Since November 2024, I have travelled regularly to Ukraine, working primarily in Odesa as a psychotherapist and clinical adviser with VseSylini, a Ukrainian charitable organisation providing psychological support to people affected by the war.
This builds on my longstanding clinical interest in trauma, displacement and the psychological consequences of violence. Before working in Ukraine, I spent a number of years working therapeutically with refugees and survivors of torture and human rights abuses, including four years as a psychotherapist at the Helen Bamber Foundation, as well as two years working within a secure prison.
In Ukraine, I work alongside Ukrainian psychologists and other professionals supporting serving members of the military, veterans, medics, people adjusting to life-changing injuries, released prisoners of war, displaced civilians and family members.
A significant part of my role involves individual trauma-focused psychotherapy, including EMDR, alongside psychoeducation and group work.
Working within an active war brings particular clinical challenges.
Psychological distress may arise not only from terrifying events, injury and loss, but from prolonged uncertainty, repeated deployment, separation from family and the requirement to continue functioning while danger remains present.
A particular area of interest is moral injury: the psychological and emotional consequences of experiences which profoundly challenge a person's moral expectations or sense of themselves and others.
This has particular relevance to military personnel and medics, who may be required to make extraordinarily difficult decisions where there is no good or uncomplicated choice.
It is important not to assume that all understandable reactions to war constitute psychiatric disorder.
Therapy must recognise resilience, adaptation and existing sources of strength alongside psychological injury.
Another strand of my role is consultation and training with Ukrainian psychologists, medics and others working with trauma-affected populations.
This includes work around trauma responses, psychological first aid, EMDR, moral injury, professional boundaries and the cumulative impact of repeatedly working with severely traumatised people.
The approach is collaborative, combining the knowledge of Ukrainian colleagues working within their own culture and the realities of an ongoing war with my experience as an integrative psychotherapist and EMDR practitioner and more than twenty years of clinical work.
A further area of focus is the development of a programme specifically for Ukrainians returning from Russian captivity. This draws on my previous work with refugees and survivors of torture and human rights abuses, while recognising the particular psychological, physical and social challenges faced by former prisoners of war.
Support following captivity needs to extend beyond the treatment of post-traumatic symptoms alone. Questions of identity, trust, relationships, moral injury, physical recovery and adjustment to family and civilian life may all form part of a much longer process of recovery and reintegration.
We are currently developing this programme collaboratively with specialists in Ukraine and internationally, bringing together expertise in trauma, captivity and torture.
More recently, I have been involved in developing Coffee & Chat, a VseSylini outreach initiative bringing informal psychological support closer to military personnel and others who may have little opportunity - or inclination - to seek conventional psychotherapy.
Rather than expecting somebody to enter a clinic and identify themselves as needing psychological help, trained staff go to them, offering coffee, conversation, psychological first aid and an opportunity to decompress and talk.
The aim is not to pathologise understandable responses to extraordinarily difficult circumstances, but to make psychologically informed human contact available, recognise when somebody may need more specialist support and create routes into that support where appropriate.
Working therapeutically in an ongoing war has inevitably refined my understanding of trauma. Much conventional trauma treatment assumes that the danger has passed and that the task is to help the nervous system recognise that it is now safe. In Ukraine, that assumption often cannot be made.
Therapy therefore cannot be about persuading somebody that they are safe when they are not. It is about helping people find greater stability within uncertainty, while preserving dignity, agency and connection. Sometimes relatively simple things matter enormously: being listened to without minimisation, having an experience witnessed, being treated with warmth and respect, and being offered choices where choice has previously been taken away.
The work has also reinforced my understanding of guilt and shame following trauma. People may judge themselves harshly for how they responded under extreme threat, or remain convinced that they should have done more. At times, self-blame can offer a painful form of control: relinquishing it may mean confronting the harder reality that there was nothing they could have done to change what happened.
These lessons extend well beyond a war zone. My work in Ukraine continues to inform my private practice, particularly my work with complex trauma, shame and moral injury. It has strengthened my belief in careful pacing, respect for the ways people have adapted in order to survive, and the importance of restoring agency.
Most importantly, it has reinforced something I have long believed clinically: healing does not require perfect safety to begin.
My experience in Ukraine has led me to deepen my academic understanding of the psychological consequences of war. In September 2026, I began the MSc in War & Psychiatry at King's College London, undertaken part-time alongside my psychotherapy practice and continuing involvement in Ukraine.
My developing academic interests include moral injury among military medics and the psychological needs of people returning from captivity.
My work in Ukraine takes place with VseSylini, whose Ukrainian team continues to provide psychological support throughout the year.
VseSylini - Psychological Support Centre
An Alaskan in Ukraine: Emily and VseSylni
An independent account of VseSylini's work and my involvement with the organisation:
https://alaskaninukraine.substack.com/p/an-alaskan-in-ukraine-emily-and-vsesylni
