A series of sessions to «clean consciousness leads to a new level of freedom for the patients to use their mental powers and to changes in their way of life.
Diagnostic phase
Patients first come to the doctor, not always knowing what to start with. One thing is obvious to them: they feel bad. What is this «bad about? How great are the number of the ways to further communication between two people, one of whom is a doctor and the other the patient? This choice of paths depends a lot on the doctors viewpoint.
Thetherapists viewpoint
Ive slipped away from Aesculapius
Lets consider what usually happens when a person turns to the classic doctor. What are you complaining about? The complaints are recounted. Anamnestic data is collected. Then an objective examination is carried out: percussion, auscultation, palpation, followed by instrumental and laboratory studies. The sum of the data allows evaluation of the state of certain organs and to put forward diagnostic hypotheses. Differential diagnosis involves the selection of the most likely conclusions from the list of possibilities. In the future, the diagnosis will be refined using ex juvantibus, which is a process of making an inference about disease causation from an observed response of the disease to a treatment. The activity of the doctor at the same time is quite large. The patient is enjoined to be obedient, to bravely endure all the hardships of service.
Thus, the diagnostician in this relationship is a doctor. Their research tool is their «clinical apparatus together with devices that are extensions of their senses. Their direction of examination is the state of organs and systems. The position of the patients is to endure everything, as it is all about their functional status (patient is in Latin «patient).
Psychiatrists still maintain the impartial study of the psychopathological phenomena, the definition of symptoms, syndromes and «nosology class of the disease.
«Well-collected anamnesis is half the diagnosis» these traditions are inherited by clinical psychotherapy. On one hand, allowing the participation of the patients personality in determining their fate, but, on the other, not overestimating the role of psychological factors in the formation of the patients condition. (Excessive psychologization is referred to as false psychology). Clinical psychotherapy is interested in the peculiarities of the constitutional and genetic type of a patient. A therapist plays the role of a mentor or a teacher: «a patients job is to be ill and a therapists job is to study their illness and to prescribe proper medical procedures.
Healers without any medical training copy the expert in a parodical way. They know everything for their client, they will tell him everything: what was, what is, what will be, who «did it to him. Their main instrument is their intuition. They are ready to answer almost all questions, as well as cure all diseases
There is a clear difference between the content of professional and non-professional approaches, but they do have one thing in common. They give the patient the role of a mute participant. (By the way, not all applicants for help reject such a passive role. Among the clients there are a lot of undisguised supporters of such a position.)
The directive position of the doctor in relation to the patient was especially present in the initial stages of the formation of psychotherapy. Charcot and his school, Pierre Jean, French doctors Lebo and Bernheim were the researchers of the phenomena of suggestion. August Forel from Switzerland did a lot in the study of somnambulism and the phenomena of hysteria, followed by the discovery of the origins of affective symptoms, particularly hysteria by Breuer and Freud. However, their methods also suggested a greater activity of the doctor.
Dialectical method
Laying the foundations of psychological psychotherapy, Freud made a remarkable move towards greater interaction with the patient in the identification, interpretation and subsequent processing of their condition. However, there were remnants of the old hypnotic period of development of psychotherapy: the patient passively lay on the couch, the analyst was separated from them.
Jung was much more inclined to the dialectical method. «If I, as a psychotherapist, feel an authority towards the patient and, in accordance with this, claim to know something about their personality and be able to make the right conclusions about it, then I, thereby, sign my own non-criticality, because I find myself untenable in assessing the person opposing me.9»
Here is his description of the features of the «dialectical mode of action, i.e. the position avoiding any methods:
«The therapist is no longer an active subject, but a witness of the individual development process. () The analyst here is not a superior, competent, judge and advisor, but a participant in the dialectical process as well as (now) the so-called patient. () In the relations «doctor-patient, two mental systems are mutually correlated, and therefore any sufficiently deep penetration into the psychotherapeutic process will inevitably lead to the conclusion that due to the individual originality of the participants, the «doctor-patient attitude should be a dialectical process. () It is clear that more complex, spiritually higher standing natures cannot be helped with complacent advice, suggestions and attempts to appeal to a particular system. In such cases, the doctor is better to remove the armor of methods and theories and rely only on the fact that his personality is strong enough to serve the patient as a point of reference and support. At the same time, it is necessary to seriously weigh the probability that the patients personality may surpass the doctor in mind, spirituality, breadth and depth in all such cases, the doctor should leave open the individual path of healing, and then the healing will not lead to a change in personality, but will coincide with the process of individuation, i.e. the patient will become who is in essence10».
On the North American continent, Carl Rogers and other humanist psychologists have proclaimed confidence in the clients own abilities for personal growth.
Significant development of this principle is in the NLP, offering to refrain from meaningful instructions and limited only to formal.
Following the clients process is a fundamental principle of process-oriented psychology.
The risk of affirmations
Reflecting on the danger of affirmations, and even more on suggestion (in particular, in the process of psychoanalysis), V. T. Kondrashenko and D. I. Donskoy note: There are certain difficulties in the use of suggestion. One of them is that the patient gets used to this regressive form of support and uses it as a prosthesis. The second difficulty arises if the suggestion is used without its subsequent realization. In this case, the suggestion of the analyst is not analyzed and, as a result, the patient may develop a new neurotic symptom complex. Most often this happens when the interpretation is presented to the patient as a dogma.11
Thus, suggestion, struggling with one complex, can give rise to another.
Thus, suggestion, struggling with one complex, can give rise to another.
To sum up the above, there is a tendency to increasingly trust the capabilities of a person undergoing treatment in determining the process of psychotherapy. The principle of interaction, rather than impact, is becoming clear. A two-way process occurs when two people come in contact, although one is called a therapist and the other is a patient. There is a search for a solution to the problem when combining efforts. To achieve success, the therapist does not need to play a Superman, all knowing and able to do everything for the patient.
A person is a self-organizing system with sufficient resources. All they may need is some assistance in the use of those resources. This is the principle of psychocatalysis which is contrary to the principles of doing something for the patient, whether interpreting their condition or the selecting more useful areas of activity for them.
Somatopsychotherapy (I will try to show) implements this principle to the greatest extent possible. The instrument of «doing are questions. But before we talk about them, we will pay attention to some more general problems related to the self-training of a psychotherapist.
Pitfalls
The clinic drives a psychotherapist, said prominent Russian therapist S. Konstorum. "The philosophy of human life directs the life of the therapist and forms the spirit of their therapy, K. G. Jung stated with him in unison.
What can prevent us from the realization of these truly golden principles? There are probably reasons for possible failures in their implementation, depending on the patient, but we will analyze what depends on the therapist. «Physician, heal yourself first» (the Church. Slavic) is a long-known principle. Before you start healing others, follow the advice of the Delphic Oracle «get to know yourself.» (And change yourself A.E.)
The merit of the introduction of the principle of preliminary and parallel analysis of the analyst themselves belongs to Jung. The need for this was also recognized by Freud.
A somatopsychotherapist, no less than the psychoanalyst or the Gestalt therapist, needs to study their own state, to know the tendencies of their reaction and the nature of their character.
Tendencies of character
In accordance with your personal character: mainly schizoid, cycloid or epileptoid you may need to track tendencies for: complication, self-admiration, domination and for commanding.
The presence of asthenic traits in the nature of the therapist can lead to the development of the patients parasitic traits.
Neurotic complexes
It is obvious that the psychotherapists own traumatic experience and the presence of their unresolved life issues can complicate the process of psychotherapy. It is discussed in detail in different literature, and I will not dwell on this further.
Cultural stereotypes
Having accepted the fact that psychotherapy is not an area of self-affirmation for the power-loving, nor an area of self-gratification for the sweet-loving. It is also neither an area where excessively smart people feed their pride (nor an area of self-torture for a good one), nor indeed, a sphere for solving neurotic problems of the psychotherapist, let us pay attention to the following:
Even if we assume that a «perfectly balanced person, who has undergone a long personal psychoanalysis or other thorough therapy, is engaged as a psychotherapy practitioner, that is to say, this person is pure in the sense of the absence of any tendencies to solve their own psychological problems when in contact with the patient; this «ideal psychotherapist still risks falling into «activism.
It is difficult for a doctor to trust the «uneducated mind of a patient. They are used to being an expert, a specialist. They know the terminology to denote the patients different states. They are competent to prescribe and cancel medications, discharge the patient to work or leave home. They are responsible for the life of the patients almost more than the patients themselves.
For the psychologist it is not easier to tune in to a trusting attitude towards the client. Although initially, they are more «consultative and can imagine that, as a specialist, they must be «smarter, stronger, more agile than their ward.
For me, falling into all these «traps as a result of being interested in my self-development of the «purity of doing, it became important to track my characterological response, my own neurotic problems and tendencies, which had appeared in the course of my previous professional life.
Below are some examples of my self-analysis (in the manner of «somato-analysis). I also mention some of the experiences that I have gained through participation in a special program.
Remarkable school
For me it was a remarkable schooling to observe and then participate in the practice of addressing the problems associated with alcohol abuse (and complex problems) according to the methodology of Croatian psychiatrist Vladimir Hudolin. I got acquainted with this approach (called ecologic, family, systemic) in Italy, where I was invited thanks to the inter-confessional cooperation of the Russian Orthodox and Roman Catholic churches.
The so-called operators consider themselves to be a facilitator of the process of staying sober and sees their task as so much doing something for the families, but rather to create conditions in which the families themselves, having problems associated with alcohol consumption, can do what will save them.
If an «active approach is used, the alcohol addicted patient is usually «coded, «torpedoed, if not sent for the «compulsory treatment to the institution of a prison type. The new program of the environmental approach sometimes suggests leaving such a patient alone and start the treatment by changing someone in their family.
The essential point is the «return of responsibility («recuperare la responsabilita» in Italian) to the members of the club (the community of families) for the process they are going through. Practically this is achieved in the following way: meeting, «chronicle, support to absent participants (patronage), the preparation of tea and other things are conducted by the members of the club at a time. The operator only cares about the safety of the atmosphere in which all this is done. Developing the pooling of experiences and resources of club members, they ensure that forces are not wasted on talking about politics, football, etc., thus restricting the simple rules of life in this community of self-and mutual aid: to just talking about the present and to rely on their own collective experiences.
In contrast to the common methods of «healing in one day (such as the above mentioned «coding or «torpedoing), this environmental approach gives much slower results, but is incomparably more reliable. The result of the club meetings is directed to the future, to the life of the descendants of the club members. This result is not limited to a period of 12 months or 5 years.
In connection with my participation in that Italian program, I thought of a «plant agronomic metaphor. What will the gardener take care of while planting beets in his garden? About the soil and light of course, but he will not try to grow it himself instead of a beetroot. Likewise, it is especially important to the doctors to understand the limitations of their competence and not to overdo it. In the end, the patients are saved by their own effort, not only by the activity of the doctor. This is my conclusion.