Found in Translation: Ukraine is Not Dead Yet^[1]

 Teaching the psychoanalytic approach in Ukraine

 

For the last seven years the Melanie Klein Trust has been funding teaching seminars in Ukraine. The project was largely the initiative of Igor Romanov, a psychologist - since qualified as a psychoanalyst - with a post in the philosophy department of Kharkiv University. He and his colleagues approached Patricia Daniels at the summer school run by the East European Committee of the European Psychoanalytic Federation (EPF) - a subsection of the International Psychoanalytical Association (IPA) - to discuss the possibility of holding seminars in Ukraine on the Kleinian approach. This resulted in Robert Hinshelwood providing a week of seminars in Kharkiv and giving two lectures at the University. The interest provoked by this visit led to a request to the Melanie Klein Trust for further teaching events.

In 2003 the Trust agreed to fund an exploratory visit by Edith Hargreaves and Jane Milton. Their visit was a great success and the Trust agreed to pay for two teachers to provide four days of seminars twice a year for two years. Funding was subsequently extended until 2007, since when the Trust funds travel expenses only. I joined Jane Milton and Edie Hargreaves as one of the teachers at the start of the project in 2003 and Anne Amos joined us in 2008.

All the local expenses and organization are managed by the hosts. We are put up in a flat - on several occasions one of the organizers has vacated her own flat - in which the fridge is packed with food and with alcohol that we barely have the time or capacity to touch. Great care and thought go into providing for our needs, into the organization of the teaching and into our social programme.  We are given dinner and lunch in restaurants, taken to the opera or to a concert, to exhibitions and a party is often held for us and the participants. When we stay an extra day we are taken on outings outside town. The thoughtfulness and generosity of our hosts is enormously touching but also it causes us worry as we are painfully aware that money is short in Ukraine.

Throughout its history Ukraine has been fought over and taken over, its history is one of brutality, particularly during the last century with twenty five million Ukranians killed in the Soviet period, seven million of which in the famine of 1933-34, others sent off to gulags and seven million in the second world war. The effect of all this can be imagined and is evident in the high mortality rate in men from alcoholism and the fifty percent divorce rate. The current population is forty six million, the number has dropped from fifty five million over the last twenty years. Although the ‘breadbasket’ of the former Soviet Union, with its enormous and enormously fertile plain, Ukraine is a poor country and one that since the demise of the Soviet Union has often been ill governed. Despite the optimism of many during and after the ‘orange’ revolution, things have not improved economically for the population at large. Political issues are discussed with black humour. The society has however felt more open over the last few years and getting in and out of the country has been easier; no longer a need for visas and less rigorous searches of our luggage. We wait to see the effects of the recent change to a government that has closer ties with Russia.

All but one of the seminar series has been held in Kharkiv, a minority destination to which there are no direct flights. We have explored every option by air and rail which means that we have spent time en route in Kiev and Odessa - cities that are distinctly different from Kharkiv and from each other - where we have been met and cared for in transit by the seminar participants from those cities, taken to see important sights and have had the chance to learn about the local psychoanalytic groups. Kharkiv itself is in Eastern Ukraine forty kilometers South of the Russian border. Founded in 1654 as a Cossack outpost, it is one of the most recognized universities in Ukraine and is well known as an intellectual centre. The area was severely hit by Stalin’s forced collectivization and by the 1932-33 famine. During World War 11 it was captured and lost twice by the Nazis and just outside the city is a memorial for the three hundred and fifty thousand Jews who were killed there. The city became a major industrial player in the Soviet era as the producer of tractors, tanks, turbines and engines. The old centre of the city, severely bombed in the war, has many buildings in a state of disrepair.  There are signs of buildings being repaired and of capitalism moving in with designer shops and luxury car showrooms but the recent economic crash may have put a stop to this. Surrounding the city centre, suburbs of flats stretch out for miles on all sides. Until the last two visits, this is where we stayed which gave us an experience of these ill-maintained blocks and also an experience of the rush hour traffic commute into town.

 

The seminars were held initially in an old hospital for railway workers where one of the participants had a consulting room. More recently they have been held in a psychotherapy clinic that is run by two of the participants. The seminars are attended by twenty four participants who are largely psychologists and psychiatrists, most of whom have senior positions in state institutions and all of whom see one or more private patients in psychotherapy. While materially poor, Ukraine has high standards of education and the participants in our seminars are high achievers, unfailingly widely read and knowledgeable about films and music. They have no difficulty in expressing their opinions. After some early changes, the core participant body has remained the same. The participants come from a large geographical area, Dnepropetrovsk, Kiev, Krivoy Rog, Lviv, Odessa, Vinniza and from outside Ukraine; Moscow and Stavropol. There is a waiting list to join the seminars and if someone cannot attend, a colleague from their town comes in their place so that they can take the discussion back to their local group. Having said that, there is often more than one group of psychotherapists in each town and groups may adhere to different theoretical models; the psychotherapists in Kharkiv for example belong to two or three different groups. For our seminars the participants are divided into two groups and this division has largely remained the same. The groups had, and to a lesser extent still have, distinct and interesting differences.

Following initial negotiations in which a ten hour a day timetable was resisted, the working day runs from approximately 9 - 5.30. Each visit is devoted to a topic and each day starts with a theory seminar. Four or five other people who are not part of the main seminar programme join in these seminars. Papers are chosen by us, translated by the organizers and sent out in advance to the participants and discussed in their local groups. This means that a lot of thought has been given to the papers before we get there. The discussion with us is very focussed and ideas from our seminars are taken back to the local groups for further discussion. There is a great hunger and enthusiasm for learning and there is no doubt that the participants and their local colleagues are very appreciative. The topics that we have covered so far are psychic change, transference, projective identification, the Oedipus complex, pathological organizations, internal and external analytic setting, symbol formation, superego, thinking, narcissism, envy and gratitude, technique, and primitive defence mechanisms. One of us also gives a paper on the topic to a much larger group at the university. This centerpiece lecture used to be the first event of each visit but, having on one occasion missed our connecting flight and had to race across Ukraine through the night in a very old taxi to get there in time to give the lecture, we now hold the university lecture on the second morning.

The rest of each day consists of clinical seminars and some individual supervisions. Clinical seminars follow the usual format of someone presenting a case with process notes on a session. We found, especially in the beginning, a high standard of theoretical understanding but much less well developed clinical skills and understanding. This is unsurprising in a situation where there had been little or no supervision and little opportunity for personal analysis. Many of the patients presented have physical symptoms and some of the cases could come straight out of Freud’s early work. Particularly at the beginning we were concerned that some of the participants were being overwhelmed by their very disturbed patients. We also found that many participants had difficulties in setting boundaries with their patients. They seemed unable to find authority within themselves and we speculated that years of authoritarian rule might have left the idea of a benign authority out in the cold.

At the start we were acutely aware of having to resist considerable pressure on us to be the authorities, to come up with clear instructions and to provide formulae on how to do it. We have always been acutely aware of the tiny input that we provide and the importance of getting the participants to use the resources that they have; their own minds and the minds of their colleagues. Our intention has been to foster their ability to think for themselves and to turn to each other for clinical discussion and for support with difficult patients. This has been far more successful than we would have anticipated and is indicative of the participants’ capacity to work.

Central to all of this are the interpreters, each of us has an interpreter constantly at our side, unflagging and good humored. Working in translation presents a lot of difficulties, it is very time consuming and there is frequently a fear that things have been missed in the translation. There is a need to be concise and clear which can be difficult when trying to explain complex and subtle ideas. None of us found this an easy task, particularly to start with, when everything and everyone was unknown; we found a very different culture with different terms of reference, different assumptions, a different language, inscrutable facial expressions and an underlying sense of hidden competitive dynamics - I longed to be airlifted out of my first seminar. Since then things have changed and developed and all of us feel welcomed with warmth and great friendship. Tough things are sometimes said by them and by us but the prevailing atmosphere is enormously positive. At the start two or three of the participants could speak English; now several of them have taken it up or brushed it up and their English has improved impressively. Also we have learnt some Russian.

The October 2009 seminar was held in Dnepropetrovsk, the home town of one of Ukraine’s psychoanalysts and of half the regular seminar participants. The city has a population of just under two million and, as the satellite and missile producing centre of the former Soviet Union, it was closed to the outside world until 1991. It is more affluent than Kharkiv, it is the home of the three richest people in Ukraine and it has possibly the largest and growing population of returning jews in Ukraine. We found a well informed local group of psychiatrists who had been reading psychoanalytic papers for several years, having been encouraged to do so by one of their teachers. Those interested in psychoanalytic work discuss their patients in six small supervision groups and they have recently set up a Psychoanalytic Club to hold joint meetings. As in Kharkiv, we were looked after with great care. We were taken to see the missile museum on the day that we discussed Hanna Segal’s paper on the death instinct, the one in which her patient has her ‘finger on the button’. At the final party the last toast given was to the death instinct with a reminder that the first line of the Ukrainian national anthem is ‘Ukraine is not dead yet’.

We have observed considerable development of psychoanalytic thinking in Ukraine over the years - and not by any means all down to us.  We are not the only foreign teachers, for example group analysts taught in Kharkiv for a number of years and recently the Anna Freud Centre has provided teaching both in Kharkiv and in London for professionals working with children. Psychoanalysts from Germany have run seminars in Odessa, the Psychoanalysis In Eastern Europe IPA training has started seminars there four times a year for its Russian speaking candidates and Odessa itself has two or three psychoanalytic groups. The PIEE also run seminars in Kiev and Lviv and various other training events occur in both of these cities.

At the start of our project there were six candidates in Ukraine undertaking shuttle analyses and provisionally accepted for the PIEE training. Two of these candidates were occasional participants in our seminars. There are now five qualified IPA psychoanalysts in Ukraine but none are training analysts. Some of our participants are in analysis with them but this is not an option for those who want to train or who are their longstanding colleagues and friends. All training analyses have to be shuttle analyses; analyses in which the analysand travels several times a year, often two days by train, to a city in another country, for example to Vilnius or St. Petersburg, where they have analysis for a week. This is very disruptive to their personal and professional lives and separates the analysis from ordinary life. Nonetheless, despite these considerable disadvantages, we have been struck by the difference in all those participants who have gone into analysis and by the great improvement in their clinical work.

Of the current seminar participants, three are doing the PIEE training, three more have been accepted and have started in analysis and others have started analysis in the hope of training. Many others not involved in our seminars are training with the PIEE. It is not easy for people from Ukraine to afford analyses in other countries and some subsidies are given to trainees from the Ukraine. The PIEE is now twenty years old and over the next two years it will be drawing its work to a close. The Ukrainian psychoanalysts and trainees have organized and will increasingly organize a great deal on their own behalf, our participants for example have put on a number of events including three conferences in Dnepropetrovsk and two in Karkiv and they have organized the translation of many psychoanalytic books and papers. They will however need continued support.

A point that has been emphasized by the participants is that while other teachers have come and gone, we have stayed and it is the continuity of our presence that has helped them to develop a psychoanalytic identity, led them to feel more educated and at the same time to be aware of their limitations. The continuity has been important for us too, it has given us the chance to learn about Ukraine, to learn about ourselves and to see the developments in the participants and in their patients. They and we are grateful to the Melanie Klein Trust for funding this project.

 

Penelope Garvey June 19th 2010

 

References

Figes, Orlando (2007) The Whisperers. Allen Lane: London

Reid, Anna (1997) Borderland: A Journey Through The History of Ukraine. Weidenfeld & Nicholson: London

Segal, Hanna (1993) ‘On the clinical usefulness of the concept of the death instinct’, Int. J. Psycho-anal. 74: 55-61.

 

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