Hektoen International

A Journal of Medical Humanities

Psychopathological aspects of the war in Ukraine

Sergei Jargin
Moscow, Russia


Euromaidan, Kiev, April 2015.

Paranoid leaders can remain in positions of great power in nations that lack appropriate checks and balances.1 This is particularly likely in one-party states where mass intimidation and imposed homogeneity of thinking prevail and where everyone conforms with the ruling party. Grave consequences can occur when paranoid and delusional ideas coexist in a dictator who otherwise is rational and efficient, but may be assisted or influenced by mentally abnormal individuals who develop ideologies sanctioning the destruction of supposed enemies. As governments in democracy are more transparent, it is less likely that power should fall into the hands of psychopaths or policies be influenced by them.

Physical abuse of children in families and bullying at schools are well-known problems in Russia, often neglected by teachers, authorities, and society. In Soviet times, violence in families was a taboo theme, ignored or denied and not a subject for public discussion.2 It has been estimated that 14% of all children are exposed to violence, two million children are systematically beaten by their parents, and 10% of them die from such beatings.3 According to another source, 40% of children are beaten in families.4 Yet in 2017 violence in families was officially decriminalized in Russia.

Both bullying and family violence have been described in biographies of Vladimir Putin. His father is said to have beaten him.5,6 There is evidence supporting an association between childhood trauma and bullying with various psychiatric symptoms, including persecutory delusions. Reportedly, the worse a child is treated, especially by his father, the more frequent are paranoid ideations observed in adult life.7 Putin is sensitive to hints of bullying and fears its re-enactments. In fact, it is not so much the Russian population who perceive external threats as it is their leader who is re-enacting his puerile fears. Victims of bullying tend to become dysphoric and angry. Blaming others may be a way to defend their self-esteem. Putin’s saying “If a fight is [perceived as] inevitable, you must strike first” is probably a reminiscence of bullying.5 In regard to the ongoing demolition of the Ukrainian infrastructure, Putin may be in grip of the idea that the “denazification” can be achieved through extensive devastation; otherwise “the Phoenix could rise from the ashes.”8 There is an opinion that Putin’s phantasm of Ukraine’s denazification is an idée fixe based on entangled memories of what he has heard about World War II. Putin wants to resist the imagined attack from the West; in the process, he may strive to become a new Stalin by completing the latter’s unfinished business of conquering Europe.8,9 Of note, defensive behaviors in certain individuals include attacking weaker persons and submitting to dominant ones.10 The latter is reflected by Putin’s relationships with Ramzan Kadyrov, head of the Chechen Republic, who seems to be a dominant personality. There has been a stereotype of “chechenophobia” in Russia.11 The most important topic in this connection is the inter-ethnic difference in birth rate and migrations, which is avoided by Russian media and officials today. In November 2022, Putin awarded the Soviet-era medal for “mother heroines” to Kadyrov’s wife, who has fourteen children. Chechnya receives considerable federal funding.

Paranoid rulers tend to promote mentally abnormal individuals and rely on their opinions.12 An example is the influential ideologist Aleksandr Dugin, who preaches Russia’s westward expansion. Here follow several citations from his works: “To close down America is our sacred duty”13; “Anti-Americanism is a Creed. . . . The prohibition of war propaganda is pharisaic. You can’t get away from the war and you shouldn’t try. Western civilization is deadly for our historical way”14; “Only a traitor would wish for peace today.”15 Dugin has also written: “We must forget about the nightmare that is called political correctness, liberalism and human rights. We must forget this terrible nonsense.”16 His writings are indicative of grandiose and persecutory delusions such as: “If we lose, we will blow up the whole world” and “Americans cause rejection, repulsion, a desire to hide from their influence.”17 Dugin’s delusion-like or overvalued ideas include the “Western plot to undermine Russia” and “Eternal struggle between Land and Sea,”18 the latter probably being a reminiscence of the novel 1984 by George Orwell. Some more quotes from Dugin’s works: “The will of any people is sacred. But the will of Russian people is a hundred times more sacred”19; “The flight of battle, the elements of war must become a true Russian University”20; “For peace to be without war, the war is first necessary… We make the war. It originates in our heart. We give birth to the war. Through the war we create the world, our Russkiy Mir.”21

Paranoid individuals are often self-centered, arrogant and vulnerable at the same time. In a sense, paranoid grandiosity is a shield for a fragile ego. The insecurity of a paranoid ruler may contribute violence. A belief that others intend harm leads to aggression. Paranoia is generally characterized by a hostile disposition and aggressive behavior against perceived enemies. Paranoid individuals are motivated to prove that they are right but have limited abilities to test beliefs for reality. Their thinking is characterized by jumping to conclusions. This bias may lead to mysterious ideas. Certain war instigators and terrorists are paranoid in their tendency to present themselves as prophets, world saviors, etc. Some of them are aggressive against delusional goals, as it seems to be the case with the “denazification” of Ukraine. Of note, such ideas are virulent. Mentally healthy people can be susceptible to psychotic appeals, a predisposing condition being fear of strangers and projection of hatred upon them. This susceptibility is exploited by propaganda. In the former Soviet Union, paranoia was recognizable both in authorities and in the whole society,22 partly decreasing after Stalin’s death. Paranoid politicians search for new enemies and resuscitate old hatreds, which is what we are observing today. The more different a stranger, the more suitable he or she is as a target for externalization. The enemy becomes a reservoir for negated aspects of the self. A lack of knowledge regarding other countries, as well as misleading propaganda and suppressed shame and envy contribute to hostility.

Moreover, envious people blame those who make them feel ashamed by comparison. Some functionaries are descendants of the rural people who burnt mansions in 1917 and committed violent crimes out of envy. The psychological projection in paranoid individuals is regarded to be an aberration of shame; being unable to tolerate shame, they project it onto others and thus disown it. In its turn, intense shame confers vulnerability for paranoia.23 Repressed shame may cause aggression.24 Shame was described as the affective core of paranoia.25 Shame confers vulnerability for paranoia and amplifies the latter’s association with stress.23 Shame is associated with different psychiatric conditions and symptoms. There are reasons to be ashamed in today’s Russia, as reflected by a comparatively low life expectancy mainly due to suboptimal healthcare.26

The declared reason of the “special military operation” (SMO), which began February 2022, was the anti-separatist activity of the Ukrainian army in the Donbas area since 2014. In principle, combating separatism within national borders is justifiable, but the 1991 borders of the Ukraine were recognized by all nations, including Russia. The United Nations considers the SMO to be a violation of territorial integrity and sovereignty, which is against the UN Charter. Moreover, any territorial claims should have been declared before resorting to war. It is a fact that the majority of residents in the southern and eastern parts of the country are Russian-speaking and some people in the Donbas area were disappointed that their region had not become a part of Russia. Statistics about the ethnic composition of Ukraine may be misleading because in Soviet times, some residents registered themselves as Ukrainians for reasons of convenience but continued to share the Russian identity. Recent referendums in occupied territories should be met with skepticism, as residents in occupied territories have voted for the unification with Russia to avoid trouble, as they did not believe the situation will be reverted. Many local inhabitants do not care much about liberties and human rights; what is important for them is security and wealth.



Mental derangements in politicians are dangerous and must be diagnosed by expert psychiatrists on the basis of speech, writings, and behavior. More expert opinions are needed. The cynical rhetoric and propaganda of Russian officials, the appeals to use nuclear weapons and the declarations of jihad27-29 have developed on the basis of the ingrained Soviet atheism, while religious vocabulary is misused for political purposes. Certain non-European subjects of the Russian Federation may be interested to continue this fratricidal war, and there are fears that Vladimir Putin has come under their influence as well as that armed conflicts of various magnitudes may become permanent. Alexandr Dugin opined: “Every civilization has the right to decide about… death, good and evil.”30 Indeed, some terrorists have already made that decision. But a preferred alternative would be leadership based on moral principles, modesty, and mutual help, aimed at preserving human life and health. Ukraine must become a testing ground for such international cooperation.



  1. Lavik NJ. Paranoide personlighetsforstyrrelser og politisk makt. Tidsskr Nor Lægeforen. 2002;121:2063-8.
  2. Kovac C. Paediatricians meet to tackle child abuse in the former Soviet bloc. BMJ, 2002;324:756.
  3. Borisov SN, Volkova OA, Besschetnova OV, Dolya RY. domestic violence as factor of disorder of social and mental health. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med., 2020;28(1):68-73.
  4. Agafonova SV, Beschastnova OV, Dymova TV, Ryabichkina TV. Preduprezhdenie zhestokogo obrashhenija s det’mi.Prevention of child abuse Astrakhan: Sorokin; 2022.
  5. Ihanus, J. Putin: Ukraine, and fratricide. Clio’s Press, 2022;28:300-11.
  6. Ressler N. Putin po Freud’u: tainoe i yavnoe.Putin according to Freud: hidden and obvious Moscow: Algorithm; 2017.
  7. Carvalho, C. B., da Motta, C., Pinto-Gouveia, J, Peixoto, E. Psychosocial roots of paranoid ideation: The role of childhood experiences, social comparison, submission, and shame. Clin Psychol Psychother., 2018;25:650-61.
  8. Beisel DR. Ihanus’ fine synthesis on Putin and Ukraine. Clio’s Psyche, 2022;28:311-3.
  9. Volkan VD, Javakhishvili JD. Invasion of Ukraine, Observations on leader-followers’ relationships. Am J Psychoanal., 2022;82:189-209.
  10. Lopes BC. Differences between victims of bullying and nonvictims on levels of paranoid ideation and persecutory symptoms, the presence of aggressive traits, the display of social anxiety and the recall of childhood abuse experiences in a Portuguese mixed clinical sample. Clin Psychol Psychother., 2013;20:254-66.
  11. Khlebnikov P. Razgovor s varvarom.Conversation with a barbarian Moscow: Detective-Press; 2003.
  12. Zoja L. Paranoia. La follia che fa la storia. Bollati Boringhieri; 2011.
  13. Dugin A. Konspirologiya.Conspirology Moscow: Eurasia; 2005.
  14. Dugin A. Filosofiia voiny.Philosophy of war Moscow: Yauza; 2004.
  15. Dugin A. Putin kak velikij pravitel’ i “posle-Putin”.Putin as a great ruler and “after-Putin” Zavtra 12 April 2023. Available from: https://zavtra.ru/blogs/putin_kak_velikij_pravitel_i_posle-putin
  16. Dugin A. Geopolitika postmoderna.Postmodern geopolitics St. Petersburg, Amphora; 2007.
  17. Dugin A. Russkaya voyna.Russian war Moscow: Algorithm; 2015.
  18. Livers, K. A. Conspiracy culture: post-Soviet paranoia and the Russian imagination. University of Toronto Press; 2020.
  19. Dugin A. Konservativnaya revolyutsiya.Conservative revolution Moscow: Arktogeya; 1994.
  20. Dugin A. Ukraina, moia voina.Ukraine, my war Moscow: Tsentrpoligraf; 2015.
  21. Dugin A. Russkaya voyna.Russian war Moscow: Algorithm; 2015.
  22. Soloway VA, Bogatikova JV. Paranoia Kommunizma.Paranoia of communism Moscow: NeftiGaz; 2015.
  23. Sundag J, Ascone L, Lincoln TM. The predictive value of early maladaptive schemas in paranoid responses to social stress. Clin Psychol Psychother., 2018;25:65-75.
  24. Elison J, Garofalo C, Velotti P. Shame and aggression, Theoretical considerations. Aggression and Violent Behavior, 2014;19:447-53.
  25. Pellegrini R, Muñoz Negro JE, Ottoni R, Cervilla JA, Tonna M. The affective core of delusional disorder. Psychopathology, 2022;55:244-50.
  26. Jargin SV. Misconduct in medical research and practice. Series: Ethical Issues in the 21st Century. Hauppauge, NY: Nova Science Publishers; 2020.
  27. Light, F. Kadyrov says Russia should use low-yield nuclear weapon. Reuters. 1 October 2022. https://www.reuters.com/world/europe/russia-says-its-troops-left-lyman-avoid-encirclement-2022-10-01/
  28. OSN “Est’ predel naporu fekalij”: Medvedev predlozhil evropejcam sposob zavershit’ krizis.“There is a limit to the pressure of feces”, Medvedev offered the Europeans a way to end the crisis OSN Obshhestvennaia Sluzhba Novostei, 18 August 2022. https://s30434431340.mirtesen.ru/blog/43386034653/-Est-predel-naporu-fekaliy-Medvedev-predlozhil-evropeytsam-sposo
  29. Stewart W. Vladimir Putin’s Chechen warlord Ramzan Kadyrov declares Ukraine war a ‘Big Jihad’. New York Post, 26 October 2022. https://nypost.com/2022/10/26/vladimir-putins-chechen-warlord-declares-ukraine-war-a-big-jihad/
  30. Mettan G. Alexander Dugin: “Ich plädiere für eine Vielfalt der Zivilisationen”. RT DE 28 January 2023 https://de.rt.com/meinung/161211-alexander-dugin-ich-plaediere-fuer/



SERGEI V. JARGIN was a pathologist and lecturer at the I.M. Sechenov Medical Academy (recently renamed university). Since 1995, he has been a lecturer at the Peoples’ Friendship University of Russia in Moscow. His scientific interests include social, medical, and pathological aspects of alcohol consumption, alcoholism and alcohol-related dementia, and child and elder abuse and neglect.


Spring 2023  |  Sections  |  Psychiatry & Psychology

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.