POSITIVE PSYCHOTHERAPY

An interesting, although not very popular in our area (despite the great popularity in Europe and especially in the USA) is the so-called positive psychotherapy, or therapy, centered on conflict. This direction was developed by Nossrath Pozheshkian, who founded the International Center for Positive Psychotherapy in Germany.

Later this work was successfully continued by the son of N. Poseshkian Hamid Pesheshkian, who in 1993 published the monograph “Basics of Positive Psychotherapy”.

This trend is certainly not of the same level as psychoanalysis, behaviorism or gestalt, but it deserves attention with its original approach and already known practical effect, as well as the continued spread in Germany and North America.

There are supporters of this trend in Russia.

The basis of positive psychotherapy consists of three principles:

- positive attitude of the patient to his illness, and the client to his problem, neurosis. (As already mentioned, this manual is focused on non-medical psychotherapy, but due to the closeness of many problems, the periodic use of the terms "patient" and "disease" is justified. - A. R. )

- a substantive assessment of the conflict (that is, what concerns the client);

- five-step self-help therapy (with the advisory guidance of a psychotherapist).

From the point of view of the authors of positive psychotherapy, it is considered that the basis of any person consists of two leading abilities and needs - to learn and love. Ability and need for knowledge they refer to the rational , intellectual essence of man. This sphere, as is known, “knows” the left hemisphere of the brain. The ability and need to love they refer to the emotional , spiritual essence of man, which "knows" the right hemisphere.

Indeed, one cannot but agree that any normal person at any conscious age experiences both those and other needs and suffers from their dissatisfaction, even if he is not recognized in this not only to others, but also to himself.

It is interesting to observe positive psychotherapists that in Western Europe and North America most people are more focused on rational, intellectual knowledge of the world, people and themselves, while representatives of the East (China, Japan) have developed the ability for spiritual, sensory knowledge. These observations led to the conclusion about the importance of the intercultural approach in psychotherapeutic work with the client, taking into account his ethnic and cultural-historical predispositions.

For example, it is important to take into account that different countries have different attitudes towards alcohol, marriage, children, etc., which should be taken into account by the psychotherapist when analyzing problems (if they are related to these issues).

The term “positive psychotherapy” is most clearly explained by the views of its supporters on various diseases. To some extent this is consonant with the fact that the Russian psychologist, academician Yu.M. Orlov calls sanogenic thinking (from lat.sano - health). We can say that positive psychotherapy tries to help the patient or client in each minus to see their plus. For example, pain is seen as a useful signal of the unhappiness of a body, allowing it to take timely measures to treat it. This approach, of course, has a positive effect on the patient, especially with a tendency to hypochondria ( exaggeration of the danger of the disease).

This technique, as is well known, was adopted in philosophy (especially in ancient Greek and ancient Eastern), where there are many parables in which unpleasantness and even unhappiness turned out to be ultimately a blessing.

By the way, similar parables and therapeutic fairy tales, instructive stories, including from the personal experience of the psychotherapist, are widely used in positive psychotherapy.

This technique can be called philosophical therapy. It is in one form or another found in all religions. However, the transfer of this technique into the sphere of medical (or psychosomatic) psychotherapy gives more opportunities, if not for a satisfactory, then at least for a rational-comforting view on what is generally accepted to be perceived only from a negative point of view.

So even the use of alcohol in the permissible measures with this method is considered not the cause, but the result of life's troubles, the severity of which under the influence of alcohol temporarily decreases. We are not saying now that such a departure from problems into wine is like an attempt by an ostrich to hide its head under the wing, and also that the habit of drinking alcohol can lead to an incurable disease and even more aggravate life problems. Poseshkian does not justify drunkenness and alcoholism, but only indicates that we are not treating what hurts . We treat alcoholism, migraine, gastritis, impotence, various neuroses instead of examining them as consequences of spiritual and life problems and directing the search to solve these problems (not excluding, of course, associated traditional treatment, but not limited to them).

Many examples can be cited where positive therapy helps a client to look at his illness, neurosis, or problem only as a symptom signaling some kind of hidden trouble, without exposing and eliminating which all medical and psychotherapeutic measures are not sufficiently effective. Figuratively speaking, in relation to many of our diseases and problems, we take the tops by the roots and, cutting them off, wonder why they grow back.

We can say that the first main task of positive psychotherapy is to remove the patient’s or client’s fear of his illness, neurosis or problem, and even to find a positive point in them - clues to finding the true causes of the disease in the right direction. Such a positive approach to your disease or problem includes three stages (implemented both sequentially and simultaneously):

- taking into account not only individual, but also intercultural (or subcultural) characteristics of the patient or client;

- a positive interpretation of the disease or problem;

Conversational rational therapy (instructive stories, parables).

Positive psychotherapy is most successfully used as the main and accompanying method in the prevention and treatment of neurosis and psychosomatic disorders. Usually it is carried out in the form of the so-called short - term conflict- centered (that is, centered on the conflict) therapy, consisting of 20-30 sessions of approximately 50 minutes each. A key part of positive psychotherapy is the so-called conflict analysis.

Conflict analysis

Positive psychotherapy sees four areas through which the client with more or less success resolves their internal conflicts (problems). These areas are:

- body;

- activity;

- contacts,

- fantasy.

Some people respond to intractable problems somatically (that is, through the sphere of the body ). In this case, the so-called unreacted emotions cause various psychosomatic disorders, autonomic dysfunctions. These often include chronic headaches, gastritis, other gastrointestinal or cardiovascular disorders, and even diseases. Such a view forces one to look for the cause of these disorders in the central nervous system. Thus, the concept of heart neurosis is in principle incorrect, since neurosis is a product of disorders in the central nervous system, and therefore, its elimination must proceed in another way.

Other individuals react through the sphere of activity , that is, they diligently move away from the problem into work, or, conversely, into idleness. Often, at the same time, the same person plunges headlong into unnecessary or non-urgent matters, at the same time not finding in himself the will power to undertake the tasks necessary and impatient.

Still others - react through the sphere of contacts : entering into conflicts with others or, on the contrary, evading contacts, relying in themselves.

The fourth - react through the realm of fantasy , hiding from reality into the world of illusions with the help of alcohol, drugs, or go into mysticism, seeking God, into the hobby of esoteric, occult sciences, astrology, etc. (Do not confuse neurotic god-seeking with traditional religiosity, taken as part of this culture.)

The reason for these departures (regardless of which of the four spheres) is one is the unresolved real life problems and the inability or lack of readiness for their real solution. Although each person has access to all four areas of response, usually one of them dominates.

Representatives of positive psychotherapy refer to a certain experience of observation, according to which representatives of North America and Western Europe more often react to unresolved conflict in body areas and activities , while representatives from Eastern countries more often engage in areas of contact and fantasy .

We all live in the world of these or other conflicts, and not all of them become pathogenic for us, that is, generating pathological reactions in one of the four aforementioned spheres.

What factors from the point of view of positive psychotherapy make ordinary conflict pathogenic?

There are a number of reasons for this, but the main ones are:

- specific conflict situation;

- individual reaction to the conflict;

- personal characteristics of the individual.

When analyzing a specific situation , first of all, the real or potential (possible) impact of this conflict on an individual is considered:

- on physical condition (including health);

- on his professional success or failure (status);

- for the future of the individual (or at least his plans).

When considering the reaction to a conflict, stereotypes of individual behavior are revealed depending on the established system of relations:

- relation to I (to myself);

- relationship to you (perceived from childhood type of relationship in the parental family);

- relation to We and great- We . These relationships may coincide, or they may differ from each other, reflecting attitudes in the parental family ( We ) towards the people and society around you, as well as the individual’s direct relation to social, religious, ideological norms and values ​​(pra- Us ).

Deviations in relation to I are determined by the costs of upbringing in childhood, expressed in extremes: either lack of attention to the child (hypopec) or excessive “caring for hands and legs” (hyper-care).

In the first case (with the hypo-tectum), the child usually develops an understated attitude towards himself, a feeling of his own insignificance and uselessness. With excessive petty care (hyper-care), a child often develops egoism, not supported by autonomy, which when confronted with real life, in which no one is going to do anything for it, is quickly replaced by resentment towards society and social disadaptation.

Attitudes toward You are shaped by absorbing from an early age the atmosphere of home family relationships and, after growing up, are often transferred to relationships in one’s own family (to a spouse, spouse, children, parents), may contribute to the formation of a strong family or, unwillingly, unwillingness to start a family.

Attitudes toward We are shaped according to the pattern of the attitude of senior family members towards society and other people. If a child sees discrepancies between words and deeds, he also accepts models of hypocrisy, believing that one can say one thing and another.

Attitude to pra-We reflects the attitude to public morality and ideology. Depending on other relations, the attitude towards the great-We can be sincere, hypocritical or rejecting.

Of course, all types of the listed relations are divided very conditionally and in many respects influence each other.

Positive psychotherapy is based on the fact that there are no perfect people in nature. On the other hand, every imperfect person has, among his personal qualities, not only negative, but also positive. Therefore, one of the main tasks of positive psychotherapy is to identify individual positive qualities and rely on them in the fight against negative qualities and habits.

The technique of positive psychotherapy usually involves five levels:

- distancing from conflict;

- elaboration of the conflict;

- situational approval;

- verbalization;

- expansion of life goals.

Conflict distance

At this stage, the psychotherapist must help the client to step aside from the problem that has blocked the light in the window and prevents him from seeing the whole world around. This is reminiscent of gestalt therapy, when some kind of problem, unnecessarily taking the place of the central figure, closed the background, which in fact is much more worthy of being a figure.

As Sergey Yesenin wrote:

Face to face does not see.

A lot is seen in the distance ...

Only by distancing itself from the painfully bloated problem, that is, looking at it as if from the side, with sober eyes, the client will be able to see its real (not as decisive as it seemed to him) value. And only then can the next stage start productively - the elaboration of the conflict.

Conflict resolution

After the client is able to see the whole picture of the conflict (previously closed to him by a separate exaggerated detail), the next stage of positive psychotherapy begins - the study of the conflict. This is quite hard work.

The psychotherapist together with the client is trying to determine the severity of this conflict in each of the four aforementioned areas, or at least in the most important of them. Creatively cooperating, they confidently find out what impact this conflict had on the client himself (his condition, professional affairs, etc.), on his family (or on its individual members), on household and business relationships with other people, social status and so forth

At the same time, a joint, most frank analysis is undertaken of how and to what extent the relationship of parents, the influence of other people and events, and their own individual psychological characteristics of the client could affect this conflict.

After a thorough study of this level of positive psychotherapy, you can proceed to its next stage.

Situational approval

At this level, the focus is on the positive qualities and patterns of customer behavior. At the same time, mistakes and negative qualities are not ignored, but recede into the background, exposing the best in the client, on which one can rely in overcoming the negative phenomena of psychological states and behavioral models.

Situational approval can be understood more broadly - as the desire to avoid various kinds of negative assessments and opinions even about outsiders, since any negative statements and even thoughts and feelings aggravate the pathogenic conflict situation.

Verbalization

Only having mastered the first three levels ( distancing from the conflict, elaboration of the conflict and situational approval ), the client with the help of a psychotherapist proceeds to the fourth stage of positive psychotherapy - verbalization.

At this level, the therapist begins to teach the client to describe the state of his conflict as verbally as possible, more and more openly and freely discuss it. For this, it is very important to create an atmosphere of benevolent trust and complete confidentiality. The client must be convinced not only that any of his revelations will not be known to anyone, but also that the therapist will not tacitly even condemn any of the confessions and statements received.

In this case, the psychotherapist does not take a conciliatory position and in a tactful manner expresses his opinions and advice, but does not impose them on the client, but only helps to better assess the situation.

At this level, the “here and now” principle widely used in many psychotherapeutic areas is observed, that is, the psychotherapist gently, but constantly returns the client to discuss this situation and its current feeling, returning his thoughts from the past and thinking about the future consequences of its development.

Expansion of life goals

After the client, as far as possible, pulled away from the conflict (saw him from the outside), worked on him (put it in shelves), tried to see everything that was possible, in a positive sense, learned to calmly discuss his conflict, he proceeds to the final level positive psychotherapy - the expansion of life goals.

A client with the help of a psychotherapist sees how much energy (mostly negative) he unsuccessfully spends in overcoming the conflict. After realizing this fact, two ways can be scheduled. The first is to expand the areas of influence on a conflict situation, that is, to solve it not through one of the above-mentioned areas ( body , activity , contacts and fantasies ), but to optimally use each of them - to solve the conflict on a broader front and not spontaneously, but according to the intended (together with the psychotherapist) strategies.

It may be the second way out (by analogy with Freud's sublimation of libidinal energy), when the client refuses to achieve his frustrating goal (direct conflict resolution) and directs the released energy to the achievement of more important life goals. Naturally, this solution can be well helped by the addition of elements of psychoanalysis, behavioral and other types of psychotherapy with their qualified implementation.