Sitting together with people in pain

Iryna Arute was in high school when she came to the United States as an exchange student in 1999. She continued her studies at Wheaton College and eventually married and settled near Chicago, but her family and a big part of her heart remain in her native Ukraine. When Russia invaded in February, Arute recalls weeks of tumult trying to keep track of family members—all living around Kyiv—and make sure they reached places of relative safety. Once they did, Arute began thinking of what she could do to help. A clinical psychologist specializing in trauma therapy, she knew Ukrainians would need help to process their war experiences, and the Razom Initiative was born. 

As Ukrainians endure a fifth month of war either displaced in their own country, hunkered in place, or having fled abroad, relief organizations are seeking resources to care for their emotional needs as well as physical ones.

Arute says the first steps to starting the Razom Initiative came from her own sense of powerlessness, watching horrific events unfold from a distance. But when she looked further into the future, she realized she did have something to offer. “I was aware of my desire to do something, anything I could do to help Ukraine and my people get through this nightmare,” says Arute. “I knew that there was one thing I could do with the experience and network I have. That was to create a setup for people to get the mental health care that they need.”

In Ukrainian, razom means “together.” The initiative is a network with the goal of providing mental health care to Ukrainians affected by war. A secondary purpose is to get support and resources to Ukrainian therapists so they can continue their work in-country. Arute realized quickly the Razom Initiative was going to grow exponentially, so she formed a nonprofit called Mansio Global Collective under which the Razom Initiative could work. She wants to make sure it’s sustainable for the long term.

“Mental health care is a bit different in that we need to start now for sure,” says Arute. “But we also need to plan on it being needed for years to come, because this is going to be a long haul to deal with the devastation this war has brought on people personally and nationally in all sorts of ways.”

Once begun, the project took off quickly. Arute says that while these first months her focus has been on building the network, still in that time over 200 clients spread out over 30 countries have been matched with 80 volunteer Ukrainian-speaking therapists to begin counseling. To Arute’s surprise, 60 percent of the volunteer counselors in the network are in Ukraine. Some have told her that doing this work and helping others has been critical in maintaining their own well-being. Razom is creating a grant program to provide professional support and financial assistance to those therapists: Most of them have lost their incomes because of the war.

ONE OF THE COUNSELORS is Olga Malah­kova. She is a psychotherapist and counselor in Rivne, a city in northwestern Ukraine. Even while dealing with her own shock at the attack on her country, she wanted to help. At first she provided supplies for the Ukrainian army. Eventually she realized the best way for her to help was to be available in her role as a counselor. Through a social media group she learned about the Razom Initiative and signed up to be in the counselor network. She now meets with clients who are spread out all over the world as well as those still in Ukraine.

“All of them have the same fears about their future or about their relatives,” Malahkova said. She says that for people under 35, it was easy to leave Ukraine. But for their parents’ generation, 50 and above, most refused to leave even dangerous regions. They feared more the loss of their homes than their lives. This is hard for younger people abroad to accept. “This is a big problem for those who have left and are now in safety, but their moms and dads and other relatives decided to stay near Kyiv,” says Malahkova. “It’s difficult for them to understand their relatives’ decisions.”

Currently almost 60 percent of Malah­kova’s clients are in Ukraine and 40 percent in other parts of Europe. Of those in Ukraine, a good portion are refugees from Kharkiv and Mariupol.

Malahkova says there is also a split between clients from western and eastern Ukraine. For those who lived in the west before the war, their conversations center on job security and how finances and relational problems have been affected by the upheaval. But for those coming from the east where fighting has been severe, most are dealing with post-traumatic stress from months of constant bombing or hiding in shelters.

“The most difficult situations to work with are people who have moved from Ukraine and now feel guilty about their safety and about their relatively good life in, say, Germany,” says Malahkova. “They are also debating whether to look for a job in their hosting country or to take government refugee assistance. Even when they do find work, there is guilt because they can have a better quality of life than in Ukraine.” Some clients are still living in refugee care centers where practical problems like internet bandwidth or lack of privacy play a role in their access to therapeutic care.

According to Malahkova, when the time comes to rebuild Ukraine, part of that rebuilding will need to be psychological care, on an individual level, but also on a national level. Until now, stories of previous decimations in World War II and Stalin’s purges have lingered in the collective Ukrainian memory. Every family can point to a tragedy in the Holodomor genocide of 1932 and 1933 which killed millions of Ukrainians by starvation. Today’s war horrors, replayed continuously on television and social media, will mark the nation for generations to come. Many Ukrainians have family in Russia, and it is hard not to view those relatives as traitors or co-belligerents. Malakhova says that in the same way people go to the gym because they care about their physical health, they need to accept that good mental health care sometimes requires help.

MARION KNELL IS A CONSULTANT on refugee care to the European Evangelical Alliance. Based in the U.K., she provides resources to frontline workers meeting refugees for the first time, in what she calls psychological first aid, a concept she developed in assisting with the Syrian refugee crisis in 2015. The themes coming out of the Ukrainian crisis are like those in other refugee crises: family separation, death and disappearance, traumatized children, people who left home with no time to prepare and no time to process.

“The unique thing about the Ukrainian situation,” says Knell, “is that they haven’t given up on their country. They haven’t been hounded out in the way that the Syrians and Afghans were. In a sense they ‘chose’ to leave or were sent to safety, but with every expectation that they will return, hopefully in the near future.” Knell says that leaves refugees in limbo, not knowing how long their “temporary stay” will last. “You can’t put roots down when you live in expectation of a return,” Knell says.

For Knell, language is a huge barrier to helping refugees process their experience and take steps into their future. She’s encouraged by some refugee care organizations now offering trauma training in Ukrainian and the languages of neighboring and welcoming countries. Knell says that the first needs to be met are relatively “easy”: food, clothing, and shelter. But as time goes on, refugees need connection to networks and to human connections that make them feel safe. “Trauma induced by humans is the worst sort of trauma,” Knell says. “The victims have lost trust in humanity.”

Knell says the Church can offer the kind of community that other relief organizations can’t. “That’s what we’re supposed to be good at,” she says, “connections as believers across towns and countries, safe places for children. A church is multigenerational, and respect for age is part of Ukrainian culture. That’s really important, especially where you haven’t got men, haven’t got fathers or grandfathers.”

Knell says often helping is more about “don’ts” than “dos.” “Don’t force people to talk, but be open to it if they would like,” she says. “Don’t tell people what they should be thinking or feeling or what they should have done. Don’t make promises you can’t keep. Don’t tell them it’s all going to be all right in the end, because you don’t know that.”

Some people will need to tell their story over and over again. Knell says that eventually as time goes on, a point will come where they will need help to reframe their life now. For that they need to know about resources available to them in their community. Reframing is difficult in the context of a conflict that is continuing and where updates are constantly available on smartphones. It is hard for refugees to disconnect from the ongoing violence. “You can’t keep people from seeing that,” says Knell. “But can you watch it with them? Can you in some way limit it? How can you help people who are being retraumatized by just what they’re seeing on a daily basis?”

FOR SOME REFUGEES, a stable environment, a listening ear, and connection to a network of resources may be all that is needed to carry on. Others need more support. “Trauma can be loosely understood as too much pain for too long by yourself,” says Arute. “We can’t control the amount of pain people are enduring, but we can somewhat control for how long and whether or not they are by themselves.”

In the acute phase of trauma, while the source of trauma is still present—as is the case in the ongoing conflict in Ukraine—the focus is to help a person cope in the present moment and not be alone. According to Arute, only after a person begins experiencing relative safety can their nervous system relax enough to allow them to start processing deeper layers of trauma. That can take from months to years. Hence Arute’s desire to build a network structure that can expand to the need and be stable over time.

Arute wanted to make the process especially simple for war-torn people seeking help, so on the website (mansioglobalcollective.org) she created a matching system based on 10 different criteria including language, presenting issues, religious background, and time zone. The semi-automated system quickly matches persons seeking counseling with therapists, who then reach out to them directly. Razom is not an explicitly faith-based initiative, but as clients come from a wide variety of backgrounds, the volunteer therapists are equipped to integrate clients’ faith practices. Clients who wish to meet with a Christian therapist can do so.

Arute’s own faith is the strength behind her work. “To me,” she says, “trauma work is like holy ground work. The work of healing is slow, messy, nonlinear. It requires a lot of patience, a lot of curiosity, a lot of humility. Without those qualities you risk doing more harm than good. But with them, there are a lot of good things that can come out of that space, not least the joy of incarnational love: just joining with another human being, being with them in the darkness, the pain, and the sense of disorientation. But we don’t have to fix anything. We don’t even have to have helpful things to say to them. Just our presence is often times enough.”

Arute has a caution for Christians looking for the positive in the Ukraine situation. She says that usually stems from their own discomfort with an uncomfortable and incomprehensible situation: “The reality is: There’s absolutely nothing positive about war and trauma. Of course there will be healing and redemption. But God is not using the war per se; He is simply deeply present in the midst of it in a mysterious way that is beyond human understanding. It’s important to get rid of this pressure to explain the evil or have a way to spiritualize it. We don’t know why it’s happening, but we can be together with people in pain and just sit with them, like Job’s friends did. They got it right at the beginning when they just showed up and sat with him. There is something very powerful about not being alone.”