Psychoanalytic intervention can be challenging in the best of times, but during wartime it can be particularly so. When the psychoanalytic community steps up, it can bring support, relief, and a reminder that those living on the frontline are not alone. An online global psychoanalytic forum can offer understanding, containment, and group solidarity to therapists and analysts impacted by war trauma. A monthly Zoom Town Hall offered to clinicians worldwide by the International Psychotherapy Institute (IPI) at the start of the Covid-19 pandemic in 2020 increased to twice-weekly in February of this year to address the Russo-Ukrainian War. With the Russian invasion of Ukraine in its fourth month at time of writing (June 2022), the Town Halls continue meeting open-endedly.
The Town Hall welcomes therapists and analysts from around the world, especially those who are directly affected in Ukraine and Russia. Other attending clinicians call in from Canada, Estonia, Italy, Lithuania, Poland, the Czech Republic, South Africa, the United Kingdom, and the United States. The group comprises individuals who began attending the Town Halls with the start of Covid-19, as well as others who joined after the Russian invasion of Ukraine began. Many participants attend regularly, whereas others attend variably, as their personal circumstances permit. Ukrainian colleagues often miss the Town Halls, leaving the rest to wonder if they (1) have been killed, (2) are seeking refuge in their basements, (3) are escaping to safer zones in or outside Ukraine, (4) are avoiding frightening encounters in the Town Hall with their Russian colleagues, or (5) are seeking solace with loved ones. Simultaneous Russian–English and Ukrainian–English translation is supported by interpreters. Tatiana Onikova, a Prague-based colleague and Town Hall co-host, distributed the IPI Town Hall flyer beyond IPI's global email list to therapists and analysts throughout Ukraine, Russia, and Eastern Europe.
The group had 150–215 participants immediately after Russia's invasion and for the first several weeks, and then diminished to an average of 80–150 participants for the next several weeks. It gradually decreased to approximately 25–30 attending regularly by the fourth month. The group considers the possible explanations for this gradual attrition to include participants' accessing alternate local supports, feelings of saturation and need for respite, and acculturation in the country to which they evacuated.
As IPI director and Town Hall moderator, I aim to cultivate a meaning-making conversation where we listen to unconscious themes and associative links, decode non-verbal communications, and analyze silences; share dreams and drawings, to which participants freely associate; and address transference–countertransference. A distance-learning environment co-founded in 1994 by David Scharff and Jill Savege Scharff, IPI employs its Group Affective Model (GAM) at conferences and certificate training programs to examine unconscious resonances of psychoanalytic concepts expressed within groups. IPI was in a singular position to bring a psychoanalytic response to clinicians who are, in a sense, on the frontlines of this world-shaking conflict. And although IPI Town Halls are not GAM groups, we adapt psychoanalytic listening and group interpretation principles in support of “thinking under fire” during wartime. I felt compelled to offer these wartime global conversations, bearing witness to colleagues who were psychically hemorrhaging on the fault lines between life and death.
When the psychoanalytic community steps up, it can bring support, relief, and a reminder that those living on the frontline are not alone.
As a wartime initiative, the Town Halls served initially as an acute crisis intervention. Heartbreaking stories flooded the meetings as traumatized clinicians express their helplessness, hopelessness, and life-and-death anxieties. They experienced imploding under the strain of uncertainties and terrors. Would their loved ones in Kyiv survive? Could their colleagues' families escape from Ukraine? Would supervisors find refuge? When would the war ever end? The war shears personal and professional identities. Russians expressed shame and guilt over their country's actions. Commonly, Russian participants voiced intense marital conflicts or intergenerational tensions arising from differences of viewpoints about the war. They described painful feelings of isolation and loneliness when their spouse or parent had voiced an unshakeable pro-war stance. A Ukrainian participant described an incident in which actors at his amateur theater group entered into a warring conversation due to the diversity of viewpoints held about the war on Ukraine, with some actors voicing pro-war sentiments. Many
of the participants say that the Town Hall is their only safe refuge.
Participants in Russia and Ukraine speak about feeling plagued by an ever-present war upon their minds, forced to defend against such horrific anxieties with denial, depersonalization, derealization, and deadening of their thinking capacities when alone, with families, or with patients. One US participant, who spent many childhood years in a Latin American country under a military dictatorship, shared a recent nightmare of being held hostage. In turn, another woman living in Russia associated to the dream—tears flooding her face, she described a constant feeling of being raped in a room with no escape. Upon noticing that she appeared to be doodling, I invited her to show her artwork. She held up the image (shown here). Many participants remained mute throughout, though their faces wore palpable distress. They appeared shell-shocked, their tears revealing their torment. Several persons extended a psychoanalytic helping hand for holding and containment. Some described first-hand and intergenerational war trauma histories. Others empathized and identified with those most traumatized.
Early on, participants bonded by their shared respect for psychoanalytic “thinking under fire” (a wartime phrase coined by Wilfred Bion), which served to unite us despite our varied languages and cultural roots. Resiliency was evident. Several persons who were initially shy became increasingly able to speak out as time went on. Russian participants voiced their freedom at being able to share sentiments and perspectives in a safe territory, which one person called a “humanitarian corridor.” For some, these Town Halls offered the only opportunity to speak freely without fear of reprisal and incarceration. Western participants from South Africa, the United States, and the United Kingdom often voiced guilt over their freedoms. For example, one American participant described her freedom to “open and close the door” to media accounts of the Russian invasion of Ukraine. She told us that it was important for her to “keep the door open (in her mind)” by participating in the Town Halls, so as to confront the atrocities that are ever-present in the lives of Ukrainians and Russians and to support those who have been robbed of such freedoms. One Western participant voiced his privilege to stay in contact with those in Ukraine and Russia as media attention recedes.
After a few weeks, I wondered aloud whether the expressions of gratitude were connected to their dependency on the Town Halls as a symbolic lifeline and their fear of the group ending, perhaps echoing their larger worry that the world may lose interest and turn away to leave Ukrainians, Russians, and Eastern Europeans to fend for themselves. I reaffirmed that IPI would continue offering these meetings open-end-edly. These interventions may have catalyzed a breakthrough for the group, deepening investigations of analytic themes because of enhanced trust in the setting.
For example, a few Ukrainians described their fear that their Russian colleagues in the Town Halls would be unable to tolerate their voiced outrage at the Russians for instigating the war, or their fierce conviction that Ukraine would ultimately prevail. In one Town Hall meeting, a kind of standoff emerged between the Ukrainian and Russian interpreters: a Ukrainian participant began speaking in Russian whereupon both interpreters began translating into English at almost the same time. Consequently, both interpreters' voices drowned out each other, leading to a confusing cacophony of sounds that created momentary chaos within the group. At this moment, I asked the interpreters to pause to allow the group to analyze the unconscious dynamics that might be at play. Then the Ukrainian interpreter recognized that she was overcome by the urge to help her fellow citizen when she later realized that it was not her remit to translate when Russian was being spoken. A mother-baby pair from Eastern Europe join regularly—the mother recently remarked that she noticed a direct correlation between the severity of her daughter's skin condition (atopic dermatitis) and their joint attendance; her baby's skin clears up when her mother attends with her and flares up if the mother misses. This compelling example has been riveting to the participants as a testament to the power of metabolizing traumatic affects lest they become deposited in the body in the current or next generation.
Several organizing threads emerged in the conversations. Ukrainian and Russian therapists and analysts felt confused and scared about—and mournful over—whether they would ever resume their analytic practice as they knew it. Participants felt pressured to live in a world of propaganda, for example, that Russia is saving Ukrainians from a Nazi government. Analysts felt challenged to remain neutral when their patients debated leaving Russia. An analyst described a patient, a single mother whose daughter feared being orphaned if her mother were arrested for protesting. One therapist joined the Town Hall from a street corner in Prague while protesting. I felt concern for her safety yet admired her courage and commitment to thinking analytically even in the heat of protesting. As some participants raged against Putin, others questioned whether there may be comfort at localizing the violence outside of the group. One Russian participant then coined the term “little Putin” to represent the internal aggressor. Consequently, we explored the “little Putin” in each of us and
the need to be alert to the latent aggression within the group. The atmosphere in the group is frequently subject to analytic study, including the various meanings that may account for the deafening silences sometimes overtaking the conversation. One participant wondered if our weighted pauses shielded us from our hearing more horrors; another viewed silences as means to avoid saying hurtful things to each other.
One day, the group witnessed a reunion between two long-lost friends. One Russian participant described how she had feared that a close friend had died in Ukraine. Eager to extend support to her, she had emailed the Town Hall flier to her but heard nothing back. Suddenly, she thought she saw her friend in the Town Hall. Unmuting, she descended into tears but could not speak. Gradually, she gathered herself to say that she had just seen her friend who “appeared one moment but disappeared almost immediately” (due to a poor internet connection as we learned later). As she was speaking, her friend reappeared and told of her frightening escape from Ukraine to France with her husband and young child. The long-lost friends were now reunited online, easing the horrific fantasies of the Russian participant that her dear friend was dead. Both participants' Zoom tiles lit up as they exclaimed poignant emotions of relief at being alive together in the same online space; the group joined in their celebration. This situation captured the struggle to retain hope in the presence of so much uncertainty and fear.
During the 11th session, we were suddenly Zoombombed by pro-Putin, Nazi-supporting intruders. They screamed profanities and attacked Jeff Taxman, chair of APsaA's Community Psychoanalysis Section, and me by name. I wondered how long they had eavesdropped on our conversation. They screenshared a video of a Russian pilot maneuvering his plane's exhaust fumes in the shape of a penis over Ukrainian skies. They copied my email address onto their Zoom tile to pretend to be me, creating more chaos and confusion. I was unable to remove them from Zoom, as they were multiple users, so I ended the meeting. This experience gave all of us a very palpable, personal sense of what is transpiring in Ukraine. Fortunately, Dr. Taxman recommended we offer crisis intervention to those for whom we had contact information using my own personal Zoom account.
The timing of the Zoombombing coincided with the Russian government's increased sanctions against citizens who participated in dissenting activities. There was a gradual attrition from the group. Over weeks we went from an average of 80 to between 25 and 30 participants. The group attributed this primarily to the Zoombombing, ever fearful of a recurrence. One group member who was devastated by the Zoombombing absented himself; upon returning, he felt disoriented—“on the edge of an abyss of nothingness.” By June 2022, as the conflict seems to be settling into a long battle, the group is restructuring into a yet-to-be defined form that continues to analytically transform the horrors—as we try to make sense of the senseless.
Over recent days, I decided to share with the group an aspect of my own heritage: my paternal great-grandparents were Russian Jews residing in Odessa, which is now part of Ukraine but was then part of the Soviet Union. I described my sense of kinship with the participants on both sides of the war and my empathy for their traumatic plight in resonance with what I understood about my father's wartime traumas. One participant from Russia exclaimed, “You are a bridge. You are from the West and East.” Upon hearing my link to Odessa, another member from Poland, who previously felt inhibited to speak, suddenly smiled from ear to ear and reminisced about her annual trips to Odessa, all while five military jets audibly flew overhead as she walked outside. Yet another participant was suddenly jarred by the realization that no longer could she visit the Odessa seaside resort that had been a source of childhood delight. She was hit by the possibility of never returning to Odessa except in her mind. I employed the metaphor of a phantom limb syndrome to convey the sense of anguishing psychic pain amid the unbidden amputation of a part of her life history.
A Russian therapist shared, “This war has destroyed my feeling of safety … With the amount and speed of change, the only thing to do is to record it. It's so hard to process … It is important to have the opportunity to have such spaces to express our thoughts.” An American participant explained, “War is designed to make us feel disconnected. We are supportive of each other as a human race, as we unite despite our geopolitical borders that separate us … My heart goes out to all of you. Do focus on the strength each of you have, and on your courage and determination to speak out and survive.”
Town Halls provide a lifeline to keep our thinking alive, our hearts connected, and our humanity flourishing. Such groups serve to mitigate the trauma taking on an underground life within. We hope participants can continue to support each other on the humanitarian online “corridor,” to inspire courage, and to fortify the thinking of those most bereft. This psychoanalytic intervention provides holding and containment during and after the atrocities of war. I am grateful to all participants who have created this meaningful experience. Like the Ukrainian cellist who continued playing music amid destruction of surrounding buildings, the Town Halls continue to create a psychoanalytic version of music, as we tune our therapeutic instruments to make sense of heartbreaking atrocities.
Caroline M. Sehon, M.D., FABP, is director and supervising child and adult psychoanalyst at the International Psychotherapy Institute (IPI); Clinical Professor of Psychiatry at Georgetown University School of Medicine; and an Executive Committee Board Member of APsaA.