Abstract

In lieu of an abstract, here is a brief excerpt of the content:Soldiers of the Invisible Front: How Ukrainian Therapists Are Fighting for the Mental Health of the Nation Under FireIrina Deyneka and Eva RegelIrina DeynekaWhen the Russian army attacked my country, I became a volunteer for a hotline offering psychological support to those in crisis; refugees, those who were under the shelling, those who were hiding in bomb shelters, and who were directly in the zone of fighting. People were lost and disoriented by constant bombing, by the fact that their country was under attack. Once, I had a woman who lived in Mariupol on one of these calls. I was living then in another city, Odessa, but was experiencing the same horrors of war that my client was—the shelling, uncertainty, and despair. We were processing my client’s feelings of grief and anxiety when I heard the sirens on her end. I offered to stop our session so she could seek shelter. She told me she would not have time to find shelter and wanted to continue our meeting. And so, we continued... But soon, Odessa’s sirens broke the silence, and it was my turn to decide what to do; should I continue our session or try to find a bomb shelter for myself? I decided to stay because I thought that was the right thing to do morally, professionally, and personally.I eventually left Odessa, but only after a bomb destroyed a house next to mine, and I saw a family, my neighbors, perish in the destruction. I am now a member of one of Slovakia’s Non-Governmental Organizations (NGOs) and work in a mobile brigade providing medical and psychological support to refugees. I can remember every one of my clients. Children, adults... I can remember their stories, their traumas, their memories of the horrors of war and devastation. Sometimes I meet with them only once, and they move on to another refugee center or are on their way to a Western part of Ukraine, trying to escape the war. And frequently, I do not know how many sessions I will be able to have with clients. Sometimes it is only one time, and sometimes we can meet for many months. Initially, I thought, What can I do in one therapy session? Now, I know that I can do a lot. I can provide people who survived the most inhuman conditions and witnessed death and destruction around them with a space and time to talk through and process their experiences. I am their support, and they lean on me as they try to make sense of what has happened to them and their country. I always tell my clients that my goal as a psychotherapist is to help them withstand, survive, and hold on while still being able to continue to function in a country at war. All I can do is treat each of the therapy sessions as our last one and try to provide as many strategies and skills as possible to cope with anxiety and depression, to be able to function, and to live in the present.Every session is about installing hope, moving slowly forward, and away from traumatic events. One of my clients, a 14-year-old boy, was diagnosed with a neurological condition, involuntary facial muscle spasm, or tics. He was barely talking when I first saw him, and I decided to use art therapy as a trauma-processing tool during one of the therapy sessions. He was drawing an explosion, fire, and destruction of his neighbor’s house. He blacked out the horrors of his experience to preserve his strength. Yet, he began slowly remembering his experiences, re-creating the story of his trauma, and making memories. I was fortunate to work with [End Page E4] him for many months, carefully and thoughtfully helping him re-create the sorry of his trauma, helping to become its witness. Ultimately, it was great to see that he could control his memories and his emotional stress; he felt empowered and in control.Eva RegelThis is the story of Irina Deyneka, one of many Ukrainian psychotherapists working in Ukraine, providing mental health support to a nation ravaged by...