Displaced by war
First published in BACP Thresholds in December 2022.
It was during an assessment with a retired couple from Donetsk – Irina and Andrei – that I first realised what makes working with those displaced by war so different from other experiences I have had as a therapist. While being deeply moving, this work is also explicitly political in the most personal of ways. I have been accompanying my clients through a devastating crisis caused by the brutality of a regime I myself lived under and fled. I have been called on by many of those clients to articulate my relationship to Russia and my position on the war. The result has been a full-spirit engagement.
‘Why do you speak Russian?’ In that first meeting, it was Andrei who did most of the talking, while Irina smiled at me reassuringly. They held hands throughout. ‘I hope you don’t mind us coming to see you together,’ Irina had said at the beginning. ‘We do everything together here because I worry about his health.’
Andrei, a stern-looking man with dark-grey hair, was dressed immaculately in suit trousers and a shirt and tie. He spoke to me brusquely, almost angrily. ‘I worked my whole life building infrastructure the Russians have destroyed. Do you know what it feels like not to be able to support your family when you’ve spent your whole life working hard to provide for them?’
'I don’t speak Ukrainian,’ he said. ‘I speak Russian. But I’ve never felt more Ukrainian.’ Then his voice changed, growing quieter, accusing. ‘Why do you speak Russian? What do you know about Ukraine? Do you know what they’re doing to our country? Do you understand what it means?’
The role of dignity In The Ungrateful Refugee, Dina Nayeri describes her experience of being an Iranian refugee child in Dubai, Italy and the US. ‘As I write these pages, I am confident that, though refuge is undeniably today’s battle, dignity is tomorrow’s.’1 I have thought a lot in my work with Ukrainian clients about the role of dignity in their battles. All those I have worked with feel embarrassed by their dependence on the kindness of strangers; and terrified at the prospect of living off state benefits in a foreign country whose immigration policies might change at any moment. They are often housed in appalling communal accommodation. Lacking the local language, they can work in only the most menial of jobs. All of this erodes their sense of dignity.
Therapy as political engagement Relationally, they find it hard to trust, but they have to; they fear being patronised and become increasingly suspicious of how others view them. In this context, the therapist’s role becomes a form of political engagement. Unlike those they meet in the outside world, the therapist is seeing them as a person, not defined by legal status or homelessness. The basic condition of the potential for therapeutic change clearly applies here, as always: what Carl Rogers wrote about as the ‘minimal relationship’ – the therapist must be ‘freely and deeply’2 herself. What is different, however, is that the deeply herself element must include expression of political views.
Van Deurzen refers to Danesh’s 2019 phenomenological research with Iranian political refugees when she writes that ‘…there are times when people are so traumatised that neutrality is not appropriate and would constitute retraumatisation’.3
She also asks, ‘Would we expect women who are victims of sexual abuse to accept therapy from someone of the same gender as their abuser and who held misogynistic beliefs?’ Equally, one might ask whether we would expect a Ukrainian refugee to be in therapy with a Russian national who calls the war a ‘special military operation’.
And so, to the couple from Donetsk, and to many of the Ukrainians I have worked with, I have not only categorically condemned Russia’s invasion of Ukraine, I have explained my own relationship to Russia: that I studied Russian at university, that Moscow was home for 14 years, that I worked in Russian NGOs, and left in 2017 out of fear and disgust.
The role of wonder In Myth of the Untroubled Therapist, Adams explores the unavoidable intersection of therapists’ raw personal experience in the world and their professional work with clients. She calls bracketing an ‘illusion’, ‘a comforting idea’, that she proposes ‘…bears absolutely no relation to reality’. She asks us to question when our experience helps our clients ‘...through our increased capacity to understand or empathise’, and when it inhibits us, ‘…unconsciously shifting the focus from them onto ourselves in an attempt to find relief from our personal traumas’.4
While I believe such self-auditing to be an essential part of our responsibility to our clients, I also see this as already present in the existential-phenomenological understanding of ‘bracketing’.
Otherwise known as epoché, bracketing involves the therapist recognising how the preconceptions and assumptions of her own situatedness colour her encounter with her client, though it doesn’t mean she can cast them aside entirely. It involves looking at our client’s experience anew, coming at it with naivety and openness. Seth, van Deurzen and Yalom have all referred to wonder as a crucial element in this process.5–7
For me, wonder in therapy is what creates a connection that is far deeper than that of my everyday interactions. It is a state in which I feel deeply moved, changed, transported into my client’s world.
Working in Russian, my second language, certainly adds to my sense of wonder. I feel grateful for this privilege of insight into the hearts, minds and souls of people who have come from a very different world from the one I grew up in, using a whole other vocabulary of emotional expression. As a result, I listen perhaps more attentively to what they share with me to ensure there is nothing I miss.
Therapy provides essential connection through the isolation of war and migration; and support in the search for courage and meaning. In wondering at my Ukrainian clients’ extraordinary stories of escaping war, and their daily battles with being refugees in France, I have also wondered outside of therapy about the moments in my own experience that make this work such a calling.
The personal impact It began in 2013: my urge to flee Russia. A friend had been imprisoned for peaceful protest. But there were jobs and lives to extract: children in school; a husband tied to his job. I spent whole nights scrolling media speculation around Putin’s intentions. In a November where the sun did not shine once, a physical panic would overwhelm me at random moments: on a bench at the local park while our kids played in the playground; in a metro carriage on our way home from school.
When Russia invaded Ukraine on 24 February 2022, though I had left Russia five years previously, that panic returned. I could not sleep for more than an hour without waking and then I would scroll my phone incessantly, images feeding my dread. When I closed my eyes and tried to sleep, my mind went back to Moscow: to the flat we had bought and made our own, where we had begun to raise our three children. I would pause on random details: the pattern of tiles on our bathroom floor; the kids’ coat hooks, shaped like birds, pinned to an IKEA wardrobe.
There was a wall of brick in our bedroom that the builders thought we were mad to expose; a tram rail we discovered above the windows and left exposed, too. I used to lie in bed and stare at that tram rail, thinking of the prisoners of war who had put it in place, and how many had died in the process. I used to think of the White House across the road from us and wonder whether, by living beside such evil, within walls constructed at the orders of such evil, the evil would become a part of us.
In the days and weeks after the war began, I thought of the people I loved back in Moscow. I wrote to them, chatted with them at ungodly hours, because they could not sleep either. Because they felt such disgust that this war was happening in their name, and because they had never believed it would happen. Some had already escaped. Others were plotting to escape. Some could do neither: they did not have the means, and they had dependants who would not leave with them.
I knew their shame. There were times I would go back to London when Putin was taking Crimea, and friends would accuse me by implication. How can you live in a country run by a murderer? The answer, of course, is that any sane person with a solid sense of right and wrong would not choose to do so without a daily dose of dread, as I was reminded while working with Oleg, a former Russian soldier.
One Russian man’s escape Oleg is in his mid-20s, from a modest background in the Russian regions, and was living in Moscow when we first met for online therapy in late March. He was gripped by overwhelming anxiety and insomnia with news of the invasion. He had been to the doctor’s and was taking medication. Over the following weeks, he talked about the attitudes within his close circle: his parents are pro Putin; most of his friends supported the invasion. He described to me what it felt like to walk down the street and see the Z signs on people’s clothes. ‘It’s as if they’re all zombies,’ he said. He told me about the first coffin that had come back to his hometown and how people reacted – with acceptance, which shocked him. ‘I can’t tell anyone how I really feel, because everyone’s gone mad.’ Even a yoga teacher at a seminar he attended spoke in support of the invasion. This experience of seeing things differently from those around him left Oleg feeling extremely lonely. ‘It’s only with you that I can say what I think,’ he would often tell me.
With increasing regularity, he would be silent in our sessions for long periods, and then he would apologise for that silence. When I asked him what came up for him in those moments, he said it was shame. ‘I feel powerless to stop it, but I feel it’s my fault.’
He began to speak of a friend who had moved to Turkey in protest. I asked him if it was something he had considered doing himself. He said he had, but he couldn’t: he couldn’t leave his mother. He had recently grown close to her and she had finally given up drinking: this was something he talked about a lot in his therapy. ‘I know it would break her heart if I left. She needs me. In theory, I could leave. I already work remotely, but I’m worried she’d start drinking again.’
Some more weeks went by, a lot more silence in our sessions. And then, one week, a month before mobilisation, Oleg told me he had bought a one-way ticket to Turkey. He was leaving that weekend. Once there, he spoke of a weight having lifted.
When Putin announced mobilisation, Oleg’s decision to leave felt like a tiny glimmer of hope in a very dark landscape. He was horrified by what was happening in his country’s name, but he wouldn’t be a part of it. Even his mother was relieved he had left.
The search for meaning In working with my Ukrainian clients and with Oleg, I have thought many times of the life and work of Viktor Frankl – his experience of surviving the Holocaust and his writing in Man’s Search for Meaning. Building on his own extraordinary biography, Frankl proposed, in logotherapy, three means we can use to find meaning in suffering: creating something or doing something, connecting with someone or loving someone, and changing attitude.
‘Even the helpless victim of a hopeless situation, facing a fate he cannot change, may rise above himself, may grow beyond himself, and by so doing change himself. He may turn a personal tragedy into a triumph.’8
While many of those I have worked with have been lucky enough to flee with loved ones, others – like Oleg – have fled alone. Therapy provides essential connection through the isolation of war and migration; and support in the search for courage and meaning. For me, building a mental health practice for victims of Putin’s war has felt like a very personal political act full of hope during incredibly dark times.
1 Nayeri D. The ungrateful refugee. Edinburgh: Canongate; 2019.
2 Rogers CR. The necessary and sufficient conditions of therapeutic personality change. Journal of Consulting Psychology 1957. https://motamem.org/wp-content/uploads/2018/08/The-Necessary-and-Sufficient-Conditions-of-Therapeutic-Personality-Change-Carl-Rogers.pdf (accessed 2 December 2022).
3 van Deurzen E. Rising from existential crisis: life beyond calamity. Monmouth: PCCS Books; 2021.
4 Adams M. Myth of the untroubled therapist: private life, professional practice. Oxford: Routledge; 2014.
5 Seth P. Being opened: a hermeneutic phenomenological enquiry into the existential psychotherapist’s lived experience of wonder. Middlesex: Middlesex University; 2017.
6 van Deurzen, E. Everyday mysteries: a handbook of existential psychotherapy. 2nd edition. Oxford: Routledge; 2010.
7 Yalom I. http://www.yalom.com/biocontent (accessed 6 November 2022).
8 Frankl VE. Man’s search for meaning: the classic tribute to hope from the Holocaust. London: Rider; 1959