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The wars inside and outside:

Experience of war in a patient, a psychoanalyst, and a society in Ukraine

Igor Romanov

(Kharkiv) Training psychoanalyst and a Head of Training Committee of Ukrainian Psychoanalytic Society (IPA study-group)

In this paper, I would like to focus on the topic of experiencing the ongoing war in Ukraine impact on both participants of psychoanalytic or psychotherapeutic process, continuing to work in these extreme circumstances. More specifically, I will be interested in two questions. First, how much psychoanalysis or, let’s say, psychoanalytic awareness expands the possibilities to help people who suffered from an extremely traumatic experience of war: injuries, shelling, loss of one’s home or relatives; and prior to this could it explain more the war impact on a whole society? Second, to what extent and in what way does “normal” mental life, with its conflicts, anxieties, and defensive strategies, continue under war conditions, and therefore there is a place for “normal” psychoanalytic work? To what extent does the psychoanalyst’s consulting room turn into a retreat from external threats (Steiner, 1993) or a kind of “enclave” (O’Shaughnessy, 1992), and to what extent, on the contrary, it is a haven for the ongoing mental life – dreams, feelings, phantasies or internal relationships acted in the transference? The mental life, which, as Freud pointed out, does not stop even in a dream, and which, how Klein hinted and Bion insisted, exists before our birth (Freud, 1900; Klein, 1957; Bion, 1977; Waddell, 2002).

 

 

Observing the reactions to the war

 

I will draw on my own experience in analysis and therapy, as well as the experience of supervisions and clinical groups with colleagues. An important source for my reflections was also the study of previous great wars influence on psychoanalysts and their theories. I will attempt to describe how we are trying to use this experience in new circumstances. But I will start with a few personal impressions and a description of the current state of the Ukrainian Psychoanalytic Society.

 

At a clinical group meeting headed by a foreign analyst one Ukrainian colleague reports a case. It is about a patient adjusting to real and imagined demands, criticizing her objects for the traumatic pressure on her, but also secretly trying to control everyone from the position of the victim: “If you refuse to be what I want you to be, you will turn out to be aggressors”. This situation is clearly acted out in the transference due to a break in therapy, and among other “misfortunes” the patient mentions the war that forced her to move to another country. During the discussion, it becomes quite obvious to the group, the supervisor, and the presenter that the war for this patient is really just one of the events in a long series of her troubles (along with the break or silence of the analyst, harsh parental training, etc.). They are the troubles which, according to the patient’s unconscious belief, she could prevent or remedy by her obedience or omnipotent control over omnipotent objects. In other words, the war did not represent for her any special “traumatic” event, but (as in the case of Richard in Klein’s famous analysis) it represented the objects and conflicts of her inner world.

 

However, another startling fact emerged from this seminar. The session following the clinical discussion was devoted to a general discussion Ukrainian colleagues’ work in current situation. And there was no other topic except the war. Interrupting each other, colleagues told horrific – and quite realistic – stories of their disasters, stories of severely traumatized patients, shared feelings of fear, anger, and helplessness. They also shared the recipes for successful work and overcoming.

 

How can one understand this strange contrast between the clinical discussion and the general one? Did a split take place so that the traumatic experience of war did not emerge in the sessions with the patient and the clinical discussion, but was split off into the analyst and the group, and was enacted in general discussion? Or was the war an occasion for specific competition around the “lethic phallus” (Schmidt-Hellerau, 2008)? Or was there a third or fourth reason?

 

Over the summer months, I had to visit many cities in Ukraine and some different places. I met colleagues, patients, volunteer psychologists, doctors, students, migrants and ordinary residents of different cities. One of the things that struck me the most was how differently war is experienced in different places. At some moments it seemed to me that, having traveled barely 100 km, I was moving not between cities, and not even between countries, but between different universes. In one of political discussions was recently said that Russia and Ukraine are waging two different wars: Ukraine is engaged in a patriotic, liberation war, and Russia is fighting a religious one, against heretics. It seemed to me that for different Ukrainians in different parts of the country there are also quite different wars (of course, not so radically). In some parts there wasn’t a single shelling or any destruction, but people feel the war quite acutely – as their own, but at the same time as something distant. They help refugees, the army, they volunteer, they are patriotic. However, the war is far away, it is happening to others and does not prevent them from leading a normal life – opening restaurants, thinking about new business, etc. In other places there was a war, it left its physical and mental traces, but now there is peace and all kinds of activities resumed: concerts, traffic jams, projects… At the same time, since the wounds still hurt, both people and cities are ready to be on guard and protect their land at any moment – sometimes for very real reasons, sometimes for imaginary ones. In my hometown, Kharkiv, I encountered the most depressing atmosphere. There were no horrors of Mariupol or Bucha (although one could hear about such things not far from the city), nevertheless the city fell into a depressive state. Continuous, daily, albeit reduced in intensity, shelling, lack of a visible end to the war, emotional exhaustion – all this creates a feeling of being in the department for patients with severe depression. Dim, amimic faces, inexpressive voices, corresponding to the topic of conversation with periodically exploding anger… At the same time, a little more than an hour from there you can see a festival city, with concerts on rooftops, carefree young people lying in the grass, children walking and not paying attention to the sounds of air raid warnings.[1] I think this list of descriptions is missing perhaps the most important thing – the situation at the battlefield. But then only the people from there should talk about it.

 

In my opinion, this emotional map of Ukraine can also be presented as a map of the mind with the loci of possible psychological reactions to the war. The current war is different from the grand wars of the past, the First and Second World Wars. This war is not total, it involves a limited number of people, resources and territories (of course, this is for now, and of course, for Ukraine and many of its regions, the war is catastrophic). In addition, this war takes place in a globalized world, with well-developed networks of communication, information and disinformation, with the possibility of rapid movement and many other technological advances. All this affects both the experience of war and psychoanalytic and psychotherapeutic work. Speaking of Ukrainian Psychoanalytic Society – approximately half of our members have emigrated from the country, many have moved to other regions, and only a small part can remain in their home cities. An even greater percentage of refugees and displaced persons are among our candidates. The UPS is an IPA study group, we have 16 members, including 6 training analysts, and 28 candidates. The process of our development in recent years has been quite fast (Mirza, Romanov, 2022). The war interrupted it, nevertheless, we have managed to restore both our work and training. The previous period of work during the Covid-19 pandemic taught us to use tools for online work, and today only a few can afford to work in offices. Most conduct therapy, supervisions, seminars, analysis and training online. In addition, almost all of us are involved in various forms of volunteer work – with war victims, first aid psychologists, the military, IDPs, refugees, etc.

 

An important stimulus for my own and my colleagues’ reflections was the study of the experience of British psychoanalysts during the Second World War and after it (see Frank, 2020; Milton, 2018; King, 1989; Bion, 1940; Jones, 1941; Money-Kyrle, 1941; 1951; Dics, 1973). There are many things that surprise me in this history. First of all, how actively psychoanalysts were involved in the discussion and solution of urgent social problems of war and post-war period, leaving their offices, but not their commitment to psychoanalysis. In my opinion, the contribution of psychoanalysts and psychoanalytically informed scientists from other fields to the discussion of the causes of war, the means of achieving peace, the functioning of propaganda and cruelty is underestimated and needs further reflection and integration into social studies. The works of H. Dics, R. Money-Kyrle, E. Glover in Britain, E. Kris in Britain and the USA (Kris, Speier, 1944; Leites, Kris, 1947), N. Leites in the USA (Leites, 1977), F. Fornari in Italy (Fornari, 1974), A. and M. Mitscherlichs in Germany (1975), T. Adorno in the USA and Germany (Adorno, 1951), and many others contain important insights and, according to many testimonies, have made a significant contribution to the establishment of post-war world and the processing of historical traumas (Shapira, 2013; Adorno, 1959). On the other hand, it is worth taking a closer look at the influence of the external reality of wartime on the fate of psychoanalysis itself, its theoretical models, group conflicts and institutional decisions, which are often underestimated (King & Steiner, 1991). Without proper reflection, such influence can lead – and in fact has led – to serious errors in the application of psychoanalytic concepts to the description and explanation of social processes (Pick, 2012).

 

And yet, even considering the potential pitfalls of the abuse of psychoanalytic methodology, the devotion to psychoanalysis by earlier generations of analysts cannot but impress. M. Klein’s correspondence, in which she proposes the concept of the “Munich complex” to explain the passivity in the face of the omnipotent destructiveness projected onto the figure of the father / Hitler, and her idea of the “internal Hitler”, Jones’ reasoning about the phenomenon of “Quislingism”, W. Bion’s thoughts about the need for social measures for distinguishing between unconscious anxieties and real dangers, the ideas of N. Leites and E. Kris about propaganda’s efforts to subjugate the individual to the group and its various forms – all these insights seem incredibly relevant at the present time.

 

 

Members of the UPS on the impact of the war on the work of a psychoanalyst

 

Inspired by the experience of predecessors, I invited members and candidates of the UPS to answer some questions related to the impact of the war on themselves, their patients and work with them (see Appendix). The majority of those who agreed to answer the questions mentioned the catastrophic impact of the war experience on the participants and all the components of the analytic or therapeutic process. Below are a few examples.

 

The question about examples of military themes in analytic or therapeutic work

 

“The patient talks about her friend’s parents, who live in Mariupol, with whom there was no contact for several weeks. Subsequently, it turned out that the mother went out into the street and got blown up by a mine, the father collected parts of her body and looked for a place to bury her. This friend was never able to evacuate her father out of the occupation zone. The story correlates with the patient’s condition, her sense of chaos, inability to put herself together. It feels like she is “falling into pieces.””

 

The question about the dreams caused by the war

 

“I dreamed that I and my husband were at home, in our apartment. I’m packing my things, and suddenly, we hear an explosion. Our small son, thank God, was not with us. We froze and dropped on the floor, feeling mute fear. Again this word – “mute”. And then, then, I get up and go to see what happened. I see that there is no kitchen, no living room, instead I can see the sky. And in my dream I think: “Phew! It’s a good thing I managed to collect our things.”” Even in a dream I act like this. Although, I’m scared to think that now we actually have nothing.”

 

(The same patient) “I dreamed that my mother and I went to a lake. We were going to swim. But we saw a lot of sunken cars, they were all in this lake. My mother decided to get something valuable from these cars. She is like that. Then she gets something, takes it, and we can see souls fly out of these cars and they try to drag me into this lake. I shout to mum: “Why do you need all this stuff?” But she wouldn’t stop. Sometimes I can wake myself up in a dream. This time I tried several times, but it went on. I felt fear, mute horror… “Mute” again…”

 

The question about the influence of the war experience on transference

 

“The solders were in the basement, grenades were thrown at them, there was a fire, they were suffocating, they were wounded, the Russians were waiting for them upstairs. They had already said goodbye to their lives. However, two days later, the Russians were forced to retreat and the Ukrainian soldiers were able to come out of the basement. They stopped trusting their commanders of different levels because they got them in this situation. In the hospital, during consultations, when switching to the story about themselves, their lives and relationships before the war — I felt a negative attitude towards me: “I won’t talk about it, I don’t know how you will use this information against me… I have already had such a bad experience””

 

The question about the intrusion of the external reality of war into analytical work

 

“During the session, we heard an air raid alarm, the patient in Ukraine says: “Alarm!” I feel anxious for her life. I tell her: “Perhaps it’s dangerous now, it’s probably better to go to the shelter”. The patient replied: “Before I reach the shelter the alarm will end”. The session continued. I had difficult feelings, thinking that I was maintaining the denial of the danger by continuing the session, but forcibly sending the patient to the shelter would have turned me into a strict parent. Second example: a session was missed because the patient was in a bomb shelter during the session. The missed session was paid for. But as a therapist, I had doubts whether it was fair to accept payment in this case”.

 

 

Most colleagues also reported the difficulty of the transference/countertransference relationship in situations where the patient and analyst are in different places, sometimes in different countries, and one of them could potentially be in a more dangerous situation. Feelings of guilt, betrayal, their corresponding attitudes of sincere concern or false attunement, avoidance of sensitive topics, etc. were fairly predictable reactions.

 

The majority indicated that only a small number of patients did not mention or barely mentioned the war. It was noted that far less often patients began to bring dreams into sessions. Nevertheless, when asked if colleagues could recall examples of the improvement in the condition of patients with the outbreak of hostilities, almost everyone was able to name such examples.

 

I do not attach much significance to this survey as a credible scientific study. Rather, it can be considered a preliminary collection of impressions. Like any survey of this kind, it somewhat imposes on the respondents a certain train of thought – war, traumatic experiences, etc. It seems to me interesting to compare the data of this survey with my own and my colleague analytic and therapeutic experience, in which, as I see it, reality looks somewhat more complicated.

 

 

Examples of analytical work in wartime

 

Clinical example 1: А  

 

Patient A, a young woman in her early 30s, who began her analysis because of difficulties in her relationships with men and insecurity. A large part of our analytic work in this period was concentrated on her attachment to a rather perverse sado-masochistic relationship with a partner – both sexually and psychologically – largely reproducing her perception of her parents’ relationships, as well as her own childhood experiences in an atmosphere of deprivation and psychological abuse.

 

In April 2022, we worked online and were in different cities. In the first session after a week-long break, A spoke in a way that made me feel detached, unable to get through to her feelings. Although she talked about rather dramatic events: her parents were under occupation, the city in which she lived was periodically shelled, she developed paranoid anxiety about the shaking streetlamp outside her window, which she took for the signals of artillery gunners, etc. At some point, she reported that she felt the floor tremble and was afraid that shelling or bombing had begun. At that moment, I felt fear for her and asked if we had to stop and she could find a safe place for herself? At the same time, I heard the sounds of repairs behind the wall of my office and I wonder whether they could have affected the patient. She replied that she hadn’t heard any air raid alarms and that the danger was unlikely to be real – she felt detachment. Perhaps it only seemed to her that there was a dangerous situation… This gave me the opportunity to draw her attention to this feeling: what was she detached from and how does she imagine the thing she was afraid of?

 

In response, A talked about her fear of confusing the reality with her fantasy. If she can feel the floor shaking when it’s not, the opposite can happen too – she won’t notice the real danger when it comes. At that point, I thought that she was able to convince me of the reality of danger – the floor shaking – so that I did not even know for sure whether it was happening in my office or coming from her room. I said that it was important for her to convey to me a sense of the reality of catastrophe that was happening to her.

 

Following this, A remembered her grandmother’s stories about deportation during World War II. Her grandmother said she felt paralyzed. The Russian invaders are now behaving worse than Germans… And she also said that she wasn’t afraid of death, but of losing an arm or leg – of being crippled, helpless in the power of strangers, which was very reminiscent of her grandmother’s stories. She then moved on to the topic of language: her parents speak “surzhik”, a mixture of Russian and Ukrainian, but she was very proud of her correct Russian. Now she felt unsure whether this was indeed her language or the language of her enemies? There was some confusion. I interpreted it by saying that A felt a lot of fear and shame about the history of her family and country. But it belongs to her, and she was not ready to give it to anyone. It was noticeable that A experienced great relief.

 

At the next session, A shared a dream. In it, she walked with her grandmother through a forest among tall pines. She was a school teacher. Then a red car pulled up and took them to a party. A rolled on the grass and her clothes changed color. In the dream there was an atmosphere of fun with restaurants and wine. She gave more and more details and explanations. I drew her attention to the sexual atmosphere in the dream. At first she was surprised, and then she shared a fantasy about sex with different men and couples. Following this, she remembered another dream: about either Russian or German occupation, and how she seduced the guard in order to get food and win him over.

 

The discussion of these dreams led to the topic of A’s sexual inhibitions, her aversion to molesting men (“slobber kisses”), and further to the father’s abusive behavior in her childhood.

 

Comments

 

This short piece of clinical material can be viewed from different perspectives. One can see in it the actualization of transgenerational traumatic experience in a situation of actual threat (Romanov, 2021). One can think about the influence of personal history on the perception of current events. I think it’s also interesting to reflect on the possibility and difficulty of conveying a dramatic experience in an online work situation. From the point of view of the transference, what is striking is the gradual transition from detachment to a kind of “infection” (I think through massive projective identification), then to the perception of the interventions of the analyst in a manic and sexualized manner, and then to a feeling of intrusion and abuse. However, in the context of the paper, I am interested in the question of the mutual influence of external traumatic reality – the threat of shelling, occupation – and internal reality, a derivative of both the historical and pre-historical experience of the patient, and the activity of her drives, anxieties, defenses and phantasies. I was particularly impressed by her realization of the threat of confusion between the one and the other – insanity, in fact – and also by how quickly, after “unraveling,” A moved towards an exploration of her history and sexuality. One may, of course, ask whether the external threats receded into the background for both of us too quickly, that is, manically. But I had a strong conviction that the problems of sexual life, as well as a rather traumatic personal history, at this stage of the work were indeed something more significant in A’s life than the war outside the window.

 

 

Clinical example 2: B

 

Patient B, about 50 years old, comes from the Ukrainian city where I also live, but for many years lived between it and a nearby Russian city. Her business and family were scattered across the two cities and countries, but her roots, memories and childhood friends are connected with Ukraine. She perceived the war as a catastrophe, timidly tried to express her indignation at the war in her Russian environment (she remained in Russia and could no longer enter Ukraine), she helped Ukrainian refugees and relatives. However, after a while, our work went back to normal, and B began to mainly discuss her relationships with men. After her divorce from her husband, she could not find a new relationship for a long time, and finally she found a man with whom she felt neither masochistically subordinated nor arrogant. He had authority for her because of his position, but the thing that especially brought them together was their common attitude to the war.

 

For a while, the discussion of these relationships, of B’s hopes, fears, and disappointments, occupied the entire space of analysis. One of the problems was B’s anger at the religious sexual restrictions of her partner. She discussed these relationships with me again and again, sometimes I was completely immersed in their intricacies, the connection of her choice with her father’s transference, personal history, etc. The war raging around, concerning me, her relatives, and our hometown, seemed more and more distant. Periodically ‘surfacing’ from these discussions, I couldn’t help but wonder if her stubborn avoidance of war topics and denial of its significance as well as the whole romance were constructed as a psychic retreat. Whether talking about it would bring back to her real concerns, or whether those were my own thoughts about the war that haunted me? One day, B casually mentioned the blows in her city and quickly moved on to the topic of sexual taboos related to her childhood, etc. This gave me the opportunity to draw her attention to her quick avoidance of the topic of war. In response, B suddenly remembered one of the most depressing impressions of her childhood: the village of her grandmother (mother’s mother), who never smiled and often looked at the photo of her little son who was blown up when he stepped on a mine which remained after the Second World War… At this point, her romance began to look like the attitude of children huddled together under bomb explosions. She remembered how her lover sent her a photo of soldiers from Mariupol at night – not children, but wounded men. He was crying and it shocked her. I assumed that this was what she was afraid of when discussing the war with me – we would just cry together, completely helplessly. There were indeed tears in my eyes, but my feelings were not unbearable. I hope our interaction at that point was better than the stiffening contact of the patient with her grandmother – and, as we knew, her mother – and I think that’s why at the end of session she especially sincerely said: “Thank you!”

 

I thought B was really grateful for that session. But she began the next one (after weekend) by accusing me of ignoring the topic of sexual problems with her man and their connection to the prohibitions of her mother. I had a clear sense of the connection between these issues, and that it was the dead-faced, depressed grandmother/mother who was the authority forbidding love. Perhaps I became the same prohibition by bringing her back to the topic of war. On the other hand, B recalled childhood masturbation, which seemed to me an example of an escape from depression into sexualization. Following the discussion of these topics, she began to talk about the fear that her partner will grow old and their romance will turn into caring for a sick old man.

 

Comments

 

In a sense, this example seems to me to be the opposite of the previous one. The immersion into romantic relationships and their discussion, “family romance” in the transference turned out to be a defense against depressive feelings and depressive anxieties associated with the war. However, as in the first example, delving into these experiences showed how much the current catastrophic situation, destroying many of her personal relationships, her business and relatives echoes her history of the interaction with a depressed mother/grandmother and the stable patterns of internal object relations acted out in transference: “you have no right to your life, you must not upset your mother”, etc. B in general looks more depressive personality – her typical dreams were often fulfilled by destroyed houses, cemeteries, and lost people. At the same time her life seemed the series of attempts to cope with depression, her own and people around her, in many different and sometimes successful ways. Of course, the war actualized her deepest depressive anxieties as well as oedipal illusion in its function of retreat and pseudo-reparation. I suppose that some period I was colluded with this wishful fantasy, and when was separated from it, the patient faced her deeply destroyed internal objects. Cruelty and guilt quickly changed each other attributed both to the patient, me, her external and internal objects.    

 

 

Clinical example 3: C

 

Patient C was born in the east part of Ukraine and lost his mother at the age of 4. According to his words, this loss provoked a “mature reaction”, one that he would go on to exhibit in response to all the difficulties of life. In his school years, C suffered from bronchial asthma, which he managed to overcome with the help of special breathing training. Ever since he has been controlling his respiration by “correcting” it. In psychotherapy C looks like a very “compliant” patient; he follows the rules, provides the material, reflects on interpretations, but at the same time causes a sense of a relationship paralysis of sorts in the therapist. With the beginning of the war this constellation changed, the patient started expressing his discontent with the therapist, although in a quite unexpected context.

 

As such, in one of the sessions, C started blaming the therapist for “excessive tolerance”. It concerned the choice of the language (between Russian and Ukrainian) given by the therapist. C spoke in his own native Russian, while expressing the opinion that it would be more appropriate for the therapist and everyone around him to demand of him and other people that they spoke Ukrainian. He personally strives to speak Ukrainian in public places, but his efforts are apparently insufficient. Some “terrible people” don’t wish to follow him and respond in Ukrainian.

 

The therapist was at a loss under the pressure of the accusations made by the patient and their confusing nature: “I want to force you to force me…” She repeated multiple times that she was ready to converse with the patient in any language she finds comfortable, emphasizing as well that Ukrainian was becoming more widespread.

 

This did not only fail to reassure the patient, but, seemingly, disappointed him even more. He said, “A Ukrainian-speaking environment is important to me, it would make it easier for me. It seems to me that everything will remain just the way it is. (He began weeping bitterly.) L (C’s home city) was always a Russian-speaking city. Only about 15-20 percent speak Ukrainian. I went to a hairdresser, her parents live in R (occupied Ukrainian town). She says everything is alright, they took the children to K (Russian city) for a holiday, provided a compensation and everything that was necessary.” A little later C continued, “You are yet another somnolent person refusing to adopt responsibility in my life. You don’t want to introduce rules which will bring about change. It’s like demanding from a child to grow up without parental involvement…”

 

Commentary

 

This session was striking to me – both in its counterintuitive content, and in the revelation of the inner structure of the patient’s personality and relationships. The mother, with her milk, tongue, and air, has betrayed him, and now C must learn to fully control his respiration, nourishment, and speech. He requires assistance in this learning process, but the kind of assistance that would be his assistance, that is, control which would prove the uselessness of all that is motherly. Bitter tears, expressing an experience of loss that lies deeper than anger, demonstrate that this mechanism is malfunctioning. “It will remain this way forever,” says the patient, “the children will be taken away”, a good mother will never return. All he can do is complain to the bad but idealized mother of control – absence of her harsh rules is equated to the absence of care. Is there a way out of this dead end and confusion?

 

In the above, as in the first example, one can note the significant meaning the problem of language represents to the patients. Both A and C are Russian-speaking Ukrainian citizens, but perceive their native language as the “enemy’s tongue”, the traitorous part of the self, which has to be combatted (in a particular moment for A, and constantly for C). I will not dive deep into the political and ideological aspects of this subject that is so sensitive to Ukraine. However, perhaps, the clinical review may shed light on it from an important angle. E. Jones and M. Klein explored the misadventures of the omnipotent destructive figure in the inner world and projections of patients (the “inner Hitler”, according to Klein, “Quislingism” according to Jones) (Milton, 2018; Frank, 2020; Jones, 1941). They described such defensive maneuvers as identifying with the omnipotently destructive figure and passive submission to it.[2] Following this line of reasoning, we may suppose that both of the patients described were trying to overcome the realized – in their perception – introjection of the destructive figure and the identification of it with a part of the self. A’s dream about the seduction of the guard may serve as evidence of this.[3] The next step that already consciously manifests itself in analysis is the attempt to dispose of the inner enemy or traitor in a particular fashion, which the therapist should have provided C assistance with (essentially, taking on the role of the rapist in a positive nature), while A achieved it via a manically tinted sexuality (as well as elements of sadomasochism, as we may recall). A’s dream about color-changing clothing demonstrates, in my view, that such an exact “excision” of the dangerous part of the self must lead to a transformation of the whole personality.

 

Brief conclusion

The impact of war on patients, analysts, and the analytic situation itself varies over a fairly wide range. We can observe reactions of denial and, on the contrary, defensive (denying) exaggeration of the impact of the war, the actualization of early and transgenerational traumatic experiences and the refraction of the perception of external reality through the prism of internal dynamics of drives, defenses and conflicts. The significance of a particular issue will depend on many factors. Among the external ones, it is important to consider whether both participants in the analytic relationship are exposed to the actual traumatic effects of the war or can work at least in relative safety. The situation of online work is complicated by the fact that the patient and the analyst may be in different situations. However, internal factors are no less important: the strength of the ego, the dominance of mature or primitive defense mechanisms (both in the patient and the analyst), internalized patterns of object relations. It is also worth pointing out the importance of social factors. Public sentiment and wartime propaganda provoke both paranoid projective maneuvers and masochistic self-sacrifice (Money-Kyrle, 1941; Leites & Kris, 1947). All this makes the analytical relationship vulnerable, subject to destructive influences from different sides. But that doesn’t make it any less valuable. War “breaks the bonds that bind people”, as Freud noted in 1915 (Freud, 1915). He later reformulated this as a threat to the binding forces of Eros, love and identification, coming from the death instinct (Freud, 1933). As I have tried to demonstrate in my examples, disconnections also occur in the inner world, which makes analytic work especially difficult and especially important under such circumstances.

 

It would be imprudent to draw far-reaching conclusions regarding social and political reality on the basis of limited clinical experience. A lot of prominent psychoanalysts, such as F. Fornari and H. Segal, followed this path with a certain degree of success, although one may mention a number of instances of serious misconceptions caused by unjustified abstraction by psychoanalysts of their personal experience with patients and transference of that experience into non-clinical areas. But even within the limits of strictly clinical reflection it is difficult not to think of the dangers of such a form of splitting of the self, where one portion is perceived as “treacherous”, identified with the omnipotent aggressor, while another portion is viewed as cleansed of evil, perfect, but quite phony (as it happened with the problem of “enemy’s tongue” as a traitor inside in cases of A and C). Such consequences of similar processes as weakening of the self and distortion of the perception of others were described by Klein in the classical work on schizoid mechanisms (Klein, 1975). This problem was encountered by all the three patients described above, including B, for whom the solution turned out to be more complex and “deactivating” one of the portions of the self every time would prove to be short-lived, even alternating with attempts at integration. Perhaps, the reason for this lies in the more extended period of analysis, or it could lie in B’s general depressive type of personality. It seems as if there is nothing unexpected about how war actualizes and intensifies in the psyche such primitive mechanisms as splitting, projective identification, idealization of omnipotent destructiveness, etc. More complex issues arise when studying the various forms and combinations they appear in. They also emerge when we wonder about their functions which at certain moments, at least subjectively, enable survival, while at other moments extremely weakening the individual and the group.

 

(Translated by Vitaliy Yaskevytch)

 


 

[1] I should say that the situation in Ukraine is changing rapidly, and my impressions of different places could be different today. Now almost all country suffers the infrastructure destruction and is anxious about winter. But I am sure the differences are still existed.

[2] F. Fornari also pointed towards relief in the case of projection or “export” of the inner Terrifying into the external enemy (Fornari, 1974). W. Bion, in his turn, emphasized the necessity of delineation between terrifying “childhood nightmares” and real enemies for the sake of efficient action during war (Bion, 1940). This is also indicated by D. Bell in a recent publication, where he casts doubt on the description of the military situation as functioning in paranoid-schizoid position (Bell, 2022, p.680). The issue of the proportion of “normal” and “pathological” mechanisms in the psyche of an “efficient soldier”, as well as any other participant of military action, was explored by many psychoanalysts during the First and Second World Wars (Freud et al., 1921; Eissler, 1960).

[3] This reminds the a “self-object fusion” in traumatic situation described by W. Bohleber (Bohleber, 2007, p.342).

References

 

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Appendix

 

QUESTIONNAIRE for UPS members and candidates about influence of war on analytic and therapeutic work

 

  1. Indicate your status.
  2. What type of work are you currently doing: analysis, therapy, counseling, other?
  3. Do you work online?
  4. Are you located in the same place as your patients?
  5. How many of your patients were affected by the war in one way or another? If you can, indicate the number, how many are in therapy and how many are in analysis, online or in the office.
  6. What experience, in your opinion, was the most traumatic for your patients: injuries, loss of loved ones, flight, shelling, other issues?
  7. Give some examples of the emergence of military themes in your analytic or therapeutic work.
  8. If you can, also give examples of dreams, memories, and other material that reflects the unconscious meaning of external traumatic reality.
  9. If you can, give examples of war-related experiences in the transference: lost of trust, fears of political differences, etc.
  10. If you can, give examples of enactment, acting out, and other forms of war experiences expressions in action.
  11. Can you give examples of external reality intrusion into your analytic work (for example, air raid alerts) and how you dealt with it?
  12. Can you give examples of specific countertransference experiences related to the war that influenced your work?
  13. Do you have any patients who constantly or often ignore topics related to the war? What is the approximate percentage? Can you provide examples?
  14. Can you give examples of the positive impact of war experience on your patients and therapeutic or analytic work?

 

 

Igor Romanov, Kharkiv

Società Ucraina di Psicoanalisi

igromanov@yahoo.com

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