How a psychotherapist works with a client. Principles of interaction between psychotherapist and patient

It is a postmodern practice, an alternative to academic psychology. Because therapists rarely find useful information in research, they are forced to develop their own knowledge base. They do this not on the basis of skills that are used in academic psychology, but on observations of the environment, using their own schemes to construct a system of knowledge that can find practical application.

Psychotherapy as a theoretical and applied direction of psychology

Psychotherapy has the following definitions:

• a direction of practical psychology based on a system of objective (scientific) knowledge about the possibility of psychological influence on a child and his adult environment;
• a system of active measures and influences aimed at correcting (changing) deviations (disorders, defects, disturbances) in the mental development of the individual, preserving his individuality, correcting the behavior of the child and adult members of his environment;
• a method of working with patients (clients) in order to provide them with assistance on modification, change, and weakening of factors that interfere with their normal life.

Subject, purpose and objectives of psychotherapy

The subject of the specialist’s consulting activity is determined by the symptoms and causes of deviations in the development and behavior of the client, therefore psychotherapy is focused on:

• human development (psychomotor, emotional, cognitive, personal, competence, communication, etc.);
• behavioral reactions, actions, acts, manifestations;
• strengthening of voluntary regulation;
• improving indicators of adaptation to an educational institution (including readiness for school, lyceum or college);
• stabilization of personal emotional state;
• structuring thinking;
• memory activation;
• broadcasting development;
• regulation of psychomotor functions, etc.

The general goal of psychotherapy is the return of the individual to internal well-being. The most important task that psychotherapy implies is to help people who are faced with their own inability to achieve goals and who experience frustration, deprivation, despondency and anxiety in connection with this, to create their own assets and liabilities and teach them to use their capabilities effectively, namely:

• recognize your own potential;
• use it;
• remove obstacles to its implementation (in particular, discard what prevents you from living with a feeling of pleasure, joy and happiness).

The objectives of psychotherapy can be presented as a list:

• information about certain psychological phenomena and characteristics of the psyche and behavior;
• training (training) in new actions, ways of making decisions, expressing feelings, etc. (these are programs aimed at enhancing life skills, communication skills in the field of human relations, problem solving, providing support in choosing a healthy lifestyle);
• development of the activity component of the personality: its skills, abilities and abilities;
• promoting the formation of age-related psychological formations (assistance in the formation of identity and personal development);
• correction of emotions and behavior;
• optimization of the social development situation;
• eliminating (reducing) anxiety, overcoming depression, stress and their consequences.

History of the development of psychotherapy

In ancient times, the first psychotherapists were shamans, magicians and sorcerers. Ceremonies, rituals, dances, fortune telling, etc. helped people whose illnesses were not so much physical as emotional. In the Middle Ages, the prevailing belief was that mental illness was caused by evil demons and diabolical forces that took possession of a person. The birth of psychological science is marked by the emergence of researchers' interest in the patterns of functioning of the psyche, and subsequently by the emergence of ideas about emotions as the cause of mental disorders. At first, scientists were interested in:

• how an ordinary person experiences the world around him;
• how a person plans his actions;
• how it really works.

Subsequently, psychology came to the conclusion about the existence of individual differences (they are the subject of differential psychology and psychodiagnostics). Further, with the advent of the doctrine of emotions as the cause of mental disorders, the focus of attention shifted towards the uniqueness and unpredictability of a person, which are not subject to typification. Then the scope of research shifted from individual differences to differences in the way people conduct discussion and dialogue. The next step is to include in the context of analysis the social environment in which a person lives, as well as the society of which he is a member (the subject of social psychology).

Individual therapy arose simultaneously with ideas about the dyadic relationship between doctor and patient (“therapeutic alliance”). Counseling psychology emerged in the mid-20th century. In the first stages of its development, it was natural to be interested in the reality that the patient faces and which gives rise to problems and troubles that force him to see a doctor. This is where organizational psychology, family psychotherapy, etc. originated. Focusing on the “consultant-client” dyad posed the task of developing norms and rules for their interaction.

Interdisciplinary connections of psychotherapy

Areas of psychotherapy (including advisory) are based on the following branches of psychological science:

• general, age, children;
• social, clinical and differential;
• personality psychology;
• psychodiagnostics (in particular, testology);
• counseling psychology.

According to traditional ideas about the psychological influence on a child in the context of successful ontogenesis, we can say that psychotherapy is a set of means and methods themselves designed to create optimal opportunities and conditions for the full and timely development of a growing individual. In this context, the activities of a specialist are represented by: psychocorrection, psychoprophylaxis, psychohygiene (preservation and strengthening of neuropsychic health), psychorehabilitation.

Counseling psychology as a theoretical and methodological background and direction of psychotherapy

Theoretical and methodological psychotherapy is advisory psychology, that is, a branch of systemic scientific and applied knowledge. As for providing assistance in the form of a conversation, it is usually provided:

• persons of different ages, including children;
• parents and teachers on issues of development, training and education.

Psychological counseling is most often understood as mental assistance to healthy people, which is provided with the goal of helping them cope with various internal and interpersonal difficulties that arise in the process of organized interaction. As a type of medical practice, this is a system of communicative interaction between a doctor and people who turn to a specialist (at the request of the administration of the institution, parents, teachers), and the process may be limited to advisory assistance. Such counseling does not have a common understanding of its essence. It is divided into two groups. This:

• counseling as influence (directive psychotherapy);
• counseling as interaction (non-directive psychotherapy).

Psychological counseling and psychotherapy include: the activity of the client, the activity of the consultant and the result of this process - psychological new formations activated (formed) in the personality of the person seeking help. In this case, five main groups of questions are considered:

• about the essence of the process that arises between the client (the person who finds himself in a difficult situation and needs specialized help) and the therapist (the person who provides this help);
• about the personal traits, attitudes, knowledge, and skills of the doctor;
• about reserves, which are the client’s internal forces, provided that they can be activated;
• about the peculiarities of the situation that has developed in the client’s life and led him to the psychotherapist;
• about the methods and techniques that the consultant will use to provide assistance to the client.

Basic models of psychotherapy

In modern psychotherapy, there are two approaches to the essence of the therapeutic process - medical-biological and psychological. There are also two basic models of psychotherapeutic influence - medical and psychological.

The medical-biological model is an emphasis on the somatic characteristics of the client. It is assumed that only a specially trained psychiatrist or psychotherapist has the right to use it. This condition must be followed strictly. Here is what psychological psychotherapy includes:

• customer centered;
• “coexistence” (when the main thing is not the general activity interaction between the therapist and the client in the advisory process, but the exchange of thoughts and emotions);
• “internal comprehension” (when the client moves in his personal space along a trajectory that he himself determines);
• “unconditional acceptance” (the doctor and the patient enter into a special relationship of intimacy based on empathy, love, respect).

Particular importance is attached to the methodology of practical work. Methods of psychotherapy (in particular those used according to the methodology of psychoanalysis), knowledge (theory) become the main guidelines of the advisory process. Most often, the doctor can tell everything about the patient: about the characteristics of his relationships in childhood, the processes of overcoming and protecting, his trauma, etc., but he cannot convey his “life spirit.”

Theory-oriented behavioral psychotherapy becomes the best means of achieving goals within the behavioral model. On the other hand, this knowledge about the client does not guarantee that internal changes will occur in him, does not promise to “awaken” his internal processes. This is only possible in the case of something important, something that is not subject to conceptualization, which is almost impossible to learn, but without which deep behavioral psychotherapy cannot occur.

Psychological models

Within the psychological model, in turn, the following are distinguished:

1. Social-psychological model. This is an approach that is based on social influence, in which it is possible to develop social forms of behavior.
2. Person-centered model (client-centered), which provides for special interpersonal interaction between the therapist and the client. The doctor uses psychological theories and special communication techniques to solve the client’s personal problems.

Areas of psychotherapy

In advisory practice it is understood that illnesses, conflicts, stress, problems are a fact of life for every person, and this must be accepted and recognized. Positive psychotherapy is the direction of maintaining and restoring the mental health of citizens. Its main purpose is to take care of the social, physical, and spiritual health of an individual, family and social group. In this regard, you need to understand that people are endowed with abilities that allow them to find ways out of the most difficult problems and situations. Positive psychotherapy emphasizes a holistic view of the individual's life and an optimistic perception of its nature. Human existence is a unity of body, mind, spirit and emotions. A doctor who works in this field will not seek to “make a diagnosis”, but will try to understand the patient in his life problems, due to which he developed diseases or disorders.

Cognitive psychotherapy is a direction that involves improving a person’s understanding of the world around him and himself. The fact is that depression, for example, sometimes makes you perceive reality biased. According to practitioners, cognitive psychotherapy allows the client to remove negative thoughts from himself and always think positively. Therefore, melancholy disappears. During classes, the doctor identifies negative thoughts and helps to assess the real state of affairs. He will be the leader of the training on mastering new ways of understanding the world, and will also help consolidate the ability to evaluate this or that event in a new way.

Group psychotherapy involves conducting classes in a group where each member has a certain deviation. For example, this direction is used to eliminate harmful addictions (tobacco use, alcohol use). At the same time, efficiency increases, since, being together, patients increase the influence on each other of the desire for treatment. Thus, group psychotherapy assumes that the group not only becomes an object of influence on the part of the therapist, but also itself influences each of its members.

Family psychotherapy uses a set of techniques that are focused not only on problematic family situations, but also have the goal of analyzing the client’s past, reconstructing certain events and the structure of relationships, etc. The current direction in development is the development of methodological foundations, relying on which will help to avoid accidents, fragmentation and intuitiveness.

Clinical psychotherapy is a discipline whose goal is to eliminate various disorders and disorders, somatic diseases. This direction studies the mental and moral aspects of health: individual differences, the influence of environmental factors on the patient’s condition and the course of treatment, mental characteristics of experiences. The theoretical foundations of this psychotherapy technique: biopsychosocial concept of pathology; research methods in medical psychology; the concept of the “illness - health” continuum.

Features of bioenergy

In the last century, bodily psychotherapy was replenished with a new method of influence, which was called bioenergetics. One of the famous Dr. Reich's students, Alexander Lowen, developed this approach. By using a slightly different conceptual apparatus, for example, “bioenergy” instead of the concept of “organ,” the doctor to a certain extent neutralized the resistance of other therapeutic directions. His system became more widespread in the United States than Reich's similar teaching. At the same time, he included in his concept the theory of breathing developed by the teacher, and part of his techniques aimed at achieving emotional uninhibition through the use of blows, screaming, and tears.

Body-oriented psychotherapy, developed by Lowen, places the concept of bioenergy at the center. It unites the body and psyche in a functional way. The second important definition on which body-oriented psychotherapy is based is “muscle armor.” It interferes with the spontaneous flow of energy throughout the human body, so there is a set of exercises to help get rid of it.

Basic methods of psychotherapy

An ordinary patient who has never encountered the work of psychotherapists has a very vague understanding of what happens in a session. There are many methods of psychotherapy. Let's learn about the main ones.

1. Art therapy. Today this is a very popular method. Art therapy is suitable for establishing a psychological connection between the patient and the therapist. This method is very effective for almost any deviation. It is especially often used when working with children. With the help of art therapy, the patient reveals all his hidden problems to the therapist. The technique uses various techniques, such as dynamic synthetic drawing, metaphorical drawing, symbolic destruction of obsessions, and many others.
2. Autotraining. The beginning of the use of this method can be dated back to the 30s of the last century, but the basics were borrowed from ancient eastern developments. It is used in the treatment of adults only.
3. Suggestion. This method can be called the basis of treatment. Almost not a single case in psychotherapeutic practice is complete without suggestion. When using suggestion, the consultant must take into account the various individual characteristics of the patient. For children there is a special method called fixation.
4. Self-hypnosis. This method is related to many religious rituals and meditative techniques. Before the patient begins to practice self-hypnosis, the therapist works with him, using the suggestion technique.
5. Hypnosis. This method of psychotherapy is the most controversial, but it is very effective. Used since the mid-20th century. In psychotherapy, there is a difference between hypnotherapy and hypnosis. There are also classical and Ericksonian methods. Hypnotherapy has a fairly wide list of contraindications.
6. Play psychotherapy. Play therapy is more often used to treat children. The following games are used: sociocultural, biological, interpersonal.
7. Rational psychotherapy. This is a technique in which the consultant convinces the client of something, using logical explanations and citing facts. Rational psychotherapy is sometimes used instead of suggestive methods. The effectiveness of this technique depends directly on the charisma of the doctor. Rational psychotherapy is more often used in the treatment of adult patients.
8. Talk therapy. During the session, the patient speaks out loud about those problems that cause him the strongest feelings. In the process of delivering a speech, there is a rethinking of what is happening.
9. Desensitization. This method of psychotherapy is based on the fact that learned manipulations are replaced by others. To begin with, the client masters the relaxation technique. He then brings to mind an image that frightens him. After this, also in thoughts, a picture of calmness appears. This takes about 30 minutes. Patients over 10 years of age can be treated with desensitization.

Psychotherapy is an effective method of curing many diseases, including somatic ones. It also relieves personal and social problems. However, a person who turns to a specialist for help must understand that he will not receive a miraculous healing. Psychotherapy is not a magic pill. In order to achieve the desired result, you need to work on yourself.

The art of professional psychological assistance is little by little gaining its place in the sun, occupying a close niche between medicine and witchcraft. I decided to shed light on what makes psychotherapy work for the uninitiated, focusing on what is usually not talked about - the hidden indoctrination of clients by psychotherapists and psychological consultants. .

The first psychotherapist, Sigmund Freud, a former physiologist, thought he was still pursuing science. His first patient, Bertha Pappenheim, thought that she was being treated in a new way (all others were ineffective) - talking. Later it turned out that psychotherapy could not become either a science or a field of medicine: psychologists are engaged in their experiments, doctors treat the body, and psychotherapists inherited the soul with its problems from the church, which was losing its authority. If you are dissatisfied with yourself and life, tormented by worries and anxieties, unsatisfied with relationships with loved ones - welcome to a psychotherapist or a consulting psychologist (when we are talking not about mental illness, but about psychological problems, then this is, by and large, one thing). and the same thing, it’s just that those who go to them for a long time usually call themselves psychotherapists, and psychologists – those whom they come to once or twice). It would seem that all of us are heading there...

But where exactly to go - to the masters of psychoanalysis or psychosynthesis, to psychodramatists or gestalt therapists, to existential-humanistic, cognitive-behavioral, or some other psychotherapists with an even more incomprehensible name? Maybe just choose the most effective method? This was not the case: numerous studies have shown that the effect of all methods of psychological assistance is approximately the same. And this despite the fact that they are based on completely different theories, often completely opposite to each other, and use completely different techniques. This paradox, perhaps, remains the main problem of psychotherapy. Even psychotherapists themselves have ceased to hold on to their theories - today most of them consider themselves supporters of simultaneously different approaches, trying to use those methods and concepts that, in their opinion, are most suitable for a particular case.

Researchers are increasingly inclined to believe that the main thing in psychological help is not theories and techniques, but the interaction between the psychotherapist and the client, which is very similar in most modern schools of psychotherapy, and not at all similar to any other human relationships. Let's try to understand these relationships and look for the key to how psychotherapy works.

Debunking the Myths
We need to start, perhaps, with some myths about psychotherapy that exist not only in folklore, but often in the minds of novice psychotherapists. Actually, it is because of inexperienced and untrained psychotherapists, of whom we have a dime a dozen, that these myths often arise.

The first myth is that the psychotherapist sees right through you.
Having met a psychologist, people often think that this expert on human nature sees them in some special way, or even uses some of his own secret psychological techniques in communication. But an experienced psychotherapist sees right through all the hidden motives, senses problems and complexes a mile away, his theories explain all their behavior.

In fact, theories rather prevent us from seeing a specific person, unique even in his “complexes.” The psychotherapist does not expose the client’s secret sins, but opens up to him, tries to understand and feel the client’s state and emotions, and then talks about his understanding. It, like a mirror, serves the client for self-knowledge. At the same time, the psychotherapist is not an indifferent “objective observer”: he does not hide his emotions and is often involved in the psychological “games” that the client plays with him. Psychotherapy sometimes resembles joint creativity, sometimes love, sometimes war.

The second myth is that a psychotherapist can manipulate you, hypnotize, zombify and program you.
Today, this myth is actively spread by adherents of a psychotherapeutic sect called “neuro-linguistic programming” or simply NLP. This sect, however, has nothing to do with neurology, linguistics and programming, and it can be classified very conditionally as psychotherapy - its advanced adherents are mainly engaged in making money by training less advanced adherents who believe that after this training they will be able to “program” those around you.

Some psychotherapists actually know hypnosis (there are far fewer of them than those who think they do), but the effect of such tricks is small and short-lived. In addition, not every person can be hypnotized, mainly those who really believe in zombies, neuro-linguistic programming, or in their psychotherapist.

It is incredibly difficult to change a person in any way. But a psychotherapist can really help a client change if he really wants and is ready to work on himself. Psychologists have long noticed that in order to change a person, the main thing is to accept, understand and love him, believe in him and let him feel it. Otherwise, he simply will not want to change. And the fact that a person’s personality and character can be changed without his desire is a fairy tale. So the fastest way to change a person is through accepting him as he already is (this, by the way, is a psychotherapeutic recipe in case you are planning, for example, to change your husband).

The third myth is that the psychotherapeutic book you bought and read contains the truth about the structure of your psyche.
Psychologists have come up with many very convincing theories. True, they do not always convince and not everyone, so the opposite myth is also widespread - that, for example, psychoanalysis is a vile lie. But psychotherapeutic explanations are needed not at all in order to find out the final truth about the structure of the soul, but in order to help a person, to give him a tool to work on himself. It doesn't matter whether a theory is true, what matters is the effect it will have. Such concepts (researchers call them “psychotherapeutic myths”) help us take a fresh look at our lives, talk about experiences for which we usually do not have words, and bring our experiences into some order. It’s just that everyone uses different myths to establish this order, and in the case of the same psychoanalysis, you risk leaving the psychotherapist’s office with the confidence that you secretly hate your father, or with memories of how you were sexually abused as a child.

The fourth myth is that a psychotherapist will cure you.
The spread of this myth is facilitated by the language of psychotherapy, borrowed from medicine. The very word “psychotherapy” is misleading, and for example the word “neurosis” literally means “disease of the nerves,” that is, something like a tumor or fracture. And this word is used to describe grief and anger over unrequited love, self-rejection, inability to rejoice, and similar “diseases.” Do you think this can be treated?
In recent decades, there have often been attempts to replace clinical expressions with “trade-politically correct” jargon - instead of “patient” they say “client”, who enters into an “agreement” with his “therapist” (this is instead of “therapist”), etc. Also, of course, good is not enough - as a participant in one of the psychotherapeutic groups said: “Thank you for not making me feel like a client.”
Let's look at what a psychotherapist does instead of treatment using the example of Arnold Mindell, one of the most famous and fashionable psychotherapists today. At his seminar, a woman suffering from cerebral palsy shared her heartache - all her life, people around her laughed at her or pitied her because of the way she moved. Mindell invited her to move, found her movements beautiful in their own way and began to dance some kind of crazy and mysterious dance with her. Perhaps for the first time in her life she liked her movements. Mindell asked her, “What are you doing?” She replied: “I fly from planet to planet. I bring clear light with me,” and added: “I do this every night.”

Instead of treatment, a psychotherapist provides psychological assistance in personal development. If you complain to him about a headache, he will not instruct your head not to get sick, like the unforgettable Kashpirovsky, but will ask you to look for meaning in this pain or express on her behalf what she thinks about you. What if you don’t want to develop and just came to end your, say, obsessive fear of riding the subway? To your surprise, the therapist will soon begin to discuss more and more distant topics, and if you join his game, you one day risk discovering that your ideas about the world have changed so much that the initial problem has ceased to be significant to you. At the same time, you may still be afraid to ride the subway, but now you have more important problems - you are busy eliminating internal obstacles to career growth and have been traveling only by car for a long time.

Psychotherapeutic Creed
The client himself, of course, does not ask to change his image of the world, but addresses a specific problem. But the primary task of the psychotherapist is the so-called “clarification of the request,” that is, turning the arrows from this problem to the client’s global “existential” problems. If it turns out that the client really has such problems (and who doesn’t?), work begins, during which the client is unobtrusively indoctrinated, he learns to look at the world and act in accordance with the new ideology. Modern psychotherapy is largely based on the adoption of a few simple ideas.

The first idea: accept yourself as you are.
The ideology of psychotherapy suggests leaving dissatisfaction with yourself, the painful struggle with your shortcomings, and loving yourself in all imperfections. One of the main sources of our torment is the conflict between the idea of ​​what I should be and the idea of ​​what I really am. In different areas of psychotherapy, this conflict is described as a war of consciousness and subconscious, mind and instincts, duty and desires, inner parent and inner child, real self and ideal self, etc.

A psychotherapist who needs to “conquer” a client’s problem understands: if the client stops fighting with himself and loves himself, then the problem will disappear. Interpreting the client’s experiences, the psychotherapist draws his attention to the fact that ideas about good and bad were instilled in him by his parents in childhood and he fights with himself for the sake of the “inner parents” living within him. The psychotherapist shows that the subconscious is not an enemy, but a partner, and one should not conquer it, but make friends with it. The psychotherapist philosophizes that life has inner wisdom, and even if everything is bad for the client, this is also good, because any problem is a source of development. The psychotherapist convinces the client that his vices are a common, natural, normal phenomenon, that “there are no bad people, there are only unfortunate ones,” and all human shortcomings come from the fact that the person feels bad now or felt bad in childhood. In general, he helps the client move from internal war to internal integrity.

Idea two: distance yourself from the problem.
Psychologists have realized that one of the main sources of life’s problems is rigid patterns, the habit of interpreting what is happening and acting according to scenarios learned once and for all. But it is not easy to part with them - a person holds on to his vision of the world and to his suffering, because he feels a threat to his Self - after all, this is his world, his suffering. Therefore, psychotherapists try to separate the Self from painful experiences, gradually and unobtrusively convincing the client that his ideas about the world, feelings of guilt or low self-esteem have nothing to do with his essence, and, for example, he borrowed from other people (most often from his parents).
There are other ways to distance yourself from a problem, to look at it “from above” (for example, a client who thinks “I’m afraid of heights”, in the process of psychotherapy begins to think “I have a fear of heights”), but the general rule always works: it is impossible to part with problem until you rise above it. By achieving detachment in relation to his worries, the client loses self-pity, but gains humor, spontaneity, and a fresh “childish” view of the world.

Idea three: live “here and now.”
Psychotherapists believe that modern city dwellers do not notice the beauty and joy of the present moment, because they are absorbed in worries about the future and regrets about the past. To be happy, you need to “be” and not “have”, play in life, and not worry about it, do your business out of interest in the process itself, and not for the result. But simply being turns out to be much more difficult than achieving and striving for something special. To illustrate this idea, psychotherapists like to tell stories like this:
A Zen master was asked:
- How do you practice?
- When I'm hungry, I eat, when I'm tired, I sleep.
- But everyone does it. Can you say that they exercise the same way as you?
- No.
- Why?
- When they eat or sleep, their mind is occupied with something else.

Idea four: accept responsibility for what is happening.
The client tends to explain his troubles by external circumstances, for example, blaming his bad spouse for his troubles. For a psychotherapist, such a position is futile - he will not be able to do anything with his spouse. Therefore, he tries to show the client that the causes of his problems are rooted in himself, more precisely, in his beliefs and image of the world. From the idea “the cause of the problem is a bad husband,” you need to gradually move to the idea “the cause of the problem is my belief that I have a bad husband.” In this way, the above-described removal from the problem is achieved. As a result of successful psychotherapy, the client begins to believe that he creates his own world, and if this world is bad, it is not the world that needs to be changed, but his attitude towards what is happening.

So how does psychotherapy work?
A psychotherapist, like a gardener, helps internal growth, not by trying to force the plant out of the ground, but by watering and warming it. It helps create conditions for personal development, but the client has to grow; all the main work is done by the client. It is useless to go to a psychological assistance specialist like a doctor so that he can “do something.” Most likely, he will not even give any specific recommendations - so as not to take responsibility for the client. In addition, the psychotherapist knows from his own experience that advice and recommendations usually do not help, they are not capable of changing a person. What is capable?

Principle one: love works.
No wonder they say that happiness is when you are understood. So many suffering people first need to be understood, accepted and loved. Acceptance, a friendly and sympathetic attitude, and support for the client, regardless of what he says, are the basis of almost any direction of psychotherapy, otherwise the client will simply “close down” and will not talk openly about his problems. Acceptance of a client by a psychotherapist allows the client to accept and love himself; it is the main condition for a person to change.

Here lies one of the main dangers of psychological help: psychotherapists are most often men (men are more authoritative), and clients are women (especially in Russia, where men are terribly afraid of appearing weak, admitting that they have problems and complexes). And a warm, frank relationship between a man and a woman threatens to develop into a romance. Love stories in the therapist's office began with the birth of psychotherapy, with Freud and Bertha Pappenheim, and continue to this day. Not having affairs with patients is the commandment of psychoanalysts (for them this is the biggest danger - psychoanalysis lasts a long time and revolves around sexual topics), but how many times has it been violated!

To fend off their clients in love, psychotherapists came up with the word “transference” - they say, this is not true love, but a transference of your tender attitude towards daddy, which you have kept inside yourself for so long. Such a belief and feelings cools, and helps to grow up.

Principle two: the personality of the psychotherapist works.
The main reason for the abundance of psychotherapeutic approaches is the abundance of bright personalities in psychotherapy. It seems to their followers that it’s all about technology, but for some reason they never succeed in repeating the successes of the founding fathers...
The requirements for the personality of a psychotherapist are very serious - he must be able to understand and love any person who comes to him, he cannot afford such luxury as moral rejection, a sense of self-superiority, principles that allow him to condemn or despise. Psychotherapists say that their personality should be “round”, without sharp corners that can hurt the client. In addition, the psychotherapist must serve as an example for the client of presence “here-and-now”, self-acceptance, responsibility and the ability to rise above the situation - the very ideas about a harmoniously developed person on which psychotherapy rests. In life, psychotherapists, of course, rarely manage to maintain this state, but they try to tune in to it, at least for the duration of psychotherapeutic sessions.

Principle three: metaphors work.
The main technique of any psychological assistance specialist is the interpretation of information received from the client. On the one hand, this interpretation should somehow change and clarify the client’s view of things, on the other hand, it should not cause his resistance. The experiences on which the client is fixed change with great difficulty; the psychotherapist tries to change the client’s attitude towards them with the help of indirect influences, which the client does not perceive as an attack on the validity of his suffering. To subtly change a client's beliefs, psychotherapists use metaphors: for example, life is seen as a school where we learn lessons. Metaphors give us, as it were, a new, unexpected angle of view on the problem, thanks to which it is transformed and becomes visible in a completely different light. Actually, psychological theories are metaphors that interpret our whole life in a new way.

Principle four: work works.
We all know one unpleasant thing from childhood: you can’t catch a fish out of a pond without difficulty. In the process of psychotherapy, a person devotes time and effort to working on his problems, and this brings results. As this work progresses, the client accepts the main ideas of psychotherapy and, with their help, rethinks his life and his problems. The work can also occur in an “indirect” form - it has long been noted that the higher the payment for psychotherapy, the more effective it is.
We fall into the grip of the same problems over and over again because our internal scripts that lead to suffering are very stable, and people are not so often willing to make efforts to change them. They come to a psychotherapist as if they were a doctor for medicine, and when it turns out that they need to work on their own, not everyone agrees to this. Psychotherapy is not an activity for everyone; the real clientele of psychotherapy are people who want and can change themselves. This, by the way, is one of the reasons (along with the high cost of psychotherapy and the “psychological illiteracy” of people) that the demand for psychotherapy in Russia is much lower than in the West - there people come to a psychotherapist just to complain, to be understood and justified, and this is what our friends serve for.

Maybe just choose the most effective method? This was not the case: numerous studies have shown that the effectiveness of all methods of psychological assistance is approximately the same. Although they are based on completely different (often opposite to each other) theories and use completely different techniques. This paradox, perhaps, remains the main problem of psychotherapy.

Even psychotherapists themselves have stopped holding on to their theories - most of them today use different approaches, trying to use those methods and concepts that, in their opinion, are most suitable in a particular case.

Researchers are increasingly inclined to believe that the main thing in psychological help is not theories and techniques, but the interaction between the psychotherapist and the client, which in most modern schools of psychotherapy occurs in a similar way and at the same time is strikingly different from any other types of human relationships. Let's try to understand this interaction and look for the key to how psychotherapy works.

Revelations: Psycho Mythology

We need to start, perhaps, with some myths about psychotherapy that exist not only in folklore, but often also in the minds of novice psychotherapists. Actually, because of inexperienced and untrained psychotherapists, of whom we have a dime a dozen, these myths, as a rule, arise

Myth No. 1. The therapist sees right through you.

Having met a psychologist, people often think that this expert on human nature sees them in some special way or even uses some of his own secret psychological techniques in communication. And an experienced psychotherapist sees through all our hidden motives, sensing problems and complexes a mile away; and his theories completely explain our behavior.

In fact, theories rather prevent us from seeing a specific person, unique even in his “complexes.” The psychotherapist does not expose the client’s secret sins, but opens up to him, tries to understand and feel his state and emotions, and then talks about his vision of the situation. It, like a mirror, serves the patient for self-knowledge. At the same time, the psychotherapist is not an indifferent “objective observer”: he does not hide his emotions and is often drawn into the psychological games that the client plays with him. Psychotherapy sometimes resembles joint creativity, sometimes love, and sometimes war.

Myth No. 2. A psychotherapist can manipulate, hypnotize, zombify and program you.

Today, this myth is actively spread by adherents of a psychotherapeutic sect called “neuro-linguistic programming,” or simply NLP. This sect, however, has nothing to do with neurology, linguistics, or programming, and it can be classified very conditionally as psychotherapy: its advanced adherents are mainly engaged in making money by teaching less advanced colleagues who believe that after this training they will be able to “program” those around them.

Some psychotherapists actually know hypnosis (though there are far fewer of them than those who think they do), but the effect of such hypnotic tricks is small and short-lived.

It is incredibly difficult to change a person in any way. But a psychotherapist can really help a client change if he really wants and is ready to work on himself. And the fact that a person’s personality and character can be changed without his desire is a fairy tale. And the fastest way to change a person is through accepting him as he is (this, by the way, is a specialist’s recipe in case you are planning, for example, to re-educate your husband or wife).

Myth No. 3. The psychotherapy book you bought and read contains the truth about the structure of your psyche.

Psychologists have come up with many very convincing theories. True, they do not always convince and not everyone, so the opposite myth is also widespread - that psychoanalysis, for example, is a vile lie.

But psychotherapeutic explanations are needed not at all in order to give a person a “final diagnosis”, but in order to help him by providing him with a tool for working on himself. It doesn't matter whether a theory is true, what matters is the effect it will have. Such concepts help us take a fresh look at life, talk about experiences for which we usually don’t have enough words, and at least somehow organize our experience.

Myth No. 4. A psychotherapist will cure you

The spread of this myth is facilitated by language borrowed from medicine. The very term “psychotherapy” is misleading, and, for example, the word “neurosis” literally means “disease of the nerves,” that is, something like a tumor or fracture. And this word is used to describe grief and anger over unrequited love, the inability to rejoice, and similar “diseases.” Do you think this can be treated?

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In recent decades, they have often tried to replace clinical expressions with “trade-politically correct” jargon: instead of “patient” they say “client”, who enters into an “agreement” with his “therapist” (this is instead of a therapist), etc. Also, of course, little good - as a participant in one of the psychotherapy groups said: “Thank you for not making me feel like a client.”

Let's look at what a psychotherapist does instead of treatment using the example of Arnold Mindell, one of the most famous current experts in this field. At his seminar, a woman suffering from cerebral palsy shared her mental pain: all her life, people around her laughed at her or pitied her because she walked differently from other people. Mindell suggested that she move, found her movement beautiful in its own way, and began to dance some kind of crazy dance with her. Perhaps for the first time in her life she liked her movements. Mindell asked her, “What are you doing?” She replied: “I fly from planet to planet. I bring with me clear light." And she added: “I do this every night.”

A psychotherapist does not treat - he promotes personal development, helps to get out of a painful or narrow rut in life. But as a result, physical pain may also go away. If you complain that you have a headache, he will not instruct your head not to get sick, like the unforgettable Kashpirovsky, but will ask you to look for meaning in this pain or express on her behalf what she thinks about you.

What if, say, you came just to end your obsessive fear of riding the subway? To your surprise, the therapist will soon begin to discuss more and more distant topics with you, and if you join his game, you risk one day discovering that your ideas about the world have changed significantly and the initial problem has ceased to be significant. At the same time, you may still be afraid to ride the subway, but now you have more important problems: you are busy eliminating internal obstacles to career growth and have been using only a car for a long time.

Psychotherapeutic Creed

The primary task of the psychotherapist is the so-called “clarification of the request,” that is, turning the arrows from the client’s specific troubles to his global, “existential” problems. If it turns out that they really do exist (and who doesn’t?), unobtrusive indoctrination of the client is carried out - he learns to look at the world and act in accordance with the new ideology. Modern psychotherapy is largely based on the understanding of a few simple ideas.

The first idea. Accept yourself as you are

The ideology of psychotherapy suggests forgetting what dissatisfaction with yourself is and loving yourself in all imperfections. One of the main sources of our torment is the conflict of ideas about what I should be and what I really am. In different areas of psychotherapy, this conflict is described as a war of consciousness and subconscious, mind and instincts, duty and desires, inner parent and inner child, real self and ideal self, etc.

Interpreting the client’s experiences, the psychotherapist draws his attention to the fact that ideas about good and bad were instilled in him by his parents in childhood and he fights with himself to please the “inner parents” living within him. The psychotherapist shows that the subconscious is not an enemy, but a partner, and one should not conquer it, but make friends with it; argues that life has inner wisdom, and even if everything is bad for the client, this is also good, because any problem is a source of development. The psychotherapist convinces the client that his vices are a common, natural, normal phenomenon, that “there are no bad people, there are only unfortunate ones,” etc. In general, he helps the client go from internal war to internal integrity.

Idea two. Move away from the problem

Psychologists have realized that one of the main sources of life’s problems is rigid patterns, the habit of interpreting what is happening and acting according to scenarios learned once and for all. But parting with them is not easy - a person holds tightly to his vision of the world and to his suffering. Therefore, psychotherapists try to separate the “I” from painful experiences, gradually and unobtrusively convincing the client that his ideas about the world, feelings of guilt or low self-esteem have nothing to do with his essence, but, for example, he borrowed from other people (most often from his parents) .

There are other ways to get away from the problem - to look at it “from above” (for example, a client who thinks: “I’m afraid of heights”, in the process of communicating with a psychotherapist begins to think: “I have a fear of heights”). At the same time, the general rule always works: it is impossible to part with a problem until you rise above it. By achieving detachment in relation to his worries, the client loses self-pity, but gains humor, spontaneity, and a fresh, “childish” view of the world.

Idea three. Live “here and now”

Psychotherapists believe that the modern city dweller does not notice the beauty and joy of the present moment, because he is absorbed in worries about the future or is immersed in memories. To be happy, you need to “be” and not “have”, play in life, and not worry about it, do your business out of interest in the process itself, and not for the result. But simply “being” turns out to be much more difficult than achieving and striving for something special. To illustrate this idea, psychotherapists like to tell stories, such as this one.

A Zen master was asked:

How do you practice?

When I'm hungry, I eat, when I'm tired, I sleep.

But everyone does it. Can you say that they exercise the same way as you?

Why?

When they eat or sleep, their mind is occupied with something else.

Idea four. Accept responsibility for what is happening

The client tends to explain his troubles by external circumstances, for example, blaming his bad spouse for his troubles. For a psychotherapist, such a position is futile: he cannot do anything with his spouse. Therefore, he tries to show the client that the causes of his problems are rooted in himself, more precisely, in his beliefs and image of the world.

From the idea “the cause of the problem is a bad husband,” you need to gradually move to the idea “the cause of the problem is my belief that I have a bad husband.” As a result of successful psychotherapy, the client begins to think that he creates his own world and, if this world is bad, it is not the world that needs to be changed, but his attitude towards what is happening.

So how does it work?

It is useless to go to a psychological assistance specialist like a doctor so that he can “do something.” Most likely, he will not even give any specific recommendations - so as not to take responsibility for the client. In addition, the psychotherapist knows from his own experience: advice and recommendations usually do not help, they are not able to change a person. What is capable?

Principle 1: Love works

No wonder they say that happiness is when you are understood. So many suffering people first need to be understood, accepted and loved. Acceptance, a friendly and sympathetic attitude, regardless of what they tell, lies at the basis of almost any direction of psychotherapy, otherwise the person will simply “close down”. Acceptance of a client by a psychotherapist allows him to accept and love himself.

Here lies one of the main dangers of psychological help: psychotherapists are most often men (and authoritative ones), and clients are women (especially in Russia, where men are terribly afraid of appearing weak, admitting that they have problems and complexes). And a warm, frank relationship between a man and a woman threatens to develop into a romance. Love stories in the therapist's office began with the very birth of psychotherapy - with Freud and Bertha Pappenheim - and continue to this day. Not having affairs with patients is a commandment for psychoanalysts (for them this is the biggest danger: psychoanalysis lasts a long time and revolves around sexual topics), but how many times has it been violated!

To fend off their clients in love, psychotherapists came up with the word “transference”: they say, this is not genuine love, but a transference of your tender attitude towards daddy, which you have kept inside yourself for so long. Such reassurance and feelings are cooling and help to grow up.

Principle 2. The psychotherapist’s personality works

Sometimes you wonder: why are there so many different schools of thought in psychotherapy? The reason is the abundance of bright figures.

The requirements for the personality of a psychotherapist are very serious: he must be able to understand and love any person who comes to him; he cannot afford such luxury as moral rejection or a sense of his own superiority.

Psychotherapists say that their personality should be “round”, without sharp corners that can hurt the client. In addition, the psychotherapist must serve as a model for the client of the here-and-now presence, self-acceptance and other ideas on which psychotherapy is based. Of course, it is rarely possible to maintain this state in life, but psychotherapists try to tune in to it, at least for the duration of psychotherapeutic sessions.

Principle 3: Metaphors work

The main technique of any psychological assistance specialist is the interpretation of information received from the client. On the one hand, it must somehow change and clarify the client’s view of things, on the other hand, it must not cause his resistance.

To subtly change a client's beliefs, psychotherapists use metaphors: for example, life is seen as a school where we learn lessons. Metaphors offer a new, unexpected angle of view on a problem, thanks to which it is transformed and becomes visible in a completely different light. Actually, psychological theories are metaphors that interpret our entire lives in a new way.

Principle 4: Work works

We all know one unpleasant thing from childhood: you can’t catch a fish out of a pond without difficulty. In the process of psychotherapy, a person devotes time and effort to working on his problems, and this produces results. Gradually, the client accepts the main ideas of psychotherapy and, with their help, rethinks his life and problems. The work can also occur in an “indirect” form: it has long been noted that the higher the payment for psychotherapy, the more effective it is.

We find ourselves in the grip of the same problems over and over again because our internal scenarios that lead to suffering are very stable and we are not so often ready to make efforts to change them. People come to a psychotherapist, like to a doctor - for medicine, and when it turns out that they need to work on their own, not everyone agrees to this.

Principle 5: Relationships work

The world is designed in such a way that people do not meet by chance. We are attracted to each other for our own internal reasons. From the point of view of Gestalt psychology, this can be explained by unfinished experiences, unresolved problems from our life in childhood. And until we complete them, we will meet them in various forms and forms. Meeting with a psychologist or psychotherapist is also not accidental - he is also a person and also has his own undeveloped aspects. There is such a feature that the client is always matched to the therapist’s request - therefore it is very interesting to work, when you help a person, you help yourself.

In therapy, people enter into relationships, and because the most difficult and often painful parts of the experience are addressed, these relationships also become complex and multifaceted. Transference and countertransference occur when the client projects an image of his parent (or other significant figure or part of the personality) onto the therapist, and the therapist, in turn, makes a counter-projection of some significant figure or part of the personality. The result is communication on several levels - human, trauma-trauma, part-part (at least one of which is rejected), parent-child, etc.
Success and effective results will depend, first of all, on good intentions, professionalism, willingness to face pain, sadness, emptiness and other emotional states that some call “negative”.
If you go to therapy, remember that the quality of your relationship with your therapist is often the most important element in healing and personal restoration. Choose a therapist whom you can trust and who you get along with. To do this, as in any relationship, everyone takes their 5 steps towards a meeting.

Psychotherapy is not an activity for everyone; the real clientele of psychotherapists are people who want and can change themselves. This, by the way, is one of the reasons (along with the high cost of psychotherapy and the “psychological illiteracy” of Russians) that the demand for psychotherapy in our country is much lower than in the West. There they come to a psychotherapist just to complain, so that they are understood and justified, and we have friends for this.

A lot, a lot can be written about how psychotherapy works - especially when you consider that today more than 35 independent methods of work are officially recognized by OPPL. I will limit myself to the very essence, and the method that I use specifically in my professional practice - we are talking about Eastern version of neuroprogramming And Neurotransforming, which were founded by Sergei Viktorovich Kovalev, professor, doctor of psychological sciences, psychotherapist of the world register, as well as my teacher, from whom I continue to study and improve my qualifications.

The essence of the method can be described by a saying: “Psychotherapy is not all psychotherapy, but only what works”. BBN and Neurotransforming included working models of a number of areas of applied psychology, spiritual practices, and religious doctrines, which were processed, polished, modernized and arranged in a certain way into a working system of effective psychotechnologies that make it possible to provide an effective solution to a number of client problems in a short time.

Psychotechnologies used in VVN and Neurotransforming are collected into a single psychotherapeutic module called Module of Sergei Viktorovich Kovalev. It represents a strict sequence of psychotherapeutic interventions in 9-18 areas at once, obtaining the expected result in 20 psychotherapeutic hours of work (for complex psychosomatics, the number of hours increases to 30-40). This is about ten sessions, approximately two months of work. Fast? Very! Why so fast? More on this below.

Even those who have nothing to do with the science of psychology know that a person has consciousness and the Unconscious. Perhaps in scientific circles they still have not come to an agreement - which is better, “unconsciousness”, “unconscious”, “subconscious” or “lower ego”. We start from the model proposed by the Italian psychologist Roberto Assagioli, the father of Psychosynthesis - a model called Assagioli's Egg (see picture)

Based on the fact that it is in the lower Unconscious that about 96% of all mental processes occur, it is there that information about all imprints and psychotraumas, about all beliefs and life positions is contained, within the framework of psychotherapy we work mainly with lower Unconscious. Here we should mention the metaphor of the greatest hypnotherapist of the 20th century, Milton Erickson. Consciousness is a stupid rider, Unconscious is a smart horse. which knows the road and can lead the rider wherever he says, but for some reason the rider constantly chooses the most difficult paths. With the help of consciousness, the direction of movement is determined, the Unconscious carries out the process and nature of achieving the goal.

Thus, by discussing every aspect of the problem at the level of consciousness (the function of which is only the interpretation of information that comes from the Unconscious, by the way, a largely incorrect interpretation), people get rid of the current negative charge, while leaving the true cause, and the problem is not solved . This is why the possibility of solving problems through dialogue with friends, especially using alcohol, is a pleasant but absolutely false myth.

Effective work involves working specifically with the Unconscious. If a child was frightened, and he has been afraid of them ever since, even as an adult, then a simple verbal belief that dogs are kind and fluffy does not give anything. The Unconscious has the opposite information on this matter, and since it is it that controls 96% of all mental processes (and therefore behavior), without changing this information, it is useless to do anything else - the result will remain the same.

If you “rewrite” this psychotrauma in the Unconscious - change the information about dogs to the opposite, then “immediately”, “by some miracle” the problem will disappear. This is why psychotherapy is so effective - we know the language of the Unconscious, which allows us to find solutions at the level where the problem arose, and not where the consequences are already felt, which led a person to a psychotherapist. As mentioned above, psychotherapy can be positioned as a direction whose priority is interaction with the lower Unconscious of a person. For other areas of work there are corresponding areas - psychocorrection, consulting and coaching, which do not relate to the topic described here.

It is important to understand the following: the psychotherapist does nothing for the client. He rather acts as a mediator, guide, translator from the language of the Unconscious. The goal is always achieved by the client himself, and specifically, he has all the necessary resources for this. The task of the psychotherapist is to help the client determine the desired result and provide internal conditions for him (his Unconscious) to naturally achieve this result.

Sometimes it is enough to convey to the Unconscious what we really want, and it will arrange it for us without any problems. Only he will be surprised: “Why didn’t you tell me about this before, I thought that everything suited you. If you want it, get it." And as a result of working with a psychotherapist, “accidents” and “miracles” “suddenly” occur, which completely change the client’s internal and external reality. This is how psychotherapy works in our modality.

The questions naturally arise:
—
— What is the collective Unconscious?
— How does a psychotherapy session go?
- Where does the Unconscious get its resources from?
— Can I work with myself without a psychotherapist?
— How stable are the results of the described type of psychotherapy?
— What is coaching, psychocorrection and consulting?
— What are imprints and psychotraumas, how to work with them?
— How does the process of interaction between consciousness and the Unconscious occur?
— What language does the Unconscious speak, and how does dialogue with it take place?
— What does a complete psychotherapeutic Module include, what is its structure?
— What principles are based on the Eastern Version of Neuroprogramming and Neurotransforming?