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Psychotherapy returns to Russia

The return of psychotherapy to Russia after Stalin’s ban has had to overcome many obstacles, including Russian suspicions of psychological colonialism
Ann Shearer
28 April 2010

Any kind of depth psychology was banned after Stalin came to power, and psychiatry was subverted by the Soviet state for political ends. So Russia entered the post-communist period shockingly badly equipped to cope with the mental and emotional distress exacted by the upheavals of past decades, and the widespread social and economic insecurity that followed the collapse of the Soviet Union.

Over the last twenty years, personal stress and uncertainty have exacted a harsh toll of depression and anxiety, drug and alcohol abuse, suicide and domestic and other violence. Families are under great pressure and children may end up in orphanages because their parents cannot cope.

In any health service, mental illness gets the lowest priority. When the overall service is as impoverished as Russia’s (in 130th place on a recent WHO rating), then the resources devoted to mental health are few indeed. The traditional healers, ‘wizards’ or ‘magicians’ were not long ago reckoned to outnumber psychotherapists and psychiatrists by 12 to one. Drug treatment in a short-staffed and under-equipped mental hospital or clinic was the best that anyone could seek.

When the ban on depth psychology was lifted at the time of perestroika, there was an upsurge of energy, as Western proponents of all psychoanalytic schools both invited themselves and were invited by the many emerging interest groups. The Russian Revival project began from such an invitation – from the East European Institute of Psychoanalysis in St Petersburg, whose physical transformation from near-derelict shell to elegantly appointed professional building tells its own story of recognition and success.

Early in our project’s visits we started to hear stories of carefully-guarded volumes of Freud and others, which carried a reminder of the psychoanalysis that had flourished in Russian cities before the revolution. It is only in the past decade that psychological treatments have begun to shake off the legacy of stigma and fear inherited from that deceptive system of Soviet state psychiatry. Now Russia is gingerly moving from exclusively drug-based treatments towards talking therapies.

 

The Russian Revival project built on earlier work with GPs and counsellors in the mid-90s by visiting Jungian analysts from London. It first offered a two-year visiting programme for mental health professionals to learn the rudiments of Jungian approaches to psychotherapy. From there grew a training programme, that spread in 2003 to Moscow as well; now 30 graduates have passed certifying exams and are recognised as full members of the International Association for Analytical Psychology.  There is also a programme in Krasnodar in the south, with no fewer than 24 candidates. Each time there is a conference in Eastern Europe on Jungian psychology the word spreads further. If any one thing has sustained the trainings through all their ups and downs, it must be the huge hunger among many Russian mental health professionals to widen and deepen their understanding. And they show a steadfast commitment which, for instance, brings one candidate regularly by train from Siberia to St Petersburg to meet the British analysts who fly in from London.

Ups and downs there have certainly been. The format of the training is itself a real challenge to Western analysts, used to the predictable circumspection and comfortable regularity of the consulting room. What does it mean to offer weekly blocks of analysis four times a year as the foundation of the training, or to offer only twelve weekends a year of supervision of ‘training’ cases?  And when the visitors’ command of Russian is generally weak or non-existent, what happens to this subtle and delicate psychological work as it passes through an interpreter? We don’t really know, and perhaps we never will.

Beyond and below these questions are the bigger ones. What shared understanding can there be about the place of the individual within the collective, the nature of therapeutic privacy and boundary, or trust in confiding relationships, when our cultural and personal experiences have been so different? 

Although the project is recognised by the Russian Ministry of Health, sometimes both sides can perceive the whole enterprise as a kind of psychological colonialism.  There is an uneasy shared undertow of gratitude and resentment too, as the ‘rich’ West struggle to raise funds and the British analysts give their time for free, and the ‘poor’ Russians establish their clinical practices and continue to find it almost impossible to tap any local funding for the programme. The Russians do indeed pay individually what they can towards the British expenses. But contrary to some assumptions in this country, Russian wealth is very unevenly shared, and most people remain short of money.

Through it all, the project is sustained by the hunger for psychological understanding, excitement of sharing experience, knowledge of the huge unmet need – and many accounts of psychological work that really has made a difference to the emotional wellbeing of individuals and families.

The Russian Society of Analytical Psychology takes over the training in 2013. But there is still a lot to do before then. Current trainees will continue to need some support from Western analysts. Work must continue to strengthen the RSAP’s democratic structures which can still seem so unaccustomed and even untrustworthy to Russian colleagues. There is always the need for more money, and not just for travel and accommodation for the visitors. There is a constant need of translations of Western psychological texts.  Established Russian analysts also need, like their Western colleagues, to continue deepening their understanding by attending international conferences and seminars. Last summer, for instance, the Russian Revival project put on a weeklong course in London for 23 of the graduates, on the special skills of supervising the work of less experienced psychotherapists.

Since 2003, the Russian Revival Fund has been holding annual fund-raising concerts, with the unflagging help of its generous patrons – the pianist and musical presenter Iain Burnside, the actress Harriet Walter and the translator Robert Chandler. In these concerts, the words and music of Russia have been interpreted through the generosity of distinguished British and Russian actors and musicians – to both delight the audiences, and remind everyone involved in the Russian Revival project of the wealth and resilience of the culture with which we are privileged to work. The project is  giving its final charity concert at London’s Hampstead Theatre, on Sunday May 9 at 6.0pm.  This fund-raiser is also a celebration of 12 years of work to bring depth psychology back to Russia and the formation of the Russian Society for Analytical Psychology.

 For more information on the project visit www.russianrevival.co.uk

Concert: Psychotherapy Revived. Hampstead Theatre. Sunday May 9th at 6pm.Tickets £35, including refreshments, from theatre Box Office at 020 7722 9301. Student rate £15.

 

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