Rita Ostrovskaya, Breath of Life, Water, 1995
This essay is part of an e-flux Notes series called The Contemporary Clinic, where psychoanalysts from around the world are asked to comment on the kinds of symptoms and therapeutic challenges that present themselves in their practices. What are the pathologies of today’s clinic? How are these intertwined with politics, economy, and culture? And how is psychoanalysis reacting to the new circumstances?
Therapist: Yes, yes … but still, somehow your husband ended up fighting at Azovsteel alongside your son.
Patient: Oh don’t. Really, really don’t go there. Maybe he wanted to prove something to me and to Dmytro, to look cool or something, but come on—it’s just nothing. And at the end of the day, he failed to save our boy.
The above conversation took place in June 2023 during a psychedelic-assisted rehabilitation program for Ukrainian soldiers and their families in Europe. By then, I was already in analytic training and working as a psychoanalytically oriented psychotherapist.
Born in Kyiv, I spent most of my adult life abroad—Stockholm, Hong Kong, Moscow. I worked with cultural institutions, curating projects on popular lifestyles and imagined futures. For years, I believed in and practiced trend forecasting and strategy. Gradually, I realized I was analyzing the world to avoid analyzing myself.
I began formal training in psychoanalytic psychotherapy in 2020. A slower, quieter world opened, where mourning, ambiguity, and internal life finally made sense. I was just in time. Halfway through my training, the full-scale invasion of Ukraine began.
As often in my life, I began with hope. The same was true for many Ukrainians. In the early days of the full-scale invasion, there was collective clarity—the energy of men and women volunteering, and me taking on new clients, mainly soldiers and their family members.
But time intervened. Slowly, for many of us—friends, patients, myself—something shifted. What felt like one long, victorious charge began to settle into something heavier. From vigorous inhale to sobering exhale, from mania to depression.
***
Petro, a combat medic, decided to get therapy after being severely wounded. During my six months of work with him, he recovered and was assignment to a quiet post near Ukraine’s western border. He hated it. He felt like he was missing the real fight. “I’m protecting Ukraine from Moldova,” he joked bitterly. He wanted to go back east—to the front, to the action. This was the motif of every session.
He told me once that he sent a letter volunteering for a battalion. It broke me. I said something like: “Okay, if you want to drop, just drop”—like when you drop into a ramp in skateboarding, which he did before the war. It was careless. Weeks later, he was accepted to a well-known assault brigade on the front line. He was proud and I was terrified. Later, I learned that he had already volunteered long before our session. And I still wonder whether my words pushed him.
In the last message I received from him, on February 14, 2024, he said he missed therapy. He was fighting 24/7. Ten days later, on the anniversary of the full-scale invasion, I saw an Instagram post—he had been killed.
All this was happening alongside my civilian practice. Some clients had bribed their way out of Ukraine. Others stayed, supporting the army or simply trying to keep going while the sky was falling. By enduring unrelenting depression and the collapse of the symbolic order, they voted with their bodies, to paraphrase Judith Butler.
Psychoanalysis against heroism—the tension I return to again and again. The analytic frame doesn’t glorify sacrifice. It doesn’t thrive on courage or conquest. It waits, listens, mourns. But when the world around you demands that you perform (which is demanded most often of the least privileged)—that you act like a hero, a warrior, even heal quickly—the container cracks. Mania seeps in. Heroism turns compulsive.
I lived it. After learning of Petro’s death, I felt I had to volunteer on the front line. I almost did. I interviewed with an assault brigade and was accepted as a therapist. It was my training analyst who stopped me. He told me he would destroy my International Psychoanalytical Association candidacy. Maybe he was right. Maybe he did what I couldn’t do for my soldier—he stopped the mania. He held the frame.
***
A few months later, I joined a grassroots psychedelic-assisted rehabilitation project for military personnel and their families. It ran entirely on donations and was organized by Ukrainians in exile who were determined to help those who had risked everything.
A group of two mothers and three soldiers came to an EU country to undergo psychedelic treatment. One of the mothers had a daughter who had been released from Russian captivity in a prisoner exchange. The second was the mother of a soldier name Dmytro, who was killed in a Russian attack on a prison holding captives from the siege on Azovsteel Iron and Steel Works in Mariupol. By a strange twist of fate, her husband—also a soldier—survived the same attack that took their son’s life.
Two of the soldiers have become public figures, national icons. The third was a quiet survivor. They were all working class. Before the war they were mostly invisible. Now, war has made them visible. Which also meant exposed.
The rehabilitation loosely followed a modified protocol from the Multidisciplinary Association for Psychedelic Studies: four preparatory therapeutic meetings, one psychedelic session (MDMA and psilocybin), and follow-up integration work.
In the session the soldiers relived the siege on Mariupol. During the first days of war, the sound of bombs was deafening. One of them looked at me and saw a Russian prison guard instead of a therapist—someone who had beaten and humiliated him. I had to endure this projection and transform it. In the end he tried to hug me. A space for trust opened—fragile, but real.
Dmytro’s mother saw her son—not in the room, but in the psychedelic space. They talked. She cried. In the following integration sessions she said she would devote herself to supporting other grieving parents. The unthinkable had been metabolized. It wasn’t exactly clinical or official. It was a temporary zone of care.
A few weeks later everyone was back home in Ukraine—the mothers back with their husbands, the soldiers back to their civilian lives. Their defense mechanisms returned too. I saw painfully clearly that the psychedelic experience alone is not enough. What mattered the most wasn’t the substance. It was the container—the holding, the attention, and the time.
This is what has been taken from the people of Ukraine—and Palestine, and so many places suffering from colonial wars: the basic psychic conditions required for mourning.
Instead, what is offered is performance. CBT and pregabalin (Lyrica) are widely promoted and prescribed—an automated model of therapeutic care. This makes sense, since there are too few trained professionals and too much pain. But it means that mourning becomes another thing to optimize. Collective trauma, instead of being metabolized, gets frozen.
In my view, and from the experience described above, psychedelics help. They accelerate transference, saving the resources of those who don’t have them—the working-class people who suffer the most from the war. But they don’t replace the need for weekly sessions over the long term, a privilege the majority doesn’t have, even as the need for deep therapeutic support grows.
The Ukrainian Psychedelic Research Association—of which I’m a proud member, alongside researchers from Ukraine and Western colleagues such as Rick Doblin and David Nutt—has undertaken a major advocacy effort.1 The communal healing approach, grounded in rigorous therapeutic support and expanded training for Ukrainian practitioners, could lay the foundation for a hybrid methodology, one that is not only effective but also just.
***
Since the middle of 2022 I have keep coming back to a house on the outskirts of Athens, my temporary refuge. This is not a strategy, but something closer to a psychic pull. Greece has always held meaning for me: the dream of autonomy, the land of radical beginnings, the place where leftist ideas first took form in my imagination. In Athens I got involved with anarchists, theorists, thinkers. They saw Ukraine through the old prism: nationalist, fascist, aligned with Western imperialism. I once gave a public talk in Athens about the reality of war in Ukraine through the lens of my therapeutic and volunteer work. Later, the organizers said that undercover cops had come to the event. I wasn’t suspected of anything; paradoxically, the cops were there to protect me in case I was attacked by people who considered me a Nazi. But the talk went well. No Molotovs were thrown.
Less placid was an event put on by the Greek political party MeRA25 that I attended two days later. Yanis Varoufakis, who founded the party, expressed his wish that the war would last long enough for the fascist forces of Russia and Ukraine, as he saw them, to kill each other. When my husband and I questioned his stance, he publicly called us fascists.2 It was violent and absurd. But it clarified that there is no neutral space.
Though many on the Greek left have pro-Russia views, I was lucky to make friends with Ioanna, Eirini, Siyavash, and Yavor. Yavor, a Bulgarian scholar, deeply influenced me by introducing me to the works of philosopher and psychoanalyst Cornelius Castoriadis. His thinking helped me begin to see Ukraine as a space for potential resistance. As a state shaped by Soviet authoritarianism and, later, post-1991 oligarchic capitalism, Ukraine became a place where neither system—neither socialist nor neoliberal—allowed room for the psychic life of its people. Despite these conditions, Ukrainians still find strength in each other and organize horizontally. Yet a reliance on digestible narratives complicates reality. This is where I began to understand “heteronomy” as Castoriadis used the term—not as an abstract theory, but as a lived condition. It describes a society that cannot imagine itself because every image it has of itself has been bestowed from above.
Recently I participated in a group training for therapists working with soldiers in Ukraine. It was provided by one of the main British psychoanalytic institutions. A Ukrainian colleague described a case that was almost unbearable to hear—a story involving child abuse, sexual slavery, trauma, dissociation, deep victimization. The trainer, a well-known English analyst, listened. Then he said that the case reminded him of Ukraine itself—a victim country that seems to find pleasure in its victimhood.
He was speaking in English. The group, mostly Ukrainian, didn’t speak English. So we had a translator who wisely softened the phrasing. He put it gently, out of care for the Ukrainian therapists from eastern-front cities who were participating in the training. He was protecting them.
But I had heard the original. I held my breath for a moment. And then I simply said: “I strongly disagree.” That was all. I couldn’t say more. I didn’t want to make a scene, but I couldn’t be silent either. At that moment I realized: the empire speaks softly, in generalizations, in meta-narratives. Even when it volunteers its time, it retains the right to interpret us. To tell us we are losing. To tell us we should make peace with defeat.
Being an analyst in Greek exile, so to speak, helped me keep a sober distance from the uncontainable, which simultaneously allowed me to hold it. Pink Aegean sunsets alongside nightmares of mass graves; waves alongside sirens; moments of soft laughter over Zoom with my clients who come to sessions straight from the trenches, followed by sudden collapse into trauma.
In both its brutality and grace, this is an “inconvenient place,” in the words of Jonathan Littel. It’s not just a geography but a psychic condition, where we learn to be present in superimposed temporalities. It’s a place between mania and depression. When I find myself in this place, I return to a question that haunts me—the question posed by Gayatri Spivak: “Can the subaltern speak?” I want to go further and ask: “Can the subaltern mourn?” With her I answer: “Only if they are heard first. Only if someone is willing to stay in that inconvenient place and listen.”
Edited by Nikita Rasskazov.
