Coping With Russia's Stresses

Anyone who has moved to Moscow knows that the first few months here can be a stressful experience. Be it the weather, the language or the sheer size of the city, there are many things that can get you down, says Dr Christophe Bagot, a psychiatrist and psychotherapist from Paris who has recently started practicing at the European Medical Center.

But despite all its stresses, the speed and complexity of social change in Russia make it a very interesting place to work, Bagot said, which is one of the reasons behind his decision to start working here.

Bagot studied medicine at the University of Paris, specializing in biological psychiatry. But after graduation he became increasingly convinced that the psychopharmacological approach of "medication can solve everything" was missing something.

"There are two complementary ways of looking at a problem," Bagot said. "Psychiatry offers a medical diagnosis and proposes treatment by medication. Psychotherapy is about understanding people's logic, their vision of reality, and helping them to evolve."

Seeing that the innovations in psychotherapy were leaping ahead of those in psychopharmacology, Bagot began to take a greater interest in this field. He trained in a range of therapies in France and the United States. "The training in Palo Alto [in California] was very lively and interactive -- a new style for me," he said.

Psychotherapy is not about advice, Bagot said, but about understanding and moderating how people see reality, helping them adapt to it. This is particularly relevant to the experience of foreigners arriving in Russia, he said. "Moving to Russia can change relationships, especially if, for example, a woman moves with her husband for his job." This change in family structure can be disorientating, particularly as it is difficult to integrate into Russian culture.

"The most important thing is for people to understand what is happening to them, why they are depressed," he said. "People often don't know, for example, what a panic attack is, so informing people is very important."

"Acceptance and understanding are a path to change," Bagot said. "You have to know where you are in order to know where you are going." This is something he has learned from experience: "When I was a child, I took part in a competition where we were placed on horses in a forest with a map. The challenge was to reach a certain point first, but before that, we had to work out where we were."

james marson / mt
Dr. Bagot has kept his practice in Paris, but he hopes to spend more time here.

Bagot characterizes himself as "an observer -- I like the ongoing process of observing people." And the complex character of Russians makes them very interesting to observe, he said. "People here have different sorts of relationships -- their contacts are more emotional. It's all very different from the bourgeois district where I live in Paris."

Bagot's interest in Russia began 15 years ago, he explained, when he read an English translation of Lev Tolstoy's epic "War and Peace." "I became very interested in Russian culture," he said. "I fell in love with 20th-century Russian music, particularly Shostakovich."

Bagot also met a whole range of Russians at his practice in Paris. He has treated second-generation emigres whose parents moved to Paris after the revolutions of 1917 as well as New Russians who have grown wealthy in the post-Soviet economic boom. "I also have recent immigrants come in who have no documents and are living in France illegally, often in awful conditions."

He started to come to Russia to improve his language skills and took a three-week course at a psychiatry institute. Bagot is interested in sharing ideas with Russian psychotherapists: "Every person works in a different way, so exchange and communication are very interesting."

He now works about one week every month in Moscow, while also maintaining his practice in Paris. He hopes to work more and more here and get to know a country that he believes is widely misunderstood. "It's an opportunity to see a fast-changing society," he said. "People often come here with preconceived ideas and find something here to confirm them, rather than finding out from people what it is really like."

Dr. David Norton, a therapist from Hartford, Connecticut, who has known Bagot for over 10 years, praised his skills. "He has an innate passion and insight that is rare." Norton believes that Bagot will bring a new approach to mental health to Russia. "This is a time of change for Russia, and people like him are needed."


European Medical Center, 5 Spiridonyevsky Pereulok, M.Pushkinskaya, 933-6655,

Dr Christophe Bagot,