This book looks at the impact of multigenerational trauma, severe psychopathology, and ethical struggles through the lens of Ukrainian psychoanalysts working amidst the Russian invasion. The contribution examines psychoanalytic responses to Russia’s aggression against Ukraine, including via lived experiences of Ukrainian psychoanalysts who practice under conditions of continued threat. The book offers analytic observations and exploration of psychoanalytically informed care with Ukrainians who are experiencing profound distress and war trauma. Contributors describe their work with diverse Ukrainian groups, including children and adolescents, war refugees, individuals experiencing severe physical and psychological crises, Ukrainian Jewish community, and Ukrainian diaspora. This will be a valuable resource for readers interested in understanding and responding to impact of wars, specifically genocidal wars. They are invited to witness the profound challenges, creativity, courage, human and professional dilemmas, and pain that are witnessed and responded to by psychoanalytically informed practitioners.