Lecture
The basics of psychotherapy are discussed in these lectures, which can be useful not only for those who receive an appropriate education, but also for those who believe that psychotherapy is just a set of tests and a series of manipulations. The basics of psychotherapy cannot be learned without an understanding of their ideological, philosophical, and psychological essence.
Psychotherapy as an impact on a person using psychotechnical techniques is a serious science, requiring a systematic approach and the ability to establish interpersonal relations. There are many schools and directions of psychotherapy and lectures will help to see their differences and similarities.
Knowledge of the basics of psychotherapy is necessary for every cultural person. Representatives of professions whose main task is to work with people — teachers, social workers, lawyers — are professionally needed in this knowledge. They help to better understand and evaluate their own and other people's actions and mental states, the causes of which are not always on the surface and are not always in reality as they appear to us.
It is important not only to understand, but to act correctly, to correct, if necessary, one’s own and another’s behavior. It is not as simple as it seems at first glance. Otherwise, we would have long ago parted ways that disturb us and other habits
One of the tasks of psychotherapy is to teach people how to behave, which will help them to solve successfully and, if possible, not to create personal and interpersonal problems.
An experienced psychotherapist often immediately sees erroneous actions that give rise to and aggravate the problems that his clients seem to arise on their own or through the fault of other people and circumstances.
Sometimes a person at the level of consciousness fully understands what needs to be done in a depressing situation, but cannot find the strength and decisiveness in himself for these actions, preferring to put up with the situation as insurmountable.
A psychotherapist, practical psychologist should be able to distinguish a situation that is objectively unsolvable (at least through his own efforts) from a situation that this person considers to be unsolvable, disclaiming responsibility for making decisions and actions to overcome it. At the same time, the psychotherapist should be able to clearly distinguish cases within his competence from cases with which a given individual should be referred to a psychiatrist with a suspected mental illness.
At present, non-medical and medical psychotherapy are clearly divided in the United States, Germany and several other highly developed countries.
Medical psychotherapy concerns mainly work with mentally healthy patients of medical institutions and is a more profound continuation of medical psychology and deontology. These specialists are trained at medical faculties of universities, and in the future they are included in trade unions and medical associations.
Non-medical psychotherapy is done by graduates of psychological, and in the USA and philosophical faculties (there philosophy is understood not only globally, but also individually and ideologically).
The psychotherapist has no right to work with patients diagnosed with mental illness, alcoholics, drug addicts, “suicidal persons” without the permission of the attending physician (psychiatrist, narcologist) who can “delegate” to the psychotherapist a part of the rehabilitation associated with the psychological support of the patient and his relatives.
In most cases, persons with mental illness are seen “with the naked eye”, primarily because of the apparent inadequacy of response to situations, words and actions of other people. However, there are so-called borderline states (“wandering” between the norm and pathology).
In all cases of doubt, the psychotherapist is obliged to refer such a patient to a psychiatrist or to consult him himself. This is extremely important, since psychotherapeutic and psychiatric approaches are fundamentally different.
The fundamental difference between a psychiatrist and a psychotherapist is as follows.
The psychiatrist works with a passive object, to whose consciousness it is useless to turn, and therefore uses such “surgical” methods as a sufficiently strong medical effect, electric shock, various hypnosis techniques, etc.
Of course, this is a concept. Separate methods of activating the personality of the mentally ill are used, for example, in the St. Petersburg Psychoneurological Institute. VM Bekhtereva, where patients provide all possible assistance to other patients.
But in principle, the psychiatrist works with the patient (translated from Latin - tolerant), that is, with a passive (in the sense of his participation in the treatment) object, while the psychotherapist works with the client, the subject, that is, the active participant in treatment, increasingly awakening his activity and autonomy.
The psychotherapist uses a fundamentally different approach, “drawing” the client (and not the patient, like a psychiatrist) into creative collaboration, trying to find and show him his own internal resources to overcome undesirable situations, states and behaviors.
The patient rarely turns to the psychiatrist himself — he is either brought by relatives or delivered after a seizure or other manifestation of the disease that is dangerous to him and others. To a psychotherapist in all civilized countries, no one hesitates to ask for advice and help in overcoming the mental conditions that oppress him. Such conditions periodically occur in any healthy person, and in those cases where he himself cannot cope with them or would like to simply consult, he does not hesitate to contact a specialist.
Unfortunately, due to the lack of psychotherapeutic culture in our society, many are embarrassed to turn with their problems not only to a psychotherapist, but also to a practical psychologist, believing that this immediately puts them in the category of mentally abnormal people.
Because of this, individual and family problems that could be easily solved at the initial stage are aggravated, becoming more difficult to overcome.
The most important condition for effective interaction of the psychotherapist with the client is the active desire of the client to overcome what is stopping him, cooperation with the psychotherapist, and not shifting responsibility to him.
If such a desire is not yet sufficiently expressed, the psychotherapist should make it clear, conscious and sustainable, explaining to the client that this is the necessary condition for solving his problem. Everyone knows that, for example, the treatment of alcoholics is useless until they themselves have an active desire to get rid of the disease.
For effective cooperation, it is important to convince the client that you will not fight together with some kind of behavior (which he may justify, especially in family conflicts), but with the suffering that this behavior brings to him and his family.
Of course, the activity, the “subjectivity” of the client in psychotherapy is also only a schematic diagram, a constantly present goal. In the process of therapy itself, the subject, being periodically exposed to certain methods of influence, becomes the object of influence.
For example, when teaching autogenic training and other types of psychoregulation, the client periodically must passively and carefully perceive the impact. But he must do this consciously, of his own free will and when it is necessary for the process of therapy. If, if desired, he cannot move from the passive state of the object to the activity of the subject, then this becomes the main concern of the psychotherapist, forcing him to search, involving the client himself in this search, methods of activating his independence resources, without which the rest of the work is doomed to failure . At the same time, the client may agree with the correct advice and even the fact that his behavior interferes with him and this needs to be changed, but he really does not take any action in this direction. For example, a person, remaining completely independent and independent in various life situations and affairs, is not able to solve the problem of smoking or overeating.
To some extent, understanding of the harmfulness of their behavior, the need to correct it and at the same time complete inaction is periodically present in each of us. It is dangerous when it becomes a permanent position in life, like, for example, in Oblomov, although his opponent, the “mechanized” Stolz, does not evoke sympathy.
The psychotherapist should avoid extremes in his recommendations, and if we cite here the opposition of the subject and the object, then only as a visual scheme of their extreme incarnations.
In real life, in each person at different times there are elements of both the other - their ratio is important, it is impossible and inappropriate to be active and concerned with responsibility all the time; It is important not to go into passivity and irresponsibility as a stable life position, from which one cannot emerge, even when objectively there is every opportunity to solve a life problem on one’s own.
A person has a feeling of meaninglessness of the efforts undertaken to achieve certain goals, which begin to seem to him worthless of these efforts. Sometimes such an excuse for inaction generally leads to a loss of the meaning of life. Interestingly, this is often found in quite reasonable people who do not have obvious life tragedies and misfortunes (more serious than most), except for one, but the most important thing is the loss of the meaning of life!
Such a feeling of meaninglessness of life can arise not only in the absence of a perspective, but also with a rigidly given perspective planned for a person.
This feeling can be equally strong on any scale: both in state (mainly in totalitarian states) and in family and individual, when personal freedom is suppressed by dependence on traditions, laws, circumstances, people. Moreover, the dependence may not be objective, real, and exist only in the representation of the individual, but from this it does not become less strong.
A classic example is addictions such as drug addiction and alcoholism, which even make an intelligent and multi-talented person “one-dimensional”. These harmful dependencies are first relegated to the background, and then almost completely crowded out all other interests, thoughts, feelings, except for the desire to satisfy a given need or experience about their illness. Disappears interest in family, work, other hobbies.
Similar deformation and destruction of the “gestalt” (structure, holistic image) of normal life also occurs with other (sometimes less obvious) addictions, neuroses and obsessive states, which to a certain extent appear periodically in any normal person (love, jealousy, exaggerated fear something or someone, a strong desire to get something or to get rid of something), it is important not to lose the sense of reality, not to dwell on these states to the detriment of other aspects of life.
Comments
To leave a comment
The basics of psychotherapy
Terms: The basics of psychotherapy