liberator but later became an enigma. May be PTSD ruined his inspirations and the goals in life. If these personality changes did not occur he would have been one of the great heroes in the Sri Lankan history.