First published in The Psychologist in August 2022.
By the time over three million Ukrainians had fled Ukraine, a local businessman had arranged for two coaches to pick up 65 Ukrainian women and children at the Polish border and bring them to an Alpine town in France near where I live. Here, I explore how therapy has worked with this vulnerable client group; and the significance of this experience for me, a British, Russian-speaking existential therapist.
In her 1943 essay ‘We Refugees’, Hannah Arendt writes in the collective ‘we’ of the lived experience of being a Jewish German refugee. Her reflections have a sardonic tone to them. ‘The stars tell us – rather than the newspapers – when Hitler will be defeated and when we shall become American citizens. We learn from the stars when we should have lunch with our benefactors and on what day we have the best chances of filling out one of these countless questionnaires which accompany our present lives.’
Almost 80 years on, Arendt’s words perfectly encapsulate the experience of Ukrainian refugees today: the not-knowing of when the war will end; the endless bureaucracy of forms and waiting lists; the lottery of depending on the kindness of strangers.
I have been working as a therapist to Ukrainian refugees since March of this year, and what I have witnessed has changed me. The connection runs deep: before I began my retraining as a counselling psychologist, I had lived for 14 years in Putin’s Russia. With a degree in Russian language and literature, and a further degree in psychology, I worked mainly in NGOs, a sector cruelly hamstrung by Putin.
I did not experience war directly: there were no sirens resounding every hour, no shells flying at residential buildings. The violence was in people’s heads, in their twisted understanding: a growing homophobia, xenophobia and nationalism. In the apathy of the many to a frightening erosion of freedoms; and in the risk of arrest for those who were far from apathetic.
I left Russia in 2017, with no leaving party, no farewell. Dread had become my modus vivendi, the culmination of blow after blow to human rights. In 2013, a friend was imprisoned for peaceful protest; another friend lost his job as a schoolteacher for a YouTube video challenging the so-called gay propaganda law.
In 2014, Russia annexed Crimea. In 2015, opposition politician Boris Nemtsov was murdered. Expat friends began to be blocked from returning; others left en masse. I remember a Moscow November when the sun did not shine for weeks, and my anxiety was crippling. One day in 2016, I could take it no longer: my husband and I agreed I would leave alone with our three sons.
On 24 February of this year, the day Russia invaded Ukraine, I was thrown back in time. I scrolled my phone incessantly, reading every news story and Telegram feed I could find, images stoking my dread. Only in my therapeutic work, entering another’s perspective, could I briefly forget. I felt grateful when a client brought it up: their horror at what was happening in Ukraine; their fear of its bleeding over borders.
When the war did not come up in a session, time passed slowly, and I became self-critical. It was as if I was losing substance, disqualifying myself from this work I so love. Conversely, there was something about being in the presence of my Ukrainian refugee clients that eradicated this self-doubt entirely.
The existential givens
I do not know what I expected, but I came out of my first session – with a young woman, ‘Tanya’*, who had escaped Russian attacks on the Kyiv region and was having daily panic attacks – feeling utterly changed. She told me of the basement she had hidden in for two weeks with her family; of her grandmother being dragged from a van by one of Kadyrov’s men at a checkpoint, a gun to her head. Sat in the small Alpine apartment she now shared with her sister, mother, grandmother and dog, she told me she was too afraid to go outside.
Tanya and I met weekly from then on. I was given a disused café for my sessions, and now Tanya came to me. The walk across town was part of the therapy: the first time, we did that walk together. I felt Tanya’s deep need for connection and love: an overwhelming loneliness, expressed in detailed descriptions of her exchanges on Tinder.
She told me about her father, who had left when she was little; and her stepdad, with whom she was still in touch. She told me she wanted to get a job and live alone, that she couldn’t stand living with her mother. I was struck by how, even in the violent dislocation of war, life goes on – people still argue, yearn for love, seek freedom.
Indeed, though conflict is the reason for the refugee’s journey, on this journey it is the internal struggle that takes over. ‘Thus we learn less about political events but more about our own dear selves, even though somehow psychoanalysis has gone out of fashion,’ writes Arendt. Her words made me reflect on how appropriate an existential-phenomenological approach is when working with refugees: entering the refugee’s lived experience rather than pursuing the ‘misdemeanours of childhood’, as Arendt rather crudely sums up psychoanalysis. ‘They don’t want ghost-stories anymore; it is real experiences that make their flesh creep.’
Refugees feel the ‘thrownness’ of their existence more starkly than any other group I have worked with. Everything they are familiar with is gone; their futures have been snatched. Accompanying them on this journey, I have experienced a powerful sense of the fragility of the things we take for granted. What Yalom (1980) refers to as the four givens of the human condition surface frequently.
A fear of losing loved ones (death); an inability to continue the work or studies one did before (meaninglessness); no choice over even basic things (freedom); separation from family, and a struggle with language (isolation). Huge courage is needed to face such an existential assault.
The language of the invader
Courage is something I have searched for in myself these past few months, too. When we introduced my services, I received a brutal accusation from one Ukrainian: ‘How dare you offer to help us in the language of the invader? You must be in the Russian camp!’ I remember feeling stung: my well-meaning attempts to help had been rejected. But it would have been naïve of me not to expect some rebuttal.
From the beginning, the invasion was carefully positioned in Russia as a special military operation to ‘liberate’ oppressed ethnic Russians. A consequence is a heightening of anti-Russian language sentiment in Ukraine, a tendency that predates the annexation of Crimea by Russia in 2014.
Yet, of the 40 Ukrainians I assessed, 90% speak Russian at home. They come from eastern or southern Ukraine, the main targets of Putin’s war, where there are large ethnic Russian populations. The language of the invader is their language, too. This is deeply problematic. A client recently told me she was raised to see the German language as evil: she still experiences a bodily reaction whenever she hears it. ‘I can’t feel this way about my own language, surely?’
As for me, I feel freer in Russian than I do in English, primarily because it took me away from the class judgment of accent that is so much a part of the UK social fabric. I began learning the language when I was 14. I have studied, raised my children and given birth in Russian. I did not train in Russian, and of course it is not my native tongue, and perhaps this is an advantage: as a professional, I craft every question, every reflection. I am never lazy. My fear that I will miss something means I pay attention in a qualitatively different manner and frequently check I have not misunderstood.
But one highly educated Russian-speaking Ukrainian refugee whose family speak English among themselves out of choice got me thinking about the Russian language differently. ‘I’m not the same person when I speak Russian,’ he explained. ‘Ukraine is shaming, conflict-prone; the Russian language is, too. English is indirect, polite, more optimistic. Russian is nostalgic, heavy, brutal. English is the language for psychology, for subtlety. It helps when you can be indirect. You can’t be indirect in Russian.’
The point is, language is not just a means to communicate: it reflects who we are, how we relate, how we experience the world. To speak the language of the invader is troubling. My clients’ Ukrainian is also fluent, and some speak Surzhyk, a Ukrainian-Russian mix, a linguistic phenomenon that says so much about the conflict. Many Ukrainians I work with have mixed roots, some with relatives in Russia, some with pro-Russian relatives still in Ukraine.
Conflict within families
For Dasha, therapy has been a space to process the grief of falling out with her pro-Russian relatives who cannot forgive her for fleeing with her 17-year-old daughter, Natasha. Dasha moved to Kyiv seven years ago, though she was born in Melitopol in Zaporizhia Oblast, the Ukrainian south, on the road to Crimea, and a three-hour drive from Mariupol, which today lies in ruins.
In October 1941, the Germans murdered the entire Jewish population of Melitopol. This is now Russian-occupied Ukraine, and all Dasha’s relatives believe the Russians came to liberate them. Dasha has never believed this.
She told me in our fifth session that her sister had been writing ‘toxic stuff’ to her. ‘Like – if Natasha decides to get a swastika tattoo, will I disown her? I told her I didn’t understand the question. We are not Nazis, I said. But you support the Nazis, don’t you? she said. I ignored that comment. Whatever Natasha does, I wrote, of course I wouldn’t disown her! She’s my daughter and the person I love most in the world.’
I asked what it meant to her to feel this conflict within her own family.
‘It hurts so much,’ she said. ‘I’ve fallen out with so many people since the war started. People I’ve known all my life. It’s so painful. But maybe I don’t need these people?’
Making sense
Arendt writes that, ‘A man who wants to lose his self discovers, indeed, the possibilities of human existence, which are infinite, as infinite as is creation. But the recovering of a new personality is as difficult – and as hopeless – as a new creation of the world.’ I paused on this sentence when I read it: its pessimism jarred on me. Is it all so very hopeless?
I have worked with several Ukrainian women who have experienced domestic violence and family alcoholism. I have witnessed a high level of alcoholism in their lives, too. Life has always been hard for these women, and they have never talked about their struggles with a professional. ‘Psychotherapy isn’t part of our culture,’ one of them told me during triage.
When I asked her why, she said psychiatric hospitals were like prisons; your health records weren’t secure; revealing you have psychological problems has always been risky. Indeed, Ukraine, like most of the former Soviet Union, has a disturbing history when it comes to mental health care. A 2019 study of people internally displaced by military conflict in Ukraine since 2014 found that 74% of those who likely required mental health support had not received it (Roberts et al., 2019).
Self-medication in the form of alcoholism is perhaps more accessible than supported self-reflection for many Ukrainians – and Russians for that matter. When Russian émigré journalist Masha Gessen tried to make sense of why Russians die so young, she found that ‘some studies actually showed Russian drinkers lived longer than non-drinkers… that alcohol may help people adapt to realities that otherwise make them want to curl up and die’ (2014). I now regularly wonder what might happen if all Ukrainians and Russians were to have access to therapy.
I end with one older refugee, Irina (aged 52), who cooked on a market stall and lived in a one-bedroom flat in Kherson with her husband and daughter. Her 59-year-old husband with heart problems was called to the front. They have been married for 35 years. He is eight months from retirement; eight months from exemption. In our first session, she kept on apologising for crying. We laughed together at her apologies. We laughed together, too, at this one irony: she said she had never been anywhere this beautiful in her life – she had always lived in a Soviet landscape, and here she was in the Alps all thanks to Putin.
In later sessions, Irina opened up about her very difficult childhood, and about her sense of hopelessness at being a refugee so late in life. She had never had someone show interest in her experiences. She had always accepted life was hard; she had never thought it something to reflect on.
‘If we are saved we feel humiliated, and if we are helped we feel degraded,’ writes Arendt. Yet, without help, refugees struggle to survive on state benefits alone, which are shockingly inadequate. Therapy is a space to explore the sorrow, shame and fear that inevitably arise and to find the courage to continue in what Arendt calls this fight ‘for private existences with individual destinies.’
*Permission has been obtained from individuals, and identifiable details, including names and gender, changed.
References
Arendt, H. (2007). We Refugees, In J. Kohn & R. Feldman (Eds.), The Jewish Writings (pp. 264-274). New York: Schocken Books.
Gessen, M. (2014). The Dying Russians. The New York Review. https://www.nybooks.com/daily/2014/09/02/dying-russians/
Roberts, B., Makhashvili, N., Javakhishvili, J., Karachevskyy, A., Kharchenko, N., Shpiker, M., & Richardson, E. (2019). Mental health care utilisation among internally displaced persons in Ukraine: results from a nation-wide survey. Epidemiology and psychiatric sciences, 28(1), 100–111. https://doi.org/10.1017/S2045796017000385
Yalom, I.D. (1980). Existential Psychotherapy. Basic Books.