What does a psychologist do? Psychologist. What does this specialist do, what diseases does he diagnose and how does he treat them?

I often hear the question addressed to me: “...how can a psychologist help?”, “...do you guarantee the result?” Of course, from a human perspective, these questions are quite understandable. And, since psychological counseling is a service, the potential client would like to know what he is investing money, time, effort, and other resources into and what will be the outcome.

This article is mainly addressed potential clients. For my part, as a psychologist, I will make an attempt to more clearly outline the position of responsibility of the client and the consultant in order to form in people an understanding and a more realistic view of the process of psychological counseling.

This has its own specifics. Psychological counseling is not buying oil in a store, not the services of a hairdresser, where the client brings his head, they do something with it, and the result is “beautiful” - it is a process, and sometimes a rather long process, in which the client and the consultant participate , and, accordingly, the result of this interaction depends on varying degrees from both sides.
When I hear the question “will there be a result?”, I feel slightly confused, since only the client himself can answer this question.

The point is that we can guarantee the result of our activities subject to the following conditions:

• High motivation, interest (not only at the level of desires and words about desires, but also actions)
• When we take real actions rather than just think about them
• Quite a high impact on the process in the activity being carried out

Now, let's look at these points in the context of psychological counseling.

1. High motivation, interest

There are some clients who come to a consultation with the attitude: “I came with my problem - let the psychologist, he and only he solve this problem. He's a professional, I pay him money. And I’ll just see where this leads, what if it happens... I have absolutely nothing to do with it...” etc.

For me, this attitude means that the client gives responsibility for his life to the psychologist. As if life and the events that happen to him are not the result of his actions, attitudes, decisions, or other acts of will, but simply “happen,” as if the client says that he does not influence what happens, but is influenced by circumstances or other people.

It turns out that according to the client, the psychologist should be more interested in change than the client himself. I wonder what role, according to the client, the psychologist plays in taking such a position?

If the client’s motivation for results in work is lower than the psychologist’s motivation, then changes can hardly be achieved. In other words, if a client is not motivated, he will not change, no matter what he thinks or says to himself or others.

There is another situation. There are clients, and there are quite a lot of them, who are motivated to change something in their lives and in themselves. And as practice shows, together we achieve results.

2. Influence on business processes and control

We can achieve results if we influence the processes in any activity.
In counseling, a psychologist, by and large, can only influence those processes that occur during meetings.

I cannot find out what the client is doing, feeling, thinking when he leaves my office. And, naturally, during the breaks between sessions, the client lives an independent life, determines what to do in a given situation, takes some actions, makes decisions. In other words, he lives and gets his own experience.

A psychologist cannot live his life for a client, establish relationships with relatives, look for a job, a life partner, etc. He can help the client form a new attitude towards his situation, understanding, or teach him to act differently, give him a new skill, help the client realize and feel, experience the experience that he has. He can also help the client accept himself, but living life for the client is impossible. And, accordingly, there will be only part of the responsibility for the result, the rest and BIG part will be with the client.

A psychologist is like a fellow traveler who meets a traveler who has lost his way. He can only show the directions of movement, different paths... but it is the traveler who chooses which path to follow and moves his feet HIMSELF. The psychologist in this role only supports and walks alongside.

Some clients sincerely believe that the psychologist gives advice. In reality, this is not the case. For example, if a psychologist finds himself in the role of an advisor, this means that he takes responsibility for the client’s life and knows better what is needed for him. But then in this case, the client acts as a CHILD who lacks life experience to resolve your situation. Do you like this picture? I don't. I sincerely believe that every person is capable of finding within himself the resources and strength to act and live more maturely, to independently cope with his difficulties, and to achieve goals.

What is a psychologist responsible for?

After reading all this, the reader may get the impression that the psychologist does not guarantee results, cannot take responsibility for the client’s life, and what then is his responsibility?

1. Since psychological counseling is a mutual process of communication and interaction, the psychologist is responsible for organizing this process. This communication is not between two friends, but interaction in a specially created context (therapeutic context), where certain boundaries and rules are set, and there is its own dynamics and stages. And this process is managed and organized by a psychologist.

2. The psychologist is partially responsible for creating a working therapeutic alliance between himself and the client. More in simple words, he is partly responsible for creating a zone of trust between himself and the client and an environment that promotes change and results. What kind of environment is this and what are its criteria?

This is a trusting environment where the client can be himself in interaction with a psychologist, where he can open up and live the experience that he has, where he can live the feelings that he experiences, with confidence that these feelings will be accepted, where he can realize step by step through living his experience of himself, where he can be HIMSELF, that he can be accepted as he is.

Subjectively, the client may experience the creation of such an environment in the form of different feelings. For example, feelings of closeness, trust, feelings of “I am accepted,” feelings of “I am.” Or a special state in which the client achieves awareness of his experiences, attitudes, and thoughts. Another subjective manifestation is a state of insight in which the client, as a result of reflection or spontaneously, finds a solution to one or another of his problems.

3. The psychologist is responsible for ensuring that the therapeutic process is safe for the client.

IN ordinary life, in interaction with other people, we may not react the way we want, sometimes we suppress our true feelings, act contrary to our desires in order to please others, we are afraid to admit to ourselves some of our characteristics, thoughts, feelings. We don’t react the way we want, and we suppress our true reactions because it can be dangerous with other people, because sometimes you don’t know (or know too well) how people will react to emotions, especially negative ones. Or because it is so beneficial for the situation and the external context requires it.

And when a client interacts with a psychologist, he, voluntarily or unwittingly, reflects in his behavior and communication those reactions or actions that are not natural for him. The therapeutic context and the participation of the psychologist himself presupposes and encourages the client to be able to live the experience that he lives in interaction with the psychologist, but with the difference that in this experience he can be NATURAL, HIMSELF, and remain SAFE .

Creating such a context is the task of a psychologist. And here there is a share of his responsibility. Share - because it is a mutual, reciprocal process. It's like a couple's dance; if one partner doesn't cooperate, it's impossible to dance.

Cooperation means:

A) This is to develop an attitude, or at least admit that your life is your life and you will have to understand it, take responsibility for what happens in it.
B) That the counseling process is not only work for the psychologist, but also a LARGE PART of the CLIENT’S WORK.

4. The psychologist is responsible for his own competence. The client brings his various experiences, situations, and problems to the consultation. And here, the client must be confident that the psychologist, professionally, from the perspective of his knowledge, therapeutic and life experience, will be able to provide qualified assistance.

What does a psychologist do?

Returning to the question of what is the result for the client, we can answer this way. The psychologist helps the client to form:

• A new attitude or a different attitude towards a problem or situation
• Understanding your situation (awareness of feelings, motives, attitudes related to the problem)
• Find new meaning
• New skill (actions)

In fact, all of this together, or part of this set, leads to change.
I hope that my thoughts in this article can help clear up the blind spots regarding counseling. I sincerely believe that this will facilitate our cooperation.

In some cases, if a child has problems psychological nature, parental support is not enough, and then a child psychologist comes to the rescue. It is this specialist who most often becomes an indispensable mediator between parents and child, whose main task is to establish a strong emotional connection between them.

Parents and other adult relatives often do not understand why the child has conflicts with peers, why he does poorly at school, throws tantrums and does not obey at home. The root of all these problems may be a serious internal psychological conflict that does not allow the individual to fully and harmoniously develop in life. childhood.

To understand what is happening with your child, it is best to make an appointment with a good child psychologist. You may need the help of a child psychologist as a younger child. school age, and for a teenager. The main thing is to consult with a psychologist in a timely manner, identify and begin working on existing problems. Ignore the unfavorable psychological condition It is very dangerous for a child or teenager, as it can subsequently lead to the development of mental and psychosomatic diseases.

What is included in the scope of activity of a child psychologist?

A child psychologist is a specialist who provides psychological assistance children and studying the functioning of their psyche, taking into account age characteristics. Psychology is one of the most rapidly developing sciences, so being a specialist in this field is considered very prestigious. Contrary to popular misconception, a child psychologist is not a doctor, since he does not have a higher medical education. Therefore, it cannot be said that a child psychologist treats mental disorders or diseases.

The main task of this specialist is to provide psychological support and help in solving psychologically difficult life situations that a child may encounter.

A child psychologist must have higher education majoring in psychology and additionally specializing in child psychology. During his studies, he receives in-depth knowledge about the peculiarities of the formation and functioning of the child’s psyche at different age stages, and also masters the necessary practical skills for with children and their parents. You can consult a child psychologist in specialized centers for psychological support for children and private offices. Child psychologists also work in preschool and school educational institutions. It is advisable to make an appointment with a specialist in demand in advance to avoid queues and long waits.

Difference from other specialists

A child psychologist should not be confused with a psychiatrist or psychotherapist. A child psychologist deals with the problems of mentally healthy children with certain psychological characteristics or those who find themselves in a difficult situation in a family or team. At the same time, a child psychiatrist is involved in diagnosis and treatment mental disorders , including with the help medicines

and special regime. A psychiatrist has a higher medical education, that is, he is a doctor and works with young patients in need of qualified psychiatric care.

A child psychotherapist is also a doctor and has been trained in psychiatry, but in his practice he uses primarily psychotherapy methods, and medications and other treatment options are only auxiliary. The psychotherapist helps patients through conversation and detailed analysis of past, present problems and conflict situations. A psychotherapist can also help if, due to severe stress in childhood, signs of a psychosomatic illness or suspicion of neurosis appear.

When to contact a specialist It is very important for parents to promptly notice changes in behavior and emotional state

• your child. Frequent whims, causeless tears and disobedience are often an unconscious request for help and support. Therefore, you should not immediately explain the child’s bad behavior as a bad character or spoiled behavior, because this way you may not notice the beginning of a serious internal psycho-emotional conflict in the child. The help of a child psychologist may be needed if your child: Very shy , experiences great difficulties when communicating with peers. Shyness is often directly linked to a negative perception of one's body and personality, so it is important to help a child overcome this trait as early as possible. Shyness and isolation lead to the fact that the child cannot fully adapt to the new environment and experiences severe stress when entering a new environment. social group (transition from to school, transfer to another school, moving, and so on).
• Hyperactive. Excessive activity is one of the most common problems in children of preschool and primary school age. It is difficult to calm a child down and engage him in useful activities; he is restless and has trouble concentrating, which leads to poor performance at school. Hyperactivity in such cases becomes main reason conflicts between parents and baby. A child psychologist will help your child learn to manage his energy and changeable desires, concentrate on studies and useful conduct leisure
• Often gets scared, prone to anxiety and worry. Many children are faced with the fear of darkness, loneliness, and fantastic monsters. These, in an adult’s opinion, groundless and insignificant fears can cause serious damage to the child’s psyche. That is why it is important to get rid of them as quickly as possible and prevent the emergence of fears in the future. If you ignore the problem, fear can develop into a phobia, which is one of the symptoms of mental disorders.
• Aggressive. There are many reasons aggressive behavior child, which a qualified specialist will help identify and eliminate. A tendency to excessive aggression harms the health of the child and the children around him, and in the future may become the basis for the formation of a hot-tempered and cruel character. Therefore, you should not turn a blind eye to outbursts of aggression in your baby, especially if they recur regularly. A psychologist will help get rid of aggressiveness and set the child up for friendly relationships with others.
• Doesn't do well at school. Another important task of child psychologists is to help students who, for some reason, cannot cope with the school curriculum. If a child has not been diagnosed with mental retardation, but he consistently gets bad grades from school, then this phenomenon may have serious reasons. For example, fear of answering in front of the class, which happened earlier conflict situation with the teacher or classmates, inability to concentrate on important information, lack of interest in the subject and understanding of its importance for the future. Working with a psychologist in this case will help to effectively eliminate existing problems.
• Went through a traumatic situation. A traumatic situation for a child’s psyche can be the divorce of parents, the death of a relative, constant quarrels in family circle, moving and even the birth of a brother or sister. You should definitely contact a child psychologist if similar situations happened in the past (even if it seems to you that a lot of time has passed and everything has been forgotten). Specially trained child psychologists also work with children who have experienced domestic violence or who have survived a natural disaster, war, or other emergency event.

Every child from early childhood is already a full-fledged individual with his own experiences, problems and fears. Taking good care of the child’s psyche and involving, if necessary, specialists in this field will allow you to avoid many unpleasant consequences in the future, so if at least one of the above points concerns your baby, a consultation with a child psychologist will only benefit him and you.

How does a child psychologist work?

A psychologist for children who have encountered certain difficulties in one or another period of growing up plays a very important role for a harmonious and healthy perception of both one’s own personality and environment. Therefore, a specialist in the field of child psychology must find contact with a wide variety of children and be able to build trusting relationships with them.

An initial consultation with a specialist begins with establishing contact between him, the child and the parents. Next, a psychodiagnostics of the child is carried out, the results of which will allow one to judge the presence or absence of mental disorders and reveal the psychological characteristics of his personality.

During the first consultation, they also determine how exactly the work with the child will proceed in the future and approximately how much time is needed to eliminate the psychological problem. During a consultation with a child psychologist, parents receive all the necessary information about the child’s mental state and recommendations for educational process, improving family relationships.

To achieve the desired result, a child psychologist and parents must work together and create for the child favorable conditions for development.

Child psychologists have many special techniques aimed at correcting certain psychological problems child. Classes can be either individual or group, depending on what kind of communication the child needs. at this stage. Work with children younger age takes place in a relaxed, playful manner. A pleasant atmosphere should be created in the child psychologist's office so that the child feels comfortable. Art therapy, teaching useful skills and correct behavior using the example of fairy tales, and educational conversations that take place in the form of an active dialogue with the child are widely used.

It would seem that now everyone knows who a psychologist is and what he is needed for. For many, this is even an indicator of a certain status; it’s even cool to have a personal psychologist.

But nevertheless, in our society there is whole line stereotypes and barriers that prevent a person from seeking qualified help. Until now, psychologists are confused with social workers, healers, psychiatrists, etc. So who is a psychologist and what is he needed for?

Nowadays, psychologists are increasingly in demand in business training. People who were sent by their managers come to trainings in order to increase their efficiency in their work. And in each such case, a person is an instrument to achieve some goal. Does he come on his own, or does someone else direct him... Those who are skilled (training in techniques and methods of influencing others) very often reveal individual psychological difficulties. For example, we learn to ask questions, it would seem, what is there to learn? And someone suddenly discovers that he is embarrassed when everyone is looking at him and waiting for his question, but he cannot “squeeze” it out of himself - he goes into a stupor. And here is the individual psychological difficulty - how to deal with embarrassment, because, in fact, I know how to ask questions, I can write it on a piece of paper, I can suggest it to a colleague left and right, but as soon as people’s attention is on me - I I pass out.

And most often, the sources of such “difficulties” are unresolved human problems.

In fact, we constantly encounter various kinds of problems, and even if for some they seem ridiculous and made up, for us, at this moment it is a real, insoluble problem. At the same time, not every time we run for help. Moreover, problems often have a beneficial effect: they teach us independence, resistance to stress, and contribute to both mental and spiritual development. But when we encounter a situation for the first time or in an inappropriate state for this (we are neither physically nor morally able to survive it), then it becomes critical. This means that there is a risk of getting stuck in this situation. At this moment, at this time, we are simply unable to think and look for a way out of the situation. And this state of failure, confusion and powerlessness begins to haunt us in similar situations.

Any living person needs someone nearby so that he can help him survive what is happening, so that he can support and, if necessary, explain what is happening. When we tell someone about our feelings and experiences, we give them a part of them. In psychology, this process is called “containing feelings.” The psychologist is the one who temporarily acts as such a container. A psychologist never evaluates a person’s actions, his personality, or his feelings. For him, each person is a unique, valuable person who is simply confused in this period of time and needs support.

A psychologist does not act as a teacher, adviser, expert or friend, he simply walks next to you, sharing the heavy burden of feelings, allowing you to be the way you want to be at this moment.

A psychotherapist is a specialist who treats borderline states and mental disorders of mild to moderate severity.

A qualified psychotherapist is awarded to those who have passed extra education and a psychiatrist or psychologist who has mastered one of the areas of psychotherapy.

Who is a psychotherapist

A psychotherapist, depending on basic education, can be:

• A psychiatrist. Due to his higher medical education and specialization in psychiatry, this specialist has the right to treat patients with any mental disorders, diagnose the patient and prescribe medications. This physician has clinical experience and must be licensed to practice as a psychotherapist.
• A doctor of any other specialty (has a higher medical education and primary specialization in any field of medicine). Such specialists make up about 10% of all psychotherapists with a medical education, have the right to use medications in treatment, and are required to have clinical experience and a license. Psychotherapists use psychotherapeutic methods in the treatment of psychosomatic diseases (arising from the interaction of physical and mental factors, including bronchial asthma, ulcers, etc.), but they do not have the right to treat mental illnesses.
• Clinical (medical) psychologist. Thanks to higher medical and psychological education, this specialist has the right to treat certain psychosomatic and mental illnesses (in contact with a psychiatrist), but does not have the right to prescribe medication. Both clinical practice and licensure are required.
• A psychologist who graduated from a university with a degree in psychology. Since psychology refers to humanities(not medical), a psychologist-psychotherapist has no right to diagnose a client, treat mental illnesses and work with medical problems, use medications in treatment and perform medical manipulations. There is clinical practice, but a license for psychotherapeutic activities is not required for these specialists.
• A psychologist who has received a certificate through courses, seminars or trainings. They do not have serious multi-level training, clinical practice and license; they cannot treat mental and psychosomatic diseases, as well as use medicinal methods of treatment.
• A person with a higher education in the humanities (or in the field of natural science) who has received a certificate as a psychotherapist through courses, seminars or trainings. There is no serious multi-level training, there is no clinical practice or license, they do not have the right or skills to treat mental and psychosomatic diseases, or prescribe medications.

The main difference between a psychiatrist and a psychologist is that a psychiatrist has a medical education, while a psychologist has a higher education in the humanities. Medical education (specialization psychiatry) gives the opportunity and right to treat a variety of mental illnesses and use drug therapy, and the education of a psychologist allows for psychological counseling healthy people, engage in professional recruitment, etc.

Psychotherapists and clinical psychologists see patients primarily in medical institutions, and psychotherapists conduct private practice, including online consultations.

A psychotherapist can be a more specialized specialist - a narcologist (consults and treats drug-addicted patients) or a sexologist (researches and treats sexual phobias, pathological sexual desire, deviations in sexual behavior).

What does a psychotherapist treat?

A psychotherapist with a basic education in psychiatry treats:

• Brief psychotic disorders, in which patients experience sudden, brief periods of psychotic behavior (abnormal mental behavior that is not critically assessed by the individual). Occurs in response to severe stress (death of loved ones, threat of violent death, etc.).
• Substance-induced psychotic disorder. Occurs when taking or quitting alcohol, cocaine and other narcotic substances, manifests itself in the appearance of hallucinations and confused speech.
• Health-related psychotic disorders. The appearance of hallucinations, delusions and other mental disorders may be associated with traumatic brain injury or a brain tumor.
• Delusional disorder (mania) is a mental disease characterized by the presence of dominant, systematized delusions. Delusional ideas are based on possible real situations (persecution, jealousy of an opponent, etc.), are devoid of whimsicality and persistent hallucinations, and persist for 3 months or more.
• A diffuse psychotic disorder that develops in a person while in a relationship with a person suffering from delusional disorder.
• Schizophrenia, which is a polymorphic mental disorder. This disease is characterized by fundamental disorders of thinking and perception, inadequate or reduced affect. These disorders can manifest themselves in the form of auditory hallucinations, paranoid or fantastic delusions, disorganization of speech and thinking, social dysfunction and impaired performance are observed.
• Schizoemotional disorder, which is characterized by a combination of symptoms of schizophrenia with symptoms of depression or bipolar disorder.
• Schizophrenic form of disorder - manifested by symptoms of schizophrenia that are observed for more than a month, but not more than six months.
• Manic-depressive psychosis (bipolar affective disorder), which is characterized by manic and depressive states, or a rapid change or combination of symptoms of depression and mania.
• Depression. It is a mental disorder in which there is a “depressive triad”: decreased mood, loss of the ability to rejoice and impaired thinking. A pessimistic mood is accompanied by motor retardation.

A psychotherapist with medical training may also treat:

• Epilepsy. This neurological disorder requires contacting a psychotherapist if the patient has various violations consciousness and mood.
• Conditions after stroke, poisoning, traumatic brain injury. Influence negative impacts on the brain, combined with the psychological crisis that patients experience, can lead to various changes in the psyche.
• Neuroses. They are a group of reversible psychogenic functional disorders that tend to be protracted. Patients with neurosis may experience asthenic, obsessive or hysterical manifestations, a temporary decrease in mental and physical performance.
• Anxiety is a mental disorder in which there is general, persistent anxiety that is not associated with a specific situation or object. It manifests itself in the form of a variety of forebodings and may be accompanied by constant nervousness, trembling, muscle tension, sweating, dizziness and palpitations. Often occurs during chronic stress, can have a wave-like course and become chronic.
• Panic disorder (episodic paroxysmal anxiety) is a mental disorder that is accompanied by a sudden attack of panic attacks (unexplained attacks of anxiety and fear combined with somatic manifestations).
• A variety of phobias, which are a strong, persistent and obsessive fear that regularly manifests itself in certain situation and not amenable to rational explanation.
• Neurasthenia is a mental disorder that belongs to the group of neuroses and is manifested by increased irritability, fatigue, and loss of the ability for prolonged stress (mental and physical). It usually develops with a combination of mental trauma, physiological deprivation (lack of rest, etc.) and excessively strenuous work.
• Psychosomatic diseases are painful conditions that include conversion symptoms (symptoms of an objectively absent disease are observed), functional syndromes (functional disorders of organs and systems in the absence of pathology in them) and psychosomatosis (diseases that develop as a result of conflict experiences and the primary bodily reaction to these experiences ).

In addition, the psychotherapist also provides assistance to people suffering from alcoholism and drug addiction.

A psychotherapist with a psychological education conducts psychological testing and counsels clients who do not suffer from mental and psychosomatic illnesses.

Child psychotherapist

A child psychotherapist is a doctor who diagnoses, treats and prevents mental disorders and psychosomatic diseases in children and adolescents.

The scope of activities of a child psychotherapist includes treatment of:

• psychopathy;
• depression;
• neurosis;
• phobias;
• autism;
• bulimia;
• apathy;
• anorexia nervosa;
• various addictions (addiction to gambling, Internet, etc.);
• mental retardation;
• suicidal syndrome.

A child psychotherapist also treats negativism, provocative behavior and learning disorders.

During the treatment process, the psychotherapist analyzes the child’s environment, as well as the influence of society and heredity.

You should contact a child psychotherapist if your child:

• inappropriate, aggressive or antisocial behavior is observed;
• for a long time there is a feeling of guilt, fear, increased anxiety or indifference;
• low self-esteem;
• tics, enuresis, stuttering, stereotypical movement disorders are present;
• there is overstrain as a result of exposure to stress factors.

In what cases should you contact a psychotherapist?

Consultation with a psychotherapist is necessary for people who:

• There was a serious stressful situation or there is a mental trauma that is difficult to overcome on your own;
• in the absence of an objective reason, a depressed state, nervousness or irritability is observed;
• there are mood swings, in which an unreasonably excited state is unreasonably replaced by apathy and indifference;
• chronic fatigue is observed;
• there is no (lost) interest in important professional and personal life moments (emotional “burnout”);
• against the background of external well-being there is constant anxiety, obsessive thoughts, rituals, fears and fantasies;
• there is an irrational, uncontrollable fear of any object or phenomenon (phobia);
• addictions of various kinds are observed (alcohol, shopping addiction, etc.);
• There are psychosomatic diseases in which there are symptoms of the disease, but the physiological pathology is either absent or is psychogenic in nature ( bronchial asthma, ulcerative colitis, essential hypertension, gastric and duodenal ulcers, neurodermatitis, etc.).
• there is an internal conflict that interferes with a full life and development.

Consultation stages

The psychotherapist provides counseling based on the “five-step” model:

1. Establishes contact with the client and orients him towards work.
2. Collects information about the client and finds out what the essence of his problem is. After assessing the psychological status of the client and his general life situation, main difficulties and motivation, the psychotherapist considers the possibility of an organic defect and, if necessary, redirects the client to receive psychiatric help.
3. Finds out what result the client expects and what he wants to achieve. In order to eliminate unrealistic expectations, the psychotherapist helps the client consciously build a system of goals focused on a specific and achievable result in the near future. The limits of psychotherapy, expressed not in a temporary, but in a meaningful form, are also clarified. The client at this stage should be warned about the difficulties of psychotherapy that he may encounter.
4. Produces alternative solutions Problems. The choice of a psychotherapeutic strategy to achieve previously set goals depends on the training of the psychotherapist, the client’s personality characteristics and the characteristics of the problem.
5. Summarizes the results of interaction with the client and evaluates the effectiveness of therapy.

Before conducting therapy itself, the psychotherapist uses a variety of diagnostic procedures, the choice of which depends on the psychotherapeutic school (diagnostic conversation, observation and projective methods in psychoanalysis, etc.).

Treatment methods

The approach to treatment of a particular psychotherapist depends on the direction of psychotherapy chosen during training (currently there are about a dozen directions). The main areas of psychotherapy are:

• Psychoanalysis, in which subconscious processes (instincts, motivations, defense mechanisms) are considered the basis of the psyche. Used: at the stage of accumulation of material, methods of free associations and dream interpretation; in the process of therapy - methods of interpretation, analysis of “resistance” and “transfer”, processing of information.
• Gestalt therapy, which is based on the idea of ​​self-regulation of the psyche. Are used various techniques(“Here and Now”, “Peeling the Onion”, etc.), exercises, transference and countertransference, completion of the gestalt (situation).
• Existential psychotherapy, which is focused not on individual manifestations of the human psyche, but on his entire life (psychodynamic approach). Group therapy and techniques for working with defense mechanisms, dreams, reducing sensitivity to death, etc.

A psychotherapist may also be a specialist in cognitive behavioral or client-centered therapy, art therapy, play therapy, etc.

“The patient doesn’t understand, and my task is to explain to him...” I sometimes hear from colleagues. And patients themselves often look for explanations in the psychologist’s office, and sometimes call working with a psychologist lessons. And how could it be otherwise? A psychologist has studied psychology, knows its laws and can teach and explain to a patient. At the same time, he turns out to be something like a mother, father and teacher in one bottle, and the patient turns out to be a not very capable student, if he himself did not understand. It may be pleasant for a psychologist to play the role of big, smart and strong, but, freed from the sense of self-importance, it is not so difficult to be convinced that this approach to psychotherapy does not work. And the patients themselves express this best: “I understand everything in my head, but my soul is tormented.”

I imagine making my life like embroidering on a canvas. It’s a good, correct outline, and I came up with a wonderful drawing, and I understand perfectly well what to do and how... But nothing works out - I want the best, but it turns out as always... Why? I embroider with a thread that I spin from the experiences of my life, in which, despite all the clarity of the experience itself (here I did the right thing, here I made a mistake, there it was necessary this way, and there that way, etc., etc.) there are many knots , knots and loops. And now I need to put an important stitch in my life. I understand that it is necessary and what it is for, but the thread keeps getting stuck or breaks. That’s why I’m going to a psychologist so that he can help untie and dissolve these invisible, unknown to me, but so disturbing mental loops and knots.

Family and friends cannot help because, for many reasons, they will discuss the experience itself rather than how it is experienced. This is due to the boundaries that we cannot cross within the framework of our real relationships with their history, character and interests of the participants. Therefore, a psychologist is prohibited from psychotherapy of family members, friends and those with whom he has personal or business relationships.

Externally, psychotherapy is a conversation between two people. What distinguishes it from just conversation?

– Just like a lawyer and a doctor, a psychologist serves the interests of that one person. So, when working with a difficult child, he does it for the child, and not for the family or school.

– Knowing the circumstances of the patient’s life, the psychologist concentrates not on them, but on their experience. The same divorce can be experienced as the happiness of liberation, as the collapse of life, as something unimportant...

– From this follows what Alexander Badkhen calls the psychotherapeutic transformation of the ethical: the good of a particular patient is more important than the good of the world with its morals, rules, etc. If, for example, the crime of Rodion Raskolnikov had not been discovered and he had come to a psychologist 10–15 years later with the words - they say, he killed two aunts for nothing and now I can’t live with it - the psychologist will accept his words as an expression of spiritual torment, which will help to deal with, and not as a confession or confession for the remission of sin.

– The psychologist accepts the patient as he is, without value judgments. Evaluation of the patient's actions as good or bad, right or wrong, etc. lies outside the scope of psychotherapy.

– The psychologist does not take what is happening between him and the patient outside the boundaries of their communication. He even has the right to give to law enforcement agencies necessary information only by special legal order.

– The psychologist does not teach, does not edify, does not prescribe opinions and behavior to the patient, but helps him to explore those unconscious experiences of past and present experience that give rise to problems that interfere with the patient. The patient, for example, is well aware that difficulties in financial relationships are due to the fact that he establishes too close relationships with people. The task of the psychologist in this case is to help the patient explore the origins of the desire to seek close relationships and work through the experiences associated with these origins.

All of the above makes the psychotherapeutic relationship truly unique, and therefore helps a person to untie the mental knots that torment him and prepare himself for life without this pain.