Bullets rained down on Nigerian troops this week as they approached the forest stronghold where nearly 300 women and girls were being held captive by Boko Haram. But at least some of the shots weren’t fired by the militants.

Instead, they came from the women, who had been so traumatized by their captivity they turned on their rescuers, the Associated Press reported.

Of all the ways Boko Haram has wreaked chaos across much of Northern Nigeria — the massacres, the beheadings, the bombings — its kidnappings are a particularly insidious form of violence. For many captives, to be held by the militant group is to be used as a sex slave, a suicide bomber, a conscript. And the experience leaves lasting scars.

“The trauma suffered by the women and girls is truly horrific,” Netsanet Belay, Africa director for Amnesty International, said in a statement about the recent rescue. “What they need now is medical and psychological care and support and privacy.”

The news of women firing on their rescuers is just the latest evidence of the kidnappings’ psychological toll. In March, advocacy groups reported that children rescued from a Cameroon encampment were so traumatized they’d forgotten their own names.

“There was a blankness in their eyes,” Christopher Fomunyoh, an NGO worker visiting the children, told The Washington Post. When aid workers attempted to extract details of their captivity, the children answered in broken Arabic rather than their native languages.

“Right now, there’s not full comprehension of the damage of this crisis,” he added. “Even if kinetic operations were to end soon and Boko Haram was taken off the battlefield, it would take years to really address consequences in humanitarian terms.”

A counselor working with freed captives told the Associated Press that some of his patients had been indoctrinated into believing the group’s extreme ideology. Many maintained that the militants were good people who had treated them well, and some had developed emotional attachments to the men they were forced to marry.

The women rescued this week were used as armed human shields, according to the AP, and had to be subdued by the approaching soldiers before they could be rescued.

Now the army has sent medical and intelligence teams to evaluate the captives, a process that includes questioning them to figure out their identities. Though the army says that these women are not the Chibok schoolgirls whose abduction sparked an international outcry last year, it is not clear where these women were kidnapped from.

“The processing is continuing, it involves a lot of things because most of them are traumatized and you have got to put them in a psychological frame of mind to extract information from them,” army spokesman Col. Sani Usman told the AP.

But Belay of Amnesty International worries about how that information will be “extracted.”

“The government must now ensure that it doesn’t add to their suffering with lengthy detention and security screening which can only add to their suffering and plight,” she said in her statement.

According to Amnesty, more than 2000 women and girls abducted by Boko Haram remain in captivity, including most of schoolgirls kidnapped from the remote town of Chibok last year.

D.C.-area human rights lawyer Emmanuel Ogebe, who works with some of the escaped Chibok girls, told The Post that the students suffer from scars that can’t be seen.

“The terrors that she has, the psychological damage, you could never tell just from looking at her,” he said of a girl named Debbie, who has moved to the U.S. with his help. “But at times at night when we want to pray, we ask, ‘Do you have a prayer request?’ She says, ‘Pray that I don’t have bad dreams tonight.’”