Russian and Ukranian Therapists Speak

I attended a symposium featuring analysts and therapists who are living and working in Ukraine or Russia, as well as those who have fled from their homes in those countries. They have come together in virtual town halls to support themselves and one another during this war. Those working inside Russia work with patients who live in Ukraine, and vice versa. Some are continuing to work with their patients, and some have stopped. All, for their own reasons or reasons outside their control. Stop and think about this for a moment. Imagine you are Ukrainian, working with a patient who lives in Russia. Russia has just invaded your country. Bombs are going off in your neighborhood, and you are preparing to go downstairs in your home apartment to shelter from these shellings—from the country your patient lives in. Imagine what that might feel like as the therapist. Imagine what that might feel like if your patient is in support of the war. Imagine what that would be like if your patient feels deep regret and shame about the war. All the while, you are trying to stay alive yourself, keep your family alive, your neighbors, trying to keep your country free. 

Now flip the situation around. You are an analyst who lives in Russia, and you see patients who are living in Ukraine. Your country has invaded their country. You may be ashamed and not in support of the war. How do you think your patients will view you in the light of their reality? How do you feel pride for your country? What has been lost here, inside yourself and the world you live in, in Russia? What has been gained? Do you secretly want to win the war? Do you want to lose the war? What if you have left Russia and now want to disavow yourself of your affiliation with your home, your heritage? A heritage that is so intricately linked with Ukraine, like family, friends, like neighbors. How do you wrestle with living with this daily?

This is what was presented to us in real time by people who are living in this experience. I sat and listened to their stories of what it is like working with patients during this ongoing war. It was profound. I wondered if there were going to be moments when bombs would go off or sirens would be heard and I would helplessly watch them leave our symposium to seek safety. That threat was real. Thankfully, it didn’t happen. However, I was acutely aware that I was sitting in Boston, in an upscale hotel. I wrestled with how to wrap my mind around that reality. The reality that while I wanted so badly to stretch my legs from hours of sitting in uncomfortable chairs, my Eastern European colleagues were sitting with me on the screen, aware their lives were in jeopardy. 

One woman told us how she can no longer smile. Literally. She recalled how she used to smile all the time and how after the war started, her face hurt because there was nothing to smile about. She described how her muscles were in a foreign position, which caused her physical pain. She talked about how at times when she tries to force herself to smile, she physically cannot. And when she is able to, it does not look the same. The light in her smile is gone. Such a simple expression yet so much depth and meaning. 

Another person talked about how he was looking at the sky on what he described as a beautiful day in Odessa. He recalls being mesmerized by the dancing planes in the air, and suddenly the planes began bombing the buildings around him. He was not jarred into action and panic but learned the meaning of depersonalization at that moment. He depersonalized to shield himself from the sheer terror and danger of being blown up himself. 

I listened to a woman’s retelling of her profound depression, where she no longer felt the need to cook for herself, her husband, and her children. She stopped it all. She said to herself and her husband, “What is the point? We are going to die anyway.” Her building had been bombed. She recalled her husband fought with her and told her she had to keep going. She got up and went and cleaned the toilet. Let’s talk about some real shit here. Her practice is gone, and she now volunteers with whatever she can. 

It embarrasses me to say that I was thinking to myself, How can she live without her income? But then I thought about it further and realized there likely isn’t much of a society to speak of at this point. That is the point. Everything has been shattered. 

We were told the town halls were filled with silences. How do you speak of such trauma, such evil, atrocities, despair? Words fail me here. I understand that silence now, or I tell myself I understand that now. But in reality I don’t. I barely had a sliver of what it must be like for them. And yet they continue to find ways to connect with one another and across country lines. 

I thanked them for allowing me to witness their experiences, and I could barely speak myself. How can you think about “thinking analytically” when confronted with that terror? Their experiences. It felt wrong, and I wrestled with this in my mind and in my heart in their presence. Ultimately, I was choked up with emotions, and I shared my dilemma and ended up simply sharing my gratitude and appreciation for their bravery and strength. Their silences were different and profound. Most in the room cried with me, and those on the screen shed some tears as well. It is a grief and terror I hope to never experience in my life. But we need to be witnesses to the trauma and be open to feeling it, to help our colleagues and ourselves, to be able to hold and tolerate the horrors of humanity.