from A War Diary of a Psychotherapist in Dire Straits

The Womanly Faces of the War

Day 4

The war got me right in the gut. Dead on. It feels better when I’m doing something. I am in an adrenaline-fueled race—I’ve gotten a whole bunch of people involved in helping the refugees. I’ve put up posts on Facebook to disseminate information to civilians trying to escape, or to those who need to learn to stay safe where they currently are . . .

This war comes with instructions for use. That’s how civilized twenty-first-century people deal with life’s problems: they google for answers and then maybe even call a therapist. It helps you descend into a boiling crisis. It softens the blow.

 

Day 6

Today was beyond awful: a pair of new-born twins was found on the battlefield and then they were lost. How did it happen? There was a call for help from a colleague who originally comes from Kharkiv (we didn’t have time to get properly acquainted, we were introduced yesterday online—all I know is that she is a psychiatrist now working in Washington): someone from her hometown wants to know where to take a pair of newborns who were just pulled out of a caved-in bomb shelter. These infants, who were most likely born on March 1 (who could have assisted with their birth? their father?), were pulled out alive—the adults were all dead. While I am trying to work this out with my new ally at UNICEF (“tell them to use the ‘kangaroo’ technique on the babies,” “we’ll try to find someone who is still in Kharkiv, but it’s very difficult”), another text arrives: “because of the intense fighting in that area, the paramedic can no longer make her way to the place where the infants are located.”

There’s no time to weep because another cry for help comes in on Messenger: “You posted that Sochnut (the Jewish relocation agency) is evacuating people out of the shelled area. Would they take a bedridden woman out as well?” How in the world would I know? But now I’ll have to call all those numbers that I myself reposted earlier, and try to talk to the evacuators, to make arrangements . . . No, I’m not getting through. I call my personal connection in Kyiv, who asks me, “And how are you related to this woman, Galina?”

I get that question a lot. As if it matters. The most important thing is to save a human being. To hold on somehow to a bit of humanity in this war. (A week later it turns out that they did get the woman out of there on my tip.)



Day 30

I am studying the map of Ukraine on Google Maps. I’ve never actually taken a close look before at the territory between Odesa and Kyiv, between Odesa and Kharkiv—and why would I have, if I only ever visited the large cities and traveled by plane or express trains, looking either up at the clouds or at the nameless fields and forests that were flashing by. But the place names that barely registered in my consciousness when I listened in on the discussions of the adults of my family and to my grandparents’ conversations are coming back to life now, and I find myself studying the world of my family, which now is being wiped off the map by those barbarians. My grandparents came from Kirovohrad Region; some of my dad’s relatives used to live in Pervomaisk; my Mom was posted to Khmelnytskyi for her internship after college; my other grandfather was born in Kryvyi Rih; I remember my father’s funny story of being trapped in the Bilhorod-Dnistrovskyi fort during a movie shoot and running through the crowd of extras dressed in medieval costumes; a boy I once loved had moved to Kherson; Mom and I vacationed in Irpin during the last summer before I went to school; Mom spent another summer vacation in Berdyansk by herself—and my grandmother, who ended up taking care of me for all the twenty-one days, kept huffing about “Berdyansk-Berdyansk.” Now all these place names are coming back to life for me, and I begin to feel responsible for all those people . . .

 

Day 31 “Ashamed”

I constantly feel that I’m living in dense fog. I went through something similar during the worst personal crisis in my life; I have to make an enormous effort to speak and not to croak hoarsely, and another effort to stretch my lips into a smile, where appropriate. Let’s say it’s Sunday: people are going out for a drink and planning their vacations, and here I am, looking like a disheveled mess, with new frown lines. Facebook—a place of rhetorical exercise for some—is where I do my work now. Shifting my gaze for a moment during my endless correspondence with this group or that, I see with astonishment that normal people are posting about birthday parties and comparing cat food, and here I am going on about the war. War is shameful. Just like rape.

A couple of things about rape, since rape has become the focus of my work during the last few weeks. Some researchers have noted a correlation between military aggression and an increased libido. The Huns set out to rape. When your average male, no sexual giant ordinarily, is implicitly encouraged to kill, his libido surges and he becomes capable of multiple orgasms. War is a lot of sperm and a lot of excrement. A revved-up peristalsis.

I get a Skype call from the well-mannered and refined Victor, who calls me in the ninth hour of his interminable bus ride from Kyiv to Lviv: “I apologize, but I can’t talk for long. I’ve been standing in the same position here since morning . . . and there is an elderly woman here . . . she’s covered in feces . . . the bus can’t make any stops . . . and the stomach, you know . . . when you have to go, you can’t help it . . . I’m afraid to move.”

Feces has a different meaning for the occupiers. It’s a weapon. And there’s an unlimited supply. Igor Pomerantsev from Radio Svoboda describes that uncontrollable wish to pollute the water and the river and sea beds, to make everything filthy:

In 1995, during the first Chechen War, I interviewed Fatima, a refugee from Grozny. I asked her that standard journalistic question: “What made the biggest impression on you during the occupation? Bombs? Tanks?” She thought about it and then answered, clearly embarrassed: “Russian soldiers would go into our empty houses and . . . poop in our beds. I’m sorry . . . Yes, they’d poop there, cover their poop with a blanket, then poop again, and cover the whole mess with pillows. We couldn’t believe it.” In March of 2022, I asked Natalka, a refugee from Chernihiv Region, “What surprised you most of all during the occupation?” And she replied, “They went into our huts and crapped in our beds.” In a list of wartime crimes, you won’t find an entry about “defecating in the beds of citizens of an occupied country.” No one will persecute instances of this in the International Court. But the stench of it hangs around for a long time.

For a pursued fugitive, feces is a means of defense: “I’m disgusting. You wouldn’t want to eat me!” A mom complains: “My kids (ages four and nine) went through everything with flying colors: the air-raid sirens, the shelling on the trip out . . . And then, when we got to Germany, both started having nightly fecal incontinence.”

But then all physiological functions serve various psychological needs in this war.

Anya Pushkelya:

At first, I was ashamed to pee in a jar in the basement in front of strangers with explosions going off overhead . . . And having to choose life over dignity. I was ashamed when Makar kept throwing up in his hood (nothing else was on hand) for the forty hours we spent on the bus. Then our choice was to either stay on the bus in our stinking clothing or to get off and go into a stranger’s house in a foreign country. I was ashamed of going inside and taking off my shoes. We were thirteen people who hadn’t taken our shoes off for many days and nights . . . The option was either to stammer, “Sorry about the smell,” and stay in the house or to go sleep outside. So then we washed our clothing. We took a shower. We washed our socks in the washroom sink and threw out the hood of Makar’s jacket. All those things hadn’t made us unworthy. Bad. Disgusting. Second-rate . . . We didn’t stay dirty, no matter what we had to do to survive!!!

Feeling ashamed is not about feces. Feeling ashamed is about helplessness.

 

Day 32–36

This entire week was dedicated to the Project “Sensory Toys.” Stated broadly, the mission doesn’t just include toys but all kinds of sensory devices that help autistic children self-regulate. “Toys” include weighted blankets, special food, and so on. I’ve never met nor spoken to Yulika, the project’s creator, but she was the one who invited me to take part in the 2013 Moscow conference organized by the Naked Heart Foundation, and in this way initiated a fascinating chapter in my life.

Now she resurfaced with an idea that led to a series of conversations with moms of children with special needs. There were twenty-two Ukraine-based moms who replied to my Facebook post; nineteen more moms reached out on the second day; six more moms have left the country and could be helped sooner by volunteers in Europe; and there was one woman who was a fraud (she wasn’t a refugee and maybe not even a mom). Altogether, there were about fifty chats—not short ones either, but extensive and detailed dialogues that took place over many days: stories of basement heroism, flight, evacuation, pain, and pride that the children have survived. There were also photographs. Here’s a series of snapshots in my message box: R., a seven-year-old autistic boy, lying under a blanket on the floor among sweaty pipes (“we’re still in Kyiv in this one”); then another photo of him, in the same place, but with eyes closed; then one of him in the corner of someone else’s house, but in daylight, and chewing on one of our oral stimulation doodads. And here’s a smiling photo of a girl with an ethereal, bluish face, who has her mother’s name and telephone number prominently displayed on the front of her jacket, like an oversized luggage tag. She has brain damage, is on a gluten-free diet, and needs developmental toys . . . The photos and requests keep coming all night, all morning, and peter out by evening. But in the evening, the dead of the night in the other hemisphere, the really desperate emails start coming in: moms who aren’t sleeping either because of air-raid sirens or because of a crisis with their child . . .

Mothers-heroines. I use the word heroism generously. Stephen Porges believes that it activates the autonomic nervous system.

Nadezhda Sukhorukova:

Down in the basement, I would spend all my time dreaming. Especially during the last days before we escaped. I would sit on an old chair, listening to the sound of the plane coming in, and dream of a miracle. The bomb that the Russian pilot had dropped would suddenly fly back at the plane. The plane would explode midair and break into pieces over the sea.

During the last days, I had turned into an immobile and apathetic blob.

The only sense that filled me to the brim was that of animal fear. I felt doomed. You know what I did during the shelling? I, an adult woman, clutched my mom’s hand and pressed myself against her, like I did back in my childhood, when I wanted to feel safe after a scary story. ( . . . ) The sounds of war combined into a symphony of death. It started with a giant gnashing of his teeth and iron strikes against the roofs. I used to think of it as warm-up. Someone was just preparing for the coming performance. Then came the “thunder” melody. The earth trembled and the walls shook. Giant blind killers were flying above us. We couldn’t figure out which way they were headed. There were people in all directions. For some of these people, this music would be the last they would ever hear. The most frightening sound for me was the sound of the planes. I’ve never actually seen them. If I had, maybe I wouldn’t have been so frightened. I would cover my head with a pillow, dreaming of going deaf. The earth swayed, the plane would circle for another strike, and we would all be dying again, until the next blast. ( . . . ) It was on March 15 that we heard new sounds in death’s symphony. They were unlike anything we had heard before. Two massive explosions. It was as if they had turned everything upside down within me: my head felt enormous and empty; the basement walls reverberated for some time after the blasts. I thought that this must be a weapon of mass destruction. I was horrified at the thought of what I might see when I got outside.

Later, some people from a village near Mariupol told us that the city had been shelled by Russian warships. They were killing us from the land, from the air, and from the sea. They were killing us from every point.

 

Day 37 Secondary Trauma and “Compassion Fatigue”

Secondary trauma is a tricky thing. It might seem that you are not greatly impacted by just talking to someone post-factum about that person’s pain or experience of being—let’s say—caught in a shelling, but the mirror neurons that are scattered throughout the human brain have been triggered, causing you to empathize, and your sympathetic nervous system acts as if you yourself are facing imminent danger. I am beginning to feel the effect—I’m driving along Belt Parkway, beside the JFK airport, when the sound of a plane coming down for a landing triggers something that I’ve absorbed from someone else, and I begin darting in and out of traffic. Luckily, there is no accident, and the conscious part of my brain quickly kicks in and puts an end to this panic. That’s a signal to step back, of course. But how can I step back? There are no days off in a war.



*

Today we get a request for a leaflet (or is it for a newspaper article?) instructing women how to survive the occupation. Madlena R., a New York colleague turned Ukrainian collaborator, and I understand that what we are being asked to write is implicit advice on what to do to avoid rape . . . I’ve never written anything like that before, but—girls, women, do everything you can to get out alive! Madlena and I write the instructions, clutching our stomachs all the while. We are writing with our guts—that’s why.

News of rape and of occupants breaking into people’s homes just to intimidate them are trickling in from villages around Kyiv and Kharkiv and from Mariupol . . . oh no, from Mariupol . . . “Community Self-Help,” my permanent contacts in Lviv, hint in their daily newsletter at hearing the unspeakable, but whispered conversations are more explicit. Hard-to-believe stories start surfacing on official sites.

 

Day 40

After spending a productive and even somewhat relaxed day off (“all” I had to do was come up with an instruction booklet for civilians, “In Captivity and After Captivity,” yet another request from Lviv), after several projects seemingly moving in the right direction, after all kinds of small positive changes, something enormous collapses on all of us: news about the nearly four hundred women survivors from Bucha and other villages around Kyiv spills out of chat boxes, out of Facebook private messages, out of friend requests.

I don’t know this Alex person. To be exact, he doesn’t even write to me. He just sends out screenshot after screenshot, possibly to anyone who’d know what to do.

Screenshot:

“Hey, in Bucha now. At least 400 rape victims here. Anyone available to triage them in Kyiv?”

“Let me ask around.”

Screenshot:
 

“OK, I have 40+ girls here. How do I transport them in my bus?”

“Just put ’em on the bus, twenty a trip, and start driving, moron!”

“They can’t sit, I can fit only four of them per aisle.”

“Oh shit . . . ”

Here we go with the shit. Also with saliva, vomit, sweat. And last but not least, blood.

Another screenshot:

“Paramedics request psych support for themselves, they’re breaking down from dealing with raped kids. 180 kids—can you fucking believe it?”

I try calling him, but he’s probably overwhelmed by the enormity of the task and all the things to arrange.

Why am I getting these messages? What should I do?

What would I say if he had picked up? Probably overwhelm him even more with questions of my own: How many psychologists do we need? Where will the women be taken? What do they themselves want?

It’s not even your emotions that respond to something like this—it’s your guts. It’s all about helplessness—the awful, unbearable helplessness and hatred. It’s hard to breathe from the helplessness and the hatred, from the strange visions that merge the canvasses of Bosch with the village of Borodyanka; Bruegel’s Triumph of Death with the village of Vorzel. All I can do is sit here with the news and wait until I can do something about it, until I’m given a specific task—to scale some bureaucratic mountain, say, or to fly somewhere. Anything at all, except inaction. Inaction is like poison to me.

 

Day 41 Waiting

My soul is cramping up. It’s amazing how a person adapts to the most unbearable things. I had once thought that pain and fear wouldn’t go away while this nightmare lasted, but now we’re in the second month and I’ve adjusted to them, just like Anya, who at first would hold it in endlessly until she got to a real washroom, but eventually began to pee into a mayonnaise jar.

An excerpt from my email to Alyona:

At first, I’d use any breaks I had during work and all my nights until midnight, to organize evacuations, help groups, connect drivers with volunteers or with whomever; it would all add up to about 15–16 hours of work a day. Then I began to fall apart, and now I try to pace myself. I’ve even managed to go out once or twice for several hours during the past forty days. None of this is going away any time soon—especially in my line of work. And whenever the stream of requests for my services dies down to a trickle, we all go down to the donation center to work manually, to help pack containers. But the cases coming to me recently are so awful, I’d much rather be loading boxes.

I can’t share anything about the multiple rape victims with her. My role is to protect, not hurt. However, in just a few days, what I hear in muffled voice messages and in incomplete texts is no longer a secret—it’s out in the world.

 

Day 42

A somewhat ragtag international team is finally assembled and we even manage to meet up on Zoom. Almost all of us are women, with the exception of Father Andrei (who didn’t come to the Zoom call because he’s setting up a shelter in Ukraine, but many people are talking about him) and an energetic man from somewhere in the Mediterranean. We all report on the resources we’ve located in our respective countries to help the victims of Bucha (somebody angrily remarks: “Don’t call them victims!”). In the course of the meeting it becomes clear that our individual levels of expertise vary enormously—we’re not a team of professionals, but more of a patchwork quilt.

Several days later, someone shares a voice message. It comes from somewhere in Poland, near the border with Ukraine. It starts with sobbing, then a woman’s wailing:

I can’t calm down for the second day in a row. I’d send you the video if you understood Polish. This girl recorded her mom’s testimony. She volunteered in the hospital and there was a bus, fourteen children from Irpin and Bucha. The oldest is fourteen years old. Their parents were executed before their eyes, and before the parents were shot, they were told, “We will keep your kids alive so that they remember this war and always respect Russians. All fourteen were raped multiple times, and all their teeth were pulled . . . Oh . . . tell our boys in Ukraine to tear the occupants apart . . . We’re in shock, we’re in utter shock . . .

The rest of the message is just inconsolable crying.

The first reaction of the professionals in our group to this phone call, to every text that comes in, is the same across the board: “Has anyone checked it out to make sure that it’s not a fake?” We don’t want to believe these testimonies, because they diminish something human within all who comes into contact with them, within each one of us. As if we could have prevented it somehow or stopped it.

We weren’t trained to deal with any of that. In any case, it's too early to talk about psychological help here. Nevertheless, I should go through the lists that Madlena and I put together in the first days of the war, to select specialists who are willing to work with that level of trauma, specialists who have the skills to work with victims of sexual assault, of group sexual assault, and of family sexual assault. It’s a bit easier to feel alive when you’re actually working.

 

Day 43

Finally, the project centered around the Bucha crisis is moving ahead beyond the stage of the hysterical, desperate posts of the medical workers breaking down at the sight of the brutalized young and old women, boys, children, and adolescents, to the stage of specific planning (even if with shaking hands) of where to take them, how to shield them from journalists, how to prepare them for meeting with the military prosecutor.

Olga Yardelevskaya:
 

People, this is going to hurt. Maybe you shouldn’t read it—I’m giving you fair warning. But I’ve got to write this. I was working the night shift of a psychological support hotline for war victims, manning the chat. I got a phone call from the husband of a woman who tried to kill herself. He wanted me to talk to her. Suicide is a very difficult topic for me. Those who know me understand why that is. But there was nothing else to do—so I began the session. A young woman picked up the phone. She spoke in a flat, indifferent voice; she was probably on tranquilizers. Quietly and impassively, she told me that the Ruscists raped her daughter and that she won’t ever be able to look her daughter in the eyes now, and that she was not fit to be a mother, because she failed to protect her. I tried to shift her away from her guilt toward anger, toward any other emotion:

“Was the young woman hurt physically as well?”

“Young woman?!” she was suddenly screaming. “Young woman?! She is six years old!”

My stomach jolted and ended up somewhere in my throat. My brain was full of traitorous, cowardly thoughts, like, “What am I supposed to say now?” “What did I do to deserve this?” “Why is this happening on my shift?” . . . Okay, stop! My shift. I remembered a phrase from some film I saw: “No one will die on my shift!” No, I wasn’t going to allow her to die on my shift. An hour later, I managed to get a firm promise from her to continue living and to go to therapy. The child would be monitored by a local psychiatrist. I reached out to everyone I could and I got them to act. But . . .

Two Russian bastards have raped a child.

The mother said that the girl had asked her twice afterwards, “Why did these men punish me? I was a good girl . . . ”

That’s all. I’m sorry that I couldn’t stay silent.

Day 46

As it happens, today marks the anniversary of Odesa’s liberation in World War II. There is a forty-eight-hour curfew, to prevent people from gathering in groups. Luckily, Odesa isn’t bombed today.

I still get startled when I hear these new words in our lexicon: “curfew,” “bombardment,” “sirens,” “occupation.” The semantics of a new era. When I’m discussing the delivery of medications with Natalya, the pharma-angel of the occupied city of Tokmak (we’ve been trying since last Friday to organize a delivery of anti-seizure and cardiac medications to her community—she’s collecting lists and prescriptions, making arrangements with courageous volunteers who drive through the minefields and traps from Zaporizhzhia, risking their lives, while I’m trying to find a purchaser and identify a delivery opportunity), she misspeaks and says “bork-point” instead of “checkpoint” (blokpost in Ukrainian). “Bork” is a company that makes tableware, which makes it more familiar to a woman living in the twenty-first century than something out of a military lexicon, like “checkpoint.”

But today I didn’t have to think about this, or about what once was, or even about Natalya. Today, cats took over everything. Nineteen cats and three dogs took up all my time from 11:30 to 5 p.m. Their owner and her mentally ill son got to Lviv from Slovyansk, and here, after a week on the road, once safe, she fell apart. A full-blown breakdown after everything she had lived through. The hotel room was rented for her for the night by Anna, a volunteer from New Jersey. I got to know the volunteer, a cheerful, capable, and dynamic young woman, and watched her handle difficult requests for three weeks, but now she too was losing it after coming face-to-face with full-blown psychosis, and I’ve got to help her regain her equilibrium as well. After talking to her, I got on the phone with the woman who was threatening to kill herself right in the hotel (T-Mobile later charged me sixty-three dollars for the call).

I’ve reached out to Viktor in Kyiv (who made it back home from a less harrowing trip), and he got me in touch with my namesake, the head of “Samadopomoga” in Lviv. Finally, a local psychologist went to the hotel to check on this victim of post-traumatic relapse and to assess her condition, but she didn’t let him in, informing him that she already has a psychologist in New York. In other words, she changed her mind about killing herself, but made me a part of her support system, and now I’ve got another person I’m responsible for!



*

Looking back, I notice with surprise how many women have become my collaborators during this time, both here and around the world. Those women who spent their time taking selfies and posting on Facebook have used their tech-savviness to become warheads. Those women who didn’t have the skills they needed acquired them on the go. In Ukraine, women drive supplies to the frontlines across the country, they pack and load ammo, they bring in crates of medical supplies, they negotiate with the governing bodies, and some have actually joined the territorial defense. Everywhere I turn, I see women’s faces: women as victims, women as fighters, women as helpers, daughters, mothers, grandmothers, all trying to keep their countrymen and their families alive, trying to go on being.

Action rescues us from insurmountable anger. It could also save us from despair: while I was at the bank working on a new money transfer so that Alyona in Odesa would get the money she needed for medical supplies, figuring out the currency rates, six Russian rockets hit the city. When the sirens sounded, Alyona chose to wait out the air raid in her narrow hallway instead of running to the faraway bomb shelter. At that precise time, she was ordering tourniquets. One rocket hit an apartment building close to hers, but maybe, just maybe, it was those tourniquets that kept her safe. And the package with the medications that hadn’t been shipped yet. Maybe good deeds don’t always safeguard us, and yet, yet . . . maybe they do provide us with an ephemeral layer of protection. I really want to believe that.