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How to Teach Students, and Treat Clients, in Hostile Countries

Your practice can help build bridges over geopolitical conflicts. Here's how.

Key points

  • Working with colleagues from countries embroiled in political upheaval can feel fraught; many psychotherapists elect not to do so.
  • Our colleagues from China, Russia, and other politically embattled countries deserve our respect and understanding.
  • We do not have to agree with the actions of other governments or a person's opinions to continue to work with them.

If you’ve ever had a friend on the opposite side of an important issue, you know how political conflicts can trickle down into personal ones. A geopolitical strain between countries can cause tension between colleagues, particularly if they hail from adversarial countries.

Today, during a time of international conflicts with both China and Russia, teaching colleagues and treating patients from these countries can feel fraught.

In the wake of Russia’s unprovoked invasion of Ukraine, some of my colleagues believe it unethical to work with Russians. Others voice similar feelings about working with Chinese colleagues and students in light of the Chinese government’s massive propaganda and humanitarian abuses.

While I share my colleagues’ frustrations and fears, I also hold dear the relationships I maintain with my Russian and Chinese patients and colleagues—and, in the name of compassion and understanding, I encourage other mental health professionals to do the same. As an international community of mental health professionals, we must separate our feelings about the foreign governments from the professional relationships with people from those countries.

Below I have shared some experiences from my years of working with Chinese and Russian colleagues that may help others:


I have taught in China since 2007, when my wife and I were invited to Wuhan by a professor of psychiatry, Shi Qijia, who was enthusiastic about psychoanalysis and interested in exposing his staff to a psychoanalytic couple and family therapy through our curriculum.

We then connected with Fang Xin from the Department of Psychology at Peking University. With her, we constructed a program in 2010 to train Chinese therapists in psychoanalytic couple and family therapy.

Since then, we’ve reached more than 500 students, many of whom have gone on to become colleagues and friends. We have supervised many of them and have grown quite close, as well as to our translators and Fang Xin’s staff. We love working with these students and colleagues, who we think have helped us become better therapists. We have since developed two additional Chinese training programs in child and individual psychotherapy.

In the process, I’ve learned a great deal about Chinese culture and a way of life that is evolving as rapidly as any culture in the world. It’s given me enormous respect and appreciation for the Chinese and their ways of thinking: a worldview that is, in many ways, fundamentally different from ours in the West.

I’ve written extensively about these differences, as well as our similarities. This body of knowledge allows me to separate foreign policy and diplomatic relations from personal belief systems and relationships. Although their culture is very different from ours, it’s easy to find commonalities that bind us.


The same considerations apply to my work with colleagues in Russia. I first went to Russia almost 20 years ago and had a wonderful encounter with people about whom I could say the same things I’ve been saying about China. I have found Russian culture closer to our own than China’s—but it is also very different, especially in terms of the effect their government exerts on their daily lives.

In 2016, I established a training program in Moscow, once again in couple and family psychoanalytic therapy, a program that has now grown to include another course on basic individual psychotherapy. These endeavors have brought me close to our collaborators, especially to our organizer Tatiana Onikova and our principal translator Yulia Motalova, but also to many Russian students. Several of them have established supervisory arrangements of their own. Some of those students were Ukrainian and took our course with their Russian colleagues and through Russian translation.

When Russia invaded Ukraine, my heart went out to all those whose lives were so deeply affected and, often, put in danger about survival. (I believe that this invasion is an unwarranted crime against humanity.) While I was concerned about my colleagues' physical safety, I was also concerned about how the war affected their psychotherapy practices and financial well-being.

An overwhelming majority of this academic cohort stands opposed to the war, sympathetic to the position of the Ukrainian colleagues and friends. This is further magnified by the fact that so many of them, as so many people in Russia, are interwoven with Ukrainian families and friends.

When colleagues have said to me that they don’t understand how I can work with the Russians under the circumstances of this war or the culture clash with China, I counter that it is precisely now that we need to maintain or even strengthen our collegial relationships and friendships with Russian colleagues. Their lives are impacted and strained, often in Russia, leading them to leave the country or, for some of their Ukrainian colleagues, to join in the fight against the Russian invasion.

Coming Together as Our Countries Split Apart

Here in the United States, we have not had to live with a brutal war or despotism on our home territory: or at least, nothing like living in Ukraine and having major cities bombed and citizens killed indiscriminately. Most of us do not know what it feels like to live in a communist or totalitarian country, living within the cogs of a massive propaganda machine. Working with people from despotic, secretive, politically embroiled countries starts with understanding how limited our initial perspectives will be.

While some may feel conflicted, I have no question about the morality of continuing this work; I consider it a pressing obligation. After all, in our work, we are frequently in a position to help patients grow, even if we share no overlap in political beliefs, religious affiliation, or personal circumstances. Just as with clients of different races, gender identities, or socioeconomic statuses, we must begin work with Russian and Chinese colleagues with the understanding that their perspectives and experiences are probably foreign to us.

Then, as when we live in such different political worlds, it is important to continue to offer help. In this situation, I believe it is critical to continue to offer the teaching and consultation that will allow our colleagues who live in such different national and political circumstances to do their work in the most effective ways and to help our colleagues and clients under the increasingly difficult conditions that they face every day.

I deeply regret the deterioration in diplomatic relationships between these countries and the U.S., particularly when we share so many qualities and sympathies with the Russian and Chinese peoples. In our position of privileged safety, we must offer all the help we can to our colleagues in both countries who are under assault and who strive to continue the work that they and we value.

At a time when it’s increasingly difficult for them to find refuge at home–and often abroad—Chinese and Russian colleagues deserve our sympathy and support.


Scharff, D. E. (n.d.). Marriage and family in modern China: A psychoanalytic exploration. Routledge.