Since the 1990s, psychological trainers, coaches, and psychotherapists have fanned out across the Russian psyche politic. In posing a psychological subject as a substitute for the “Soviet Person,” psychologists have also resuscitated the individual personality as site of social concern. This cultural shift is evident in the way that positive psychological concepts like self-esteem, personal growth and emotional management have been integrated into parenting, education policy, mass-media programming, advertising, human resourcing and economic modernization. And yet outside these capital-intensive circuits—in the considerably less resourced domain of public services—specialists work in other therapeutic registers, drawing on a prophylactic language of metrics, early intervention and correction. Inasmuch as their clients are often those left behind by Russia’s post-Soviet recovery, the results are the reproduction of social difference at a psychological level. This talk describes the factors that collude to produce this form of “psychological difference,” but then turns to the day-to-day improvisations practitioners undertake as they seek to renegotiate the terms of care. Care, I conclude, is double-edged—caught up in a bind between harm and help. In the conclusion I reflect more broadly on what lessons Russia’s psychologization offers current humanitarian conversations about global mental health.