Victims with traumatic histories and hatred may suspect that forgiveness is an impossible illusion and resign themselves to an existence in a harsh, hostile world in which one is destined to live chronically by one's sword; such a stance undermines constructive vision, hinders learning from experience, and obstructs healing and renewal. It is therefore crucial to enable the unfolding of a culture of forgiveness as an essential element woven into the process of reconciliation with oneself and others. In the framework of this dynamic the process of mourning all losses is of crucial importance, in order to restore the capacity to believe and to enable a dialogue to unfold.

The aim of this study was to assess the effectiveness of the psychotherapeutic model of treatment of war veterans in Croatia with post-traumatic stress disorder (PTSD). The symptoms of PTSD are analysed and evaluated, together with associated neurotic symptoms, ways of coping with stress, and indicators of quality of life and depression.

Due to the long-lasting and resistant symptoms characteristic of chronic combat posttraumatic stress disorder (PTSD), its treatment is complex and often requires a tailored therapeutic approach incorporating both psychotherapy and pharmacotherapy. A multimodal approach of psychoeducative, sociotherapeutic, and dynamically oriented trauma-focused groups is described. We assessed the short- and long-term effectiveness of this therapeutic program by monitoring its impact on PTSD symptoms, depression, neurotic symptoms, coping skills, and quality of life for three years. The findings revealed short-term reduction in the symptoms of PTSD and depression, while the long-term results were manifested as the increased use of all coping mechanisms and a greater level of obsession.

Introduction: Understanding Post Traumatic Stress'The war is the woe of human nature', wrote the Renaissance writer from Dubrovnik, Marin Držć (1979: 10). The Croatian experiences at the end of the 20th century had to pass through another woe of that kind, after having suffered two world wars and experienced three entirely different political and social systems. So far very little or almost nothing is known about impacts of these historical periods on the population, and it is only during the last decade that there has been research into therapeutic efforts, in order to understand better how warfare and terrorism influences the entire human personality and the society.At the beginning of the war in Croatia in 1991 and in Bosnia and Herzegovina in 1992 it was very popular to quote the Chinese curse: 'May you live in interesting times'.These times in the former Yugoslav state started to evolve a decade before this war broke out, culminating in armed conflict. The 'usual' dynamics of life became 'interesting' ones, bringing about deep changes, leading to death and destruction in personal, social and cultural spheres, as well as in the establishment of some newly-independent states, different organizations of these societies, and the possibilities for them to reaffirm their specific cultures and cultural heritage.

During a group psychotherapeutic process, many layers of inner and outer worlds are mirrored through constant interaction. The author follows up part of the group analysis of a small group of patients who, through projections and projective identifications, dreams and fantasies, slowly disclose their deep inner conflicts, up to the barriers that all of them avoid. `Going around' the projection of one patient opens a path through these psychogenic autistic encapsulations, enabling the whole group to develop the analysis of the group process. The author conceptualizes this situation as a phase preceded by high tensions and resistances and followed by new insights into the psychodynamics of each member and the group as a whole. Barriers are understood and well defended as nuclei of pregenital conflicts, disclosing early fixations, which imply autistic qualities, while neurotic `boundaries' are seen as conflictual lines against which one uses defence mechanisms, and which are generally more accessible to exposition and confrontation, and are of either oedipal or pre-oedipal origin.

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The feeling of shame is very difficult to recognize, to reveal, to face, and to work through. Starting with some expressions of human aggression, the authors underline the difference in treating feelings of guilt and feelings of shame. The authors detail the elaboration of shame in group psychotherapy with released prisoners of war and with war veterans and review important analytic theoretical concepts of shame, projective identification, empathy, and countertransference. They examine the importance of unlocking and identifying the silent shame, as well as the mourning process essential to working through the burden of catastrophic shame. Special counter transference problems with PTSD patients are analyzed.

This article highlights specific and unique challenges which confront the therapist when dealing with patients suffering from the effects of trauma within a war situation - refugees, displaced persons and relatives of those who have ‘disappeared’ in war. In presenting clinical vignettes, the author focuses on war in Croatia, whilst also demonstrating how many problems are common to all those in war situations, including the therapist as well as patients, particularly problems and dilemmas in countertransference and empathy.