Psychotherapy is a specially organized help to a person facing difficulties. There are many approaches to psychotherapy, each of which uses its own unique techniques aimed at harmonizing the client's inner world and improving the quality of his life. Before starting psychotherapy, it is important to know about the peculiarities of its organization, for example, indications and contraindications, the duration of the session, the functions of the psychotherapist. For therapy to be effective, it is necessary to carefully choose a specialist and an approach in which it would be comfortable to work with your difficulties.

Basics of psychotherapy

Human life is very eventful. It consists of many events that, to one degree or another, leave an imprint on the personality and put a person in front of a choice. Coping with difficult feelings, the effects of stress, or making important decisions can sometimes be difficult. A person may feel that the world around him presses too much, but he is not able to resist this pressure, to lead his life and be happy. In these and many other situations, psychotherapeutic work can help.

When a person comes to psychotherapy, he has a need to get out of the usual circle of behavioral and mental strategies, change his life, fill it with new meaning. The therapist, with the help of his personality, as well as special techniques and exercises, helps the client to take control of his life, change his behavior and attitude towards the world and himself. As a result, the very personality of a person changes, and with it his life.

Sometimes for a person, these changes can be the result of tremendous effort and mental work. Therefore, the psychotherapist must be a highly professional in order to support and help the client in the process of self-discovery and personality transformation.

Psychotherapy deals with a wide range of a person's problems and difficulties. This type of help can be combined with other treatments to achieve the best effect.

Most often, various types of psychotherapy are used for the following problems:

- Neuroses

- Neurotic reactions

- Psychosomatic disorders

- Problems in children and adolescents

• Enuresis and encopresis
• Fears
• Tics and stuttering
• Difficulties at school
• Asocial behavior
• Loss of a close relative

- Post-traumatic stress disorder as a result of:

• Natural Disasters
• Military action
• Terrorist acts
• Experienced violence
• Loss of a loved one
• Long-term severe illness

- Problems of the sexual sphere in men and women

- Depressive disorder

- Phobias and anxiety, panic attacks

- Various kinds of addictions

- Vegetovascular disorders

- Crises (personal, age, professional, family, existential)

- Difficulties in family relationships

Contraindications to psychotherapy

There are few contraindications to psychotherapy, but not adhering to these prohibitions can lead to unpleasant consequences for both the client and the therapist. It:

• Exacerbation of severe mental illness
• Severe organic diseases of the nervous system
• Moderate and severe mental retardation
• Alcohol or drug intoxication
• Lack of motivation and desire (if relatives insist on visiting a therapist)

The integral parts of psychotherapy are the therapist, the client and their relationship. Each of these elements has an impact on work efficiency. Thus, the success of psychotherapy lies not so much in the correct application of the necessary methods, but in the correctly structured interaction.

The relationship between client and psychotherapist is governed by a code of ethics. However, its provisions are not external, but internal regulators. Because these rules are the foundations of psychotherapy and are mandatory for every professional.

One of the main prohibitions in psychotherapy is the prohibition of "double relationships". That is, a specialist cannot be with a client in any relationship, except for workers. Therefore, you cannot provide professional assistance to relatives, friends and lovers. In most areas of psychotherapy, the client-therapist relationship is never outside the office. That is, they meet only at a psychotherapy session at the appointed hour.

Here are some of the provisions of the psychotherapist's code:

• Act in the best interest of the client
• Comply with privacy terms
• Act within their professional competence
• Respectfully treat the client regardless of his age, gender, nationality, sexual orientation, social status, physical capabilities and other reasons.
• To inform the client about the possible goals of the work, the peculiarities of the organization of the therapeutic process, the methods used, the qualifications of the specialist himself.

For psychotherapy to be successful, the client's own input is also important. He is not a passive participant in the process and influences the result of the work.

Qualities of an effective client:

• Commitment to change
• Willingness to interact with the therapist in confidence
• Interest in the psychotherapy process
• Willingness to overcome difficulties and face strong feelings

Few people know, but almost every psychotherapist was at the client's place. In most areas of psychotherapy, the mandatory requirement for the issuance of a diploma is a certain number of hours of personal psychotherapy. It is very important for the professional to work with their personal and professional difficulties. After all, a psychotherapist can accumulate negative states, which must be eliminated with the help of individual psychotherapy. Otherwise, they will have a destructive effect on the workflow.

Each psychotherapy session follows a specific pattern, but the content of the conversation varies depending on the client's request, his mood and mood for the conversation. To simplify greatly, during the session the client tells his story, the content of the problem, and the specialist asks questions. However, these questions do not come from the simple interest of the therapist, but are formulated in a special way and have specific goals. For example, the professional may use specific psychotherapy techniques and questions to activate the client's inner resources. When it comes to group psychotherapy, the therapist monitors and guides the process, and the participants take turns speaking and sharing their experiences.

The first session usually involves acquaintance, the conclusion of an oral contract and initial interviewing. The client learns about the qualifications, features of the specialist's work and tells about himself and his difficulties. The client and the therapist set professional boundaries and negotiate all the conditions for the upcoming work.

Payment for psychotherapy

Paying for a psychotherapy session is one of the most difficult and debatable topics. However, any profession involves the provision of services in exchange for money. In this case, the client pays money for the specialist to spend his time working with him. In addition, money is important for the very process of psychotherapy and affects its success. Giving the amount within his power, the client is more likely to get involved in the work, appreciates the process more and is more willing to strive for speedy changes. Paying for psychotherapy sets boundaries, creates distance between the client and the therapist.

The cost of a psychotherapy session varies on average from 500 to 6000 rubles per 60 minutes. The psychotherapist informs about the cost of his work in advance, at the first meeting. In most cases, it depends on the qualifications of the specialist and his professional experience.

However, psychological assistance can also be free. For example, there is a government psychological service that provides free counseling. Or in extreme situations, specialists work who provide short-term assistance to victims. For example, during hostilities, terrorist attacks or natural disasters. When it comes to long-term psychotherapy, it is desirable that the client pays for the sessions himself. It tunes in to work and change.

Psychotherapy methods

Various psychotherapy methods are ways of realizing assistance to a client and include many techniques and techniques. The method depends on the direction of psychotherapy to which the specialist belongs.

At the moment, there are more than 400 different methods of psychotherapy, many of which are effective and widespread. The method determines the way of working with the client, and the understanding of the psyche and mental disorders. Many scientists are trying to analyze the main methods of psychotherapy and systematize them.

Soviet scientist and psychotherapist I.Z. Velvovsky and his colleagues have developed the following classification, depending on the client's condition:

• Waking psychotherapy
• Psychotherapy in special states of brain functioning (hypnosis, autogenous training, relaxation)
• Psychotherapy under stress and acute trauma

Within each method of psychotherapy, there are many techniques that are applied at a certain stage and when working with certain difficulties of the client. The complexes of methods connected by general ideas and approaches to treatment represent different directions of psychotherapy and schools.

Each direction and school has its own variety of psychotherapy techniques and exercises. However, all of them are the foundations of psychotherapy and are aimed at improving the psychological state, alleviating negative symptoms, achieving emotional comfort and improving the quality of life.

The use of psychotherapy techniques depends on the direction of the therapist's work at the moment:

• work with emotions and states,
• work with behavior,
• work with attitude to the problem,
• working with the problem itself.

In the process of work, the specialist constantly checks whether the psychotherapy techniques he has chosen have the desired effect. If they turn out to be ineffective, then the therapist changes the strategy of work. Due to the wide range of psychotherapy techniques, the process becomes very flexible, and the specialist selects exercises and techniques depending on the specific situation and characteristics of the client.

Psychotherapy and medications

Medication can only be prescribed by a psychotherapist with a higher medical education. This is usually a psychiatrist who has received additional training as a psychotherapist. Such a specialist owns psychotherapy techniques, in addition to medical knowledge. He has the right to work with clients with mental disorders and, in parallel with psychotherapeutic assistance, prescribe pharmacological treatment. Thus, the therapist acts on the disease and removes negative psychological consequences, negative emotions, problems in interpersonal interaction.

The duration of psychotherapy depends on many factors, such as, for example, the characteristics of the problem, the personality of the client and therapist, external events. Thus, it can last from one meeting to several years of weekly sessions. How long psychotherapy will last is determined jointly by the client and the therapist. As they work, they summarize and redefine goals and estimated completion dates. Much depends on how long it takes to research a topic of concern to a client, to understand all its nuances and find ways to resolve difficulties.

However, initially psychotherapy can be short-term or long-term, depending on the severity of the situation and the characteristics of the problem.

Short term psychotherapy

On average, short-term psychotherapy lasts five to ten sessions. It aims to address one problem or a specific symptom. Such psychotherapy does not bring global results, but it is able to give quick relief and quickly help the client. Most often, short-term therapy is resorted to in a situation where an urgent need to make an important decision, there is a conflict at work or anxiety before the upcoming exams. Usually, these difficulties appear in the client's life immediately before coming to a psychotherapist and have not yet had time to acquire a multitude of accompanying difficulties, stresses, experiences and defense mechanisms. In such a situation, the psychotherapist does not go deep into the client's life story, but gives specific exercises to resolve this situation.

Long-term psychotherapy

Long-term therapy can last from about six months and is aimed at profound personal changes. Here it is important not only to reduce the destructive impact of the problem, but also to understand its origins, to develop coping strategies for the future. Long-term psychotherapy is suitable for people who have difficulties in different areas of life, have psychological trauma, problems that cannot be eliminated for a long time. The psychotherapist helps the client to take a fresh look at his life and change the prevailing stereotypes of behavior and response to ordinary situations.

There have been many studies of the effectiveness of psychotherapy, which have shown that therapy leads to better results than no treatment and treatment with placebo. On average, studies have shown that a client who has received psychotherapy shows more improvements in quality of life than 80% of people who have not received therapy. Psychotherapy has been shown to be effective in treating anxiety disorders, addictions, eating disorders and other problems.

If we talk about the effectiveness of a particular type of psychotherapy, then there was no significant difference. In order for the work with a therapist to bear fruit in a particular case, you need to carefully select a highly qualified specialist and an approach that will be comfortable for you.

The result of psychotherapy

Many clients, coming to psychotherapy, expect a miracle, magical healing and the instantaneous disappearance of the symptom. However, after several meetings, he realizes that the psychotherapist is not a magician at all, and his happiness is only in his own hands. From this moment, deep work begins, which will certainly bear fruit. As a result, personal changes are bound to occur and a different view of difficulties and life in general appears.

The goal of any psychotherapeutic assistance is not just to relieve the symptom and temporarily alleviate the condition, but to improve the quality of life. The therapist together with the client in the process of working together find tools and ways to improve the quality of life. Thus, the client learns independently, without the help of a psychotherapist, to cope with difficult situations and conditions in the future.

However, having dealt with one problem, the client may want to continue psychotherapy and formulate a new request. Then all the conditions are negotiated anew and new goals are set.

In general, counseling and psychotherapy overlap in many ways, have similar techniques and methods. And nevertheless, for each specific case, you need to choose your own type of assistance. The success of the work and the long-term nature of the changes depend on this. Therefore, counseling and psychotherapy have their own indications and contraindications.

Psychological counseling is aimed at solving the client's daily difficulties. The psychologist helps people who have difficulties in interpersonal communication, at work, in relationships with loved ones. If the client is at a crossroads, he needs to make a decision and weigh the pros and cons, he is in a collected and active state and ready to act, psychological counseling is more suitable for him.

Psychotherapy is aimed at helping a person with certain mental disorders or not clinical, but serious conditions, for example, mild depression, phobias, anxiety. In some cases, psychotherapy is used in conjunction with medication. It focuses on a person's intrapersonal issues. Psychotherapy is aimed at helping people in a more serious condition. Such clients feel powerless, they do not have the strength to quickly get together and solve all the difficulties. They expect salvation and healing from a specialist. They first need to harmonize their inner state, and then deal with life's difficulties.

Psychological counseling is aimed at:

• finding a way out of a difficult situation (professional, educational)
• solution of interpersonal conflict situations
• overcoming stress and increasing stress resistance
• change in attitude to the problem
• decision making and others

Psychotherapy is aimed at:

• change in habitual behavior and thinking
• overcoming a personal crisis
• way out of depression
• overcoming difficult conditions associated with the loss of a loved one
• additional help in the treatment of mental disorders

Types of psychotherapy

There are two types of psychotherapy: individual or group. In the first case, the psychotherapist and the client communicate one-on-one, and in the second, the specialist works with a group that interact both with him and with each other. In addition, child psychotherapy is distinguished as a separate type of psychotherapy. It focuses on working with children and adolescents. All these types of psychotherapy are aimed at helping people with different problems and difficulties.

A specially organized form of interaction between the client and the psychotherapist is called individual psychotherapy. This type of psychotherapy includes various techniques, techniques and exercises. Individual psychotherapy often involves the participation of the therapist and the client. During a psychotherapy session, all the attention of the specialist is directed to the client, his difficulties and strengths. There are short-term (up to 20 sessions) and long-term (from 20 sessions) therapy. The duration of work, targets and characteristics of the relationship between the client and the therapist in the framework of individual psychotherapy depend on the approach in which the specialist works.

Group psychotherapy

Unlike individual psychotherapy, group therapy is designed for several participants. This type of psychotherapy is aimed at interpersonal interaction, exchange of experience and getting a response, feedback in response to your words and experiences. Group therapy is often associated with Alcoholics Anonymous meetings, but the group can discuss a very wide range of problems and difficulties. During interaction, people talk about themselves and their difficulties, feelings and experiences, attitudes towards each other, dreams and plans for the future. The specialist monitors the process of group psychotherapy, creates conditions for the safe work of clients, monitors the process, regulates and guides it. Gradually, the group turns into a unique team, where their difficulties arise and are solved, where a common process takes place, to which each participant makes an equally important contribution.

Child psychotherapy is aimed at helping children and adolescents with symptoms of mental, borderline and psychosomatic disorders who have experienced a traumatic event, learning difficulties or behavioral difficulties.

Psychotherapy for children dates back to the work of Freud, in which he described the application of psychoanalysis to young children. However, in his work, he did not take into account the peculiarities of age and used the same techniques as when working with adult patients. Since then, child psychotherapy began to develop as a separate direction, with its own specifics. Such famous scientists as M. Klein, A. Freud, D. Levy and others made a great contribution to the development of this direction.

Child psychotherapy can be focused on working only with a child, and can also include parents, educators or teachers in the process. When working with children, psychotherapists use play methods and creativity. Through these processes, natural for a child, the specialist reveals the emotional, behavioral and other characteristics of the child. The therapist takes into account the stages of the child's neuropsychological development and selects an individual approach to each child. Thanks to working with a psychotherapist, the child learns to express his strong feelings, overcome fears, interact with others, and control his behavior.

Clinical psychotherapy

Such a direction of therapeutic practice, as clinical psychotherapy, is used in the framework of helping a patient in a psychiatric clinic. This is not a mandatory procedure, but can be successfully used in conjunction with medical treatment as directed by a doctor. Most often, clinical psychotherapy is used for borderline mental disorders and addictions.

The methods of clinical psychotherapy are extensive, but their application depends on the diagnosis of the patient, his personality characteristics. Working with the patient is aimed at removing or mitigating the side effects of drugs, alleviating communication difficulties and changing the attitude towards oneself and one's disease. In clinical psychotherapy, the specialist helps the patient to activate internal resources and improve the quality of life. The psychotherapist may have very narrow practical tasks, for example, dealing with sleep disorders, adapting to hospital conditions, or conflicts between patients. The clinic can provide both group psychotherapy and individual psychotherapy. Correctly selected techniques and a benevolent attitude of a specialist are the foundations of psychotherapy and psychocorrection.

Directions of psychotherapy

At the moment, there are many different schools and areas of psychotherapy, both in Russia and in the world. Their diversity and multidirectionality make the process of their classification and systematization very difficult. But it is possible to highlight the main directions of psychotherapy, which are the most common and have a scientific basis.

At the turn of the 19th and 20th centuries, Sigmund Freud developed a psychological theory, from which the psychotherapeutic approach would later emerge. Freud and his colleagues saw a direct connection between human behavior and psychological characteristics with internal unconscious processes, drives and conflicts, as well as a number of psychological structures described by them. These ideas became widespread and resulted in more than 20 concepts and approaches to working with the human psyche.

The main task of the analyst is to help the client in the process of psychotherapy to become aware of his unconscious conflicts and childhood experiences. And also, together with the client, he must work out the conflict, finding out exactly how it affects the behavior, relationships and, in general, the life of the client. For this, specialists have many methods, for example, the interpretation of dreams and the method of free association.

In addition, for individual psychotherapy to be effective, the psychoanalyst and the client must create a so-called therapeutic alliance. It is a trusting relationship between the patient and the therapist, a joint effort aimed at achieving a common goal.

The analyst's personality and professional skills are the foundations of analytical psychotherapy and predetermine its effectiveness. He must, together with the client, plunge into the depths of his unconscious and at the same time interpret the discovered phenomena. This process can often take many years of weekly meetings.

Client-centered psychotherapy

Client-centered psychotherapy is one of the most popular psychotherapy methods. In the middle of the 20th century, the foundations of this direction of psychotherapy were laid by the famous American psychologist Carl Rogers. Rogers' main idea was that the person himself is the expert for his life. This approach has become an alternative to psychoanalysis, where the analyst is considered the undisputed authority. Despite criticism from analysts, client-centered psychotherapy has helped many people and is incredibly popular. Carl Rogers was nominated for the 1987 Nobel Peace Prize for his work.

The main ideas of client-centered psychotherapy are unconditional acceptance, respect and a benevolent attitude towards each person. Rogers believed that the right relationship between the client and the therapist, built on trust, is the most important condition for effective psychotherapy. The therapist must accept the person with all his characteristics and create favorable conditions that allow the client to develop.

The psychotherapy process is a dialogue between the client and the therapist. The client chooses a topic that is interesting to him at the moment and, thanks to the special questions of the psychotherapist, explores it. The therapist is focused on the client, providing him with attention and acceptance. Thanks to such a trusting atmosphere, a person has the opportunity to speak on the most exciting and difficult topics without fear of condemnation. The client feels supported, and he has the strength to cope with his difficulties, finds ways to solve the problem.

Client-centered psychotherapy helps a person to form a stable adequate self-esteem, look at the world more realistically and trust it.

Perceiving the world, people, events, each of us receives completely different information. We cannot cope with the colossal amount of data that flows through our sensory systems. Therefore, each person perceives information individually and chooses what is important for him. As a result, we form our own unique view of the world.

The outstanding American psychologist Aaron Beck, developing his direction of psychotherapy, came to the conclusion that it is the interpretation of events, that is, thoughts, that determine emotions, behavior and features of a person's existence. The scientist observed people with depression and realized that in many ways their suffering is associated with a negative perception of themselves, their lives and the world. Beck's observations formed the basis of cognitive psychotherapy as a method of working with a person's thoughts and his ideas about the world.

Years of practice have shown that this direction is suitable for eliminating a wide range of difficulties and symptoms and has practically no limitations. A psychotherapist in the framework of cognitive psychotherapy helps the client to look at things from different angles, to expand his vision.

The methods with which cognitive psychotherapy works are varied. They are designed to help the patient learn to analyze and check their thoughts for truth, cope with maladaptive beliefs, look at the world and their own experience from different angles. For example, a cognitive psychotherapist works with the client's irrational belief: “I couldn't keep my husband, so something is wrong with me.” Because of this, her self-esteem suffers, negative emotions do not allow a woman to concentrate on work, the accumulated one leads to quarrels with relatives and friends. The therapist works with the client to deal with this and the client's other beliefs, their nature and the impact on her life. As a result, the person who asked for help has new ideas about the situation and new ways of solving their difficulties.

Behavioral psychotherapy

Behavioral (behavioral) psychotherapy was founded in the 1920s by the students of John Watson, the founder of the behavioral (behavioral) direction in psychology. At the very beginning of development, behavioral psychotherapy was a complex of methods aimed at teaching one or another behavior. It was based, among other things, on the doctrine of the conditioned reflex of the Russian physiologist I.P. Pavlov. Originally, the behavioral approach to counseling and psychotherapy was developed to help people with behavioral and emotional disorders such as fears and phobias.

There are many indications for the use of behavioral psychotherapy. It can help with phobias, panic attacks, psychosomatic disorders, eating and sleeping disorders, sexual problems, learning difficulties and hyperactivity in children.

The main goal of behavioral psychotherapy is to change the client's habitual behavior, which will entail many profound changes. Currently, elements and individual techniques of the behavioral approach are used by different types of psychotherapy when dealing with a wide range of difficulties.

Behavioral psychotherapy exercises focus on the gradual training of a skill. At the very beginning, the client and therapist work together to analyze the habitual behavior, find the interfering elements, formulate the correct behavior and determine the stages of work. The client then trains the new behavior in small steps, receiving rewards from the therapist for good work. Such exercises are the basis of this type of psychotherapy and lead to significant changes. So gradually behavioral psychotherapy helps the client build a new way of acting in his life and get rid of harmful and destructive habits.

Behavioral psychotherapy and cognitive psychotherapy became the basis for the creation of a cognitive-behavioral direction that combines work with thoughts and human behavior. Certain methods of this direction are effectively used in clinical psychotherapy and other approaches.

Existential psychotherapy, which originated in the twentieth century, did not seek to decompose a person into separate parts and diagnose the client. Its goal was to study a person in combination with his ideas about such global things as the meaning of life, death, loneliness, truth. In this regard, there is a very close interweaving of existential psychotherapy with philosophical ideas.

The existential approach in counseling and psychotherapy is aimed at helping a person find himself, his place in life. He does not aim to change his behavior or teach him to think differently, but only to comprehend his own goals and intentions. Thus, existential psychotherapy focuses on the freedom of the individual, the choice of life path.

Within the framework of existential counseling and psychotherapy, it is argued that all the client's difficulties originate from the very nature of man, his constant search for the meaning of life. A person has to make decisions and take responsibility for them, face a contradictory world and interact with different people. Coping with all of this and dealing with your own feelings and experiences can be very difficult. Therefore, existential psychotherapy aims to bring the client to the realization of life values ​​and change life in accordance with them.

The work is based on a trusting dialogue between the client and the therapist. At the same time, the specialist does not put pressure on the client and does not impose his opinion on him, but gently guides him with his questions to realizing his values, needs, beliefs and ideas about a harmonious and happy life.

One of the most famous adherents of modern existential psychotherapy is Irwin Yalom. He is an ardent supporter of an individual approach to each person and each time he reinvents therapy for the client so that all carefully selected methods of psychotherapy are right for him. His books on existential psychotherapy When Nietzsche Cried, Mom and the Meaning of Life, Schopenhauer as Medicine, and others became bestsellers.

Systemic family psychotherapy

Systemic family psychotherapy is one of the youngest areas that continues to develop actively. The main difference with this approach is that the client is not one person, but the whole family or some family members. Even if one person comes to the reception, his whole family and relationships with close relatives are involved in the work. Systemic family psychotherapy emerged in parallel in Europe and America in the 1950s. Psychologists, anthropologists, physicians, and mathematicians have all participated in the development of this approach. It was based on the idea of ​​the family as a whole system, with its own structure, crises and internal connections.

Family psychotherapists consider the problems of each family member as a result of difficulties in the functioning of the entire system and disorders in interpersonal communication. The psychotherapist tries to identify violations and their role. Even negative symptoms can be beneficial. For example, a family unites and gets closer in the fight against alcoholism of one of the members. Therefore, in the framework of family psychotherapy, the specialist examines the entire family history, understands the relationships and role positions that family members occupy. In the process of work, the family is transformed, the behavior of family members changes, and subsequently family relationships also change. For a therapist who works in the framework of family psychotherapy, it is important to analyze the usual ways of communication in the family, family rules. Then, together with the client or clients, there is a joint creative search for alternative options for interaction. As a result of therapy, the whole family system is harmonized.

Work with married couples can also be carried out within the framework of group psychotherapy, and not just individually. This gives clients the opportunity to share their story with others and look at other people's family models from the outside. This therapy is designed for 3-7 couples. Specialists in their work use the methods of group psychotherapy and family psychotherapy. The group understands, analyzes and solves various problems related to intra-family communication, raising children, everyday life and other aspects of married life.

Body-Oriented Psychotherapy is a very interesting area of ​​care that deals with problems through movement and body exercise. The foundations of body psychotherapy were laid by Wilhelm Reich, a student of Sigmund Freud. He drew attention to the fact that working with the body, with a muscle corset, helps in resolving many difficult situations. Reich compared muscle clamps to a protective carapace, which is formed in response to negative external influences. These clamps are very closely connected with psychological defenses, with fears and conflicts that are repressed into the unconscious. The work of body psychotherapy is aimed, among other things, at getting rid of clamps and, through this, resolving a psychological conflict.

Now this approach has many branches, approaches and schools. Some of the adherents of body psychotherapy work with the life energy of a person, someone through dance or other physical exercises. The main goal of body psychotherapy is to release the clamps, become aware of your body and express all your hidden feelings. The therapist supports the client, draws his attention to bodily tension and helps connect him with certain experiences. However, body psychotherapy is used in conjunction with other psychotherapy methods to increase effectiveness.

Positive psychotherapy

The emergence of positive psychotherapy is associated with the name of the famous German neurologist, psychiatrist and psychotherapist Nossrat Pezeshkian. The researcher notes that the term "positive psychotherapy" comes from the Latin "positum" - "whole, single, given, really existing", and not from "positivus" - "positive." Thus, Pezeshkian emphasizes that for positive psychotherapy it is important to consider a person's life, his features and problems, as a totality, unity of both positive and negative aspects.

The advantage of this approach is that it is available for many social and age groups, as well as for people of different cultures. In its methods, positive psychotherapy integrates the wisdom of the East with the scientific and systematic nature of the West. The specialist does not work with the problems and diseases of a person, but with his actual abilities. By actual abilities, positive psychotherapy understands the sides of the personality that a person uses in everyday life. For example, these are punctuality, politeness, confidence, patience and others. The main goal of positive psychotherapy is to mobilize a person's inner resources so that he can make healthy and balanced decisions in all life situations. The work of the therapist with the client is not aimed at fighting the world around him, but at accepting it in all its diversity.

Gestalt therapy has come a long way from an unknown theory to one of the most famous and authoritative approaches. Its founder is the renowned psychiatrist and psychotherapist Frederick Perls. The term "gestalt" is understood as something integral, not reducible to the sum of its parts. This type of psychotherapy allows the client to gain a holistic view of life and himself.

The therapist helps the client to focus on the present moment, start living in the here and now, and develop self-awareness. With the help of special techniques, an attentive attitude to emotions and bodily sensations is formed. The client learns to be careful and caring in relation to himself, and also to live not in the world of fantasies and memories, but to live the present moment to the fullest extent.

Duration of psychotherapy

V.V. Makarov identifies four options for the duration of psychotherapy (meaning the totality of all meetings with a specific client):

Ultrashort (ultrafast) therapy,

Short (quick) therapy,

Long-term (slow) therapy,

Ultra-long (ultra-slow) therapy.

The first type of therapy lasts minutes and hours. The efforts of the psychotherapist are aimed at resolving urgent, isolated problems and conflicts. In this case, we are not talking about deep personal problems. The effect of ultrafast therapy may be variable over time. Often, the ultra-short form of therapy is practiced by specialists in neurolinguistic programming (NLP).

The short therapy lasts for hours and days. Here, the personal content is touched upon within the necessary minimum for solving an urgent problem. Its effectiveness is often more persistent than in the previous case. The target for the psychologist here is often not a direct solution to the problem, but the initiation of a positive process of change, which continues after the end of therapy. An example is the problem crystallization method.

Slow therapy lasts months. In this case, psychologists are concerned with the personal content of the problems. A lot of details are being worked out here. The effect develops slowly, but it is more persistent. An example is transactional analysis.

Ultra-slow therapy lasts for years. Here psychologists and psychotherapists deal with not only the conscious, but also the unconscious of the client. Much time is devoted to achieving an understanding of the essence of experiences, identifying cause-and-effect relationships. A deep retroanalysis takes place, the client's childhood is investigated. Psychoanalysis is a typical example.

1. Who needs psychotherapy?

The help of a psychotherapist should be sought when a person has difficulties associated with:

with relationships with other people: relationships with loved ones / spouses, relationships with children (small and adults), colleagues, etc.

with the emotional sphere of a person: fears, anxiety, anger, irritability, apathy, resentment, etc.

with self-realization: development of career growth, achievement of social respect, success, creativity, etc.

with existential questions: freedom and responsibility, the meaning of life and fear of death, and so on.

with psychosomatic symptoms: headaches, allergic reactions, neuralgia, etc.

2. How can psychotherapy help?

Psychotherapy is a movement towards maximum awareness, it is awareness of awareness. There is such a law of paradoxical development, it says that if a symptom or problem is conscious to the highest degree, they begin to fade away, since we can control what we are aware of, make our own choice.

And psychotherapy is also the process of gaining an "experience from the inside" in a safe environment. To achieve this effect, the specialist uses certain psychotherapeutic methods. As a result, the patient searches for answers, accompanied by a psychotherapist through understanding the situation (instinct, awareness), living (necessary to complete this story, the situation in the inner plane of the personality, in the soul), interiorization (appropriation, assimilation of the experience gained). Once the experience is gained, it serves us for the rest of our lives, even if it is obtained in the safe "laboratory" conditions of a psychotherapy office. The main thing is that the soul already knows how to do this.

3. What does psychotherapy look like?

Usually, the process of psychotherapy from the outside looks like an interested conversation between two adults. In this conversation, usually one says more (this is the client), and the second listens with interest, asks clarifying questions and tries to understand the first one as much as possible (this is a specialist). This is how this most interesting process looks unpretentious from the outside.

In addition to the conversation, the specialist can use additional psychotherapeutic techniques or procedures: exercises, appeal to childhood experience, dramatization, drawing, play, etc.

4.How long does the session last?

Usually an individual meeting lasts 1 hour. Child therapy sessions with young children can last 30 minutes, and with whole families - 1.5 hours.

5.How long is the course of psychotherapy?

The answer to this question is very individual. Only one thing can be said for sure: one consultation, as a rule, may not be enough. You should be guided by an average of 5-10 meetings. If the problem is deep and complex, therapy can last from several months to several years.

6.How often do you need to schedule consultations?

The optimal frequency of meetings is once a week. During this time, the person manages to "assimilate", "fit" in the head and heart that was at the previous meeting. But at the same time, this meeting has not yet been erased from memory.

7.How is the first consultation going?

At the first meeting, the therapist and the client get to know each other, discuss the goals of the work, possible and desired results, ways to achieve them. Determine the number of meetings. Also, within the framework of the first meeting, the specialist collects information about the problem, analyzes the history of this problem (it is often intertwined with the history of life), thinks over an approximate work plan and observes.

8. What methods can a psychotherapist use?

This is perhaps the most difficult question, since there are a great many methods and techniques in psychotherapy. And there are no universal ones. Each specialist owns several methods and puts them into a variety of mosaics that help each specific client to solve his problem, improve the quality of life, and develop.

The most commonly used are:

Responding to negative emotions (anger, aggression, grief). In our society, there are a lot of prohibitions on the expression of emotions (“boys don’t cry,” “you cannot be angry with your parents,” etc.). We follow these prohibitions, and emotions accumulate inside us and, not finding a natural outlet, manifest themselves in psychosomatic problems and neuroses. Being aware of and responding to this emotional burden allows you to free yourself from it.

Self-knowledge, self-awareness. During therapy he learns a lot about himself. Begins to be aware of the motives of their own actions, learns to distinguish between irrational thoughts, negative feelings. This knowledge helps to understand what led to the current difficult situation and gives an answer to the question of how to get out of it and get the desired result.

Learning new behavior. We all have stereotypes of behavior that have been developed over the years. They often fully justify themselves, and sometimes they fail and become ineffective. Psychotherapy not only provides an opportunity to recognize these stereotypes, but also in a safe environment without much risk of trying new behaviors. If the “new behavior” appears to the client to be successful, he can use it in real life.

There are others. The main thing in all of them is one thing - they serve the purpose of psychotherapy - to learn to be aware of oneself and be aware of one's own consciousnesses, which ultimately will inevitably lead to an improvement in the quality of life.

9. What does the therapist NOT do?

Doesn't force you to talk about what you don't want to tell him.

Does not use words such as "you must", "you need", etc. in conversation.

Doesn't leave you alone ("You say, you say ...").

Do not scold the previous specialist (s), even if you are not enthusiastic about that work.

Is not late with the beginning and end of the session.

Does not limit psychotherapy to a certain number of sessions.

10. What makes up successful psychotherapy?

Successful therapy has perhaps three main components:

1) The client's willingness and desire to work on himself. There are no simple miracles in psychotherapy, a specialist has neither a miracle pill nor a magic wand that can solve all your problems in a moment. Psychotherapy is a complex and creative process in which the client has to work hard.

2) Trust between specialist and client. In psychotherapy, there are often very emotional moments or cases when the client's problem hides his personal secret, which he did not reveal to anyone. In such conditions, it is very important for the client to feel supported and trust their specialist. Otherwise, moving forward is very difficult, and sometimes becomes completely impossible.

3) Professionalism and personal qualities of a specialist. Unfortunately, today the service market is full of unskilled "specialists" after 2-week courses, charlatans, magicians, wizards, parapsychologists, etc. It is important not to be mistaken in choosing a specialist to whom you will turn for help. Psychotherapy cannot be practiced by people without a higher psychological or medical education and without additional psychotherapeutic training. Pay attention to this and ask to confirm qualifications, talk about education and experience, there is nothing to be ashamed about.

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Many of us think of a psychotherapy session as a spontaneous conversation about feelings. No, it is a structured length of time during which the therapist helps clients solve their problems until they learn to deal with them themselves. In most cases, the task is achieved - and it does not necessarily take years.

Studies show that most problems do not require long-term, many years of therapy. Says Bruce Wampold, a counseling psychologist at the University of Wisconsin at Madison: “Yes, some clients go to therapists for chronic conditions like depression, but there are many whose problems are not so difficult to resolve (for example, conflict at work) ". In such cases, psychotherapy can be compared to visits to a doctor: you make an appointment, receive certain funds that will help you cope with your problems, and then you leave.

“In many cases, twelve sessions are enough to have a beneficial effect,” agrees Joe Parks, senior medical advisor to the US National Council on Behavioral Sciences. A study published in the American Journal of Psychiatry gives an even lower figure, with an average of 8 sessions for clients of psychotherapists.

"Psychotherapists can be wrong too, which is why it's so important to jointly define a goal and then check with it."

The most common form of short-term psychotherapy is cognitive-behavioral therapy (CBT). Based on correcting thought patterns, it has proven to be effective for a wide range of psychological problems, from anxiety and depression to chemical addiction and PTSD. To achieve a result, psychotherapists can and combine CBT with other methods.

“But it will take a lot longer to find the deep roots of the problem,” adds Christy Beck, a psychotherapist at State College in Pennsylvania. In her work, she uses both CBT and psychoanalytic methods to deal with deeper problems stemming from childhood. A few sessions are enough to resolve a purely situational problem, ”she says. More complex ones like eating disorders take years to work with.

In any case, according to Bruce Wompold, those psychotherapists who have good interpersonal skills, including such qualities as the ability to empathy, the ability to listen, and the ability to explain the therapy plan to the client, are most effective. The initial phase of therapy can be difficult for the client. “There are some unpleasant, difficult things to talk about,” explains Bruce Wompold. However, after just a few sessions, the client will begin to feel better. But if relief does not come, it is necessary to discuss this with the therapist. “Psychotherapists can be wrong, too,” says Joe Park. - Therefore, it is so important to jointly define a goal and then check with it, for example: to establish sleep, find motivation to vigorously perform everyday tasks, improve relationships with loved ones. If one strategy doesn't work, another can help. ”

When to end therapy? According to Christie Beck, both sides usually come to a consensus easily on this issue. “In my practice, this is usually a mutual decision,” she says. “I don’t keep the client in therapy longer than necessary, but he needs to mature for this.” However, sometimes clients want to continue therapy even after they have solved the local problem they came with. “It happens when a person feels that psychotherapy helps him to understand himself, promotes his inner growth,” explains Christy Beck. "But this is always a personal decision of the client."

See the Quartz website for details.

1 The American Journal of Psychiatry, 2010, vol. 167, no. 12.

I decided to write answers to some frequently asked questions from clients. Questions are not personal, of course, but questions about psychotherapy. It is interesting for me now to write down the answers to specific, special questions that often arise in the course of work.

Here is one of them:

Why does it have to take so long? Is it really not enough one or two meetings for you to understand the problem, and then in a couple of meetings explained to me what is happening and what to do? Why don't you know exactly how long it will take?

The fact is that in the era of the Internet, knowledge is worthless. Almost all information on any topic can be found on Google. Do you want to know everything a psychotherapist knows about psychotherapy? Exactly KNOWS, I'm not talking about skills, qualities, experience, but only about knowledge-information-text. I think that it will take about 5-7 months of daily reading of psychological literature, viewing professional psychotherapeutic forums - and that's it. You will know everything your psychologist knows.
The process of psychotherapy is only 10-15% percent ... ... the process of transferring information (interpretations, theories) from the psychologist to the client. What is the remaining 90%?

We go deeper. A person lives his life, communicates, works, builds a personal life - better or worse or really bad. In the process of his development, he mastered different ways of life, he learned to build relationships, he was formed. When he comes to a psychotherapist and says - "something is wrong", it means that some methods no longer satisfy him, moreover, often he himself already KNOWS what exactly is going wrong, in what place a failure occurs, dead end, trap, he may even know how exactly this trap is arranged. But he cannot change this on his own. A simple UNDERSTANDING OF THE PROBLEM IS NOT ENOUGH FOR CHANGE. You need something else, something completely different.

The psychotherapeutic space, the space of relations with a psychologist, is a kind of testing ground, a testing ground. Whether we like it or not, talk about it or keep quiet, a relationship develops between the therapist and the client. These relationships are really special, not similar to those that happen in life, but, nevertheless, they are real - all feelings, thoughts, actions that take place in the space of psychotherapeutic relationships are real. The male client feels sympathy and attraction for the female psychotherapist, the male psychologist competes with the male client, the older one envies the younger and vice versa ... and so on. Nobody plays here. Neither the client nor the therapist. The only difference with life is that, firstly, it is safe here, and secondly, here you can be aware of your feelings and talk about them, thus, better understanding what and how you are doing in relationships, in contact with other people, in my own life, outside the office. But, and here the most important thing is not only to understand. In the process of psychotherapy, you can try to do something new, something different from what is not satisfying at the moment.

And the point is not that the Internet or the therapist will TELL and let you try some new "magic" "correct" method, quite often a certain suitable method is ALREADY known to a person, not always consciously, but VERY OFTEN a person knows the answer to his question to a psychologist. But to hear this answer in oneself is very scary or very ashamed or very painful or ... somehow else, but only very difficult, that is, unbearable.

A person experiences the strongest burning shame when he thinks about some of his qualities, features. He understands by UMOM that this is only HIS shame, that others will hardly treat him with contempt, BUT instead of telling someone about his “defect”, showing it, presenting it to others, and seeing sympathy, support in return and participation, instead, a person hides a part of himself in every possible way and conducts an endless internal dialogue, in which he speaks to someone about this "flaw" and endlessly hears - "oh, horror ... how can you live with this ...".
In a psychotherapeutic contact, he has the opportunity to gradually, very carefully try to show to ANOTHER person what is so unbearably difficult to hide, but so scary to discover, and perhaps after some time, not right away, he will gain courage and after he told about himself , will raise his eyes and still consider the real reaction that the OTHER has.

Will the shame disappear right away? Unlikely. Most likely, it WILL NEED TIME and many, many of these "sorties" to really believe that the therapist TRUE thinks so, that he TRUE does not despise the client, the TRUTH does not want to drive him away, TRUE, treats him with sympathy and warmth. And only after that, the client will be able to decide to turn this side of his (the one that has been in the shadows for so long) to other people, to establish relations with them in which he can be present in whole, and not partially.

Psychotherapy is a very special kind of human activity. This is not medicine, not art, not spiritual practice. But at the same time, psychotherapy has all this and something else special. And therefore, what happens at the meetings of the client and the therapist can also be very different. What I described above is just one part of the job, one of the possibilities. I have described it here to show why it sometimes takes a long time to work.