There are a number of approaches to solving this issue, e.g. psychoanalysis with its method of free associations and catharsis while understanding the «primal scene’; gestalt therapy, which aims to modify the expression of feelings through finding a «formula’ of constructive appeal to the «addressee’, etc.
SPT implements a specific approach. In the diagnosis, it suggests turning to body sensations, finding unresolved experiences by their (), and in the therapy (). The special issue is obtaining new experiences. «mass’the technique of «objectification of sensations’– calming downwithout preconditions,the technique of «zeroing’
Phases of work with sensations
Diagnostic phase
1. “Where?” (Sensations, associated with the experience – at the level of head, chest, abdomen?)
2. «What?» (Is it something big or small? Light or dark? Heavy or lightweight? The image of what is it?)
Evaluation phase
1. Can it be bigger or smaller?
2. What parts of the body are «de-energized’?
3. Did it emerge recently or long ago?
4. Under what circumstances?
5. Was it brought from the outside or formed inside?
6. What condition does it correspond to?
7. Does it solve problems or complicate them?
8. Do you want to continue living with this feeling or do you want to part with it?
9. What percentage of your forces is concentrated on it?
10. Would these forces be useful for anything else?
11. Other issues
Therapeutic phase
1. Calming down
2. Suspending
3. Testing of “secondary formations’
4. Application of the forces to new areas of activity
Psychocatalysis of body sensations
The essence of the work can be described as follows: the sensation in the body, corresponding to a certain experience, is objectified from questions about how much it “weighs’, what “volume’ takes, is it “light’ or dark’? After that, a decision about this sensation is made. It is either preserved, “fed’, applied to life in an unchanged or modified form, or, on the contrary, a person chooses to calm down and observes the resorption of this sensation.
After a short conversation, a patient is invited to turn to inner sensation and determine its nature. Where is there an accumulation of heat sensations or gravity? Where, on the contrary, is there a lack of filling?
When the location of the experience is revealed, there is a discussion about the evaluation of this formation which has been subjectively felt inside the body.
If the feeling has a negative impact on the health and way of life of the patient, the therapist invites them to take a decision on this formation or somatic structure. The correct outcome of this part of the work is considered to calm the patients. It is accompanied by the observation of the process of resorption or «shrinkage’ of the specific formation.
At the end of this process, the diagnostic phase is repeated. The key question of this phase is: «What is left in the place of the previous structure?» As a rule, it is defined as something scanty in size, volume, weight, something like or a . Then it is specified once again: «Do you need it for something?» If it is not necessary, the patients observe the cleansing of the body from the rest of the experience that has spoiled their condition. Usually it is done by , etc. In some cases, «the dot’ simply «flies away’. a dotspeckabsorption,evaporation, washing out
The result of this part of the work is the restoration of the balance of sensations in the body. A program of actions for the future is formed based on this state. A new style of behavior is developed for a problem situation to meet what caused a failure in the patients’ condition.
A series of sessions to «clean’ consciousness leads to a new level of freedom for the patients to use their mental powers and to changes in their way of life.
Diagnostic phase
Patients first come to the doctor, not always knowing what to start with. One thing is obvious to them: they feel bad. What is this «bad’ about? How great are the number of the ways to further communication between two people, one of whom is a doctor and the other the patient? This choice of paths depends a lot on the doctor’s viewpoint.
Thetherapist’s viewpoint
“I’ve slipped away from Aesculapius…”
Let’s consider what usually happens when a person turns to the “classic’ doctor. “What are you complaining about?” The complaints are recounted. Anamnestic data is collected. Then an objective examination is carried out: percussion, auscultation, palpation, followed by instrumental and laboratory studies. The sum of the data allows evaluation of the state of certain organs and to put forward diagnostic hypotheses. Differential diagnosis involves the selection of the most likely conclusions from the list of possibilities. In the future, the diagnosis will be refined using “ex juvantibus’, which is a process of making an inference about disease causation from an observed response of the disease to a treatment. The activity of the doctor at the same time is quite large. The patient is enjoined to be “obedient’, “to bravely endure all the hardships of service.”
Thus, the diagnostician in this relationship is a doctor. Their research tool is their «clinical apparatus’ together with devices that are extensions of their senses. Their direction of examination is the state of organs and systems. The position of the patients is to endure everything, as it is all about their functional status (patient is in Latin – «patient’).
Psychiatrists still maintain the impartial study of the psychopathological phenomena, the definition of symptoms, syndromes and «nosology class’ of the disease.
«Well-collected anamnesis is half the diagnosis» – these traditions are inherited by clinical psychotherapy. On one hand, allowing the participation of the patient’s personality in determining their fate, but, on the other, not overestimating the role of psychological factors in the formation of the patient’s condition. (Excessive psychologization is referred to as false psychology). Clinical psychotherapy is interested in the peculiarities of the constitutional and genetic type of a patient. A therapist plays the role of a mentor or a teacher: «a patient’s job is to be ill and a therapist’s job is to study their illness and to prescribe proper medical procedures’.
Healers without any medical training copy the expert in a parodical way. They know everything for their client, they will tell him everything: what was, what is, what will be, who «did’ it to him. Their main instrument is their intuition. They are ready to answer almost all questions, as well as cure all diseases…
There is a clear difference between the content of professional and non-professional approaches, but they do have one thing in common. They give the patient the role of a mute participant. (By the way, not all applicants for help reject such a passive role. Among the clients there are a lot of undisguised supporters of such a position.)
The directive position of the doctor in relation to the patient was especially present in the initial stages of the formation of psychotherapy. Charcot and his school, Pierre Jean, French doctors Lebo and Bernheim were the researchers of the phenomena of suggestion. August Forel from Switzerland did a lot in the study of somnambulism and the phenomena of hysteria, followed by the discovery of the origins of affective symptoms, particularly hysteria by Breuer and Freud. However, their methods also suggested a greater activity of the doctor.
Dialectical method
Laying the foundations of “psychological’ psychotherapy, Freud made a remarkable move towards greater interaction with the patient in the identification, interpretation and subsequent processing of their condition. However, there were “remnants’ of the old “hypnotic’ period of development of psychotherapy: the patient passively lay on the couch, the analyst was separated from them.
Jung was much more inclined to the ’dialectical method’. «If I, as a psychotherapist, feel an authority towards the patient and, in accordance with this, claim to know something about their personality and be able to make the right conclusions about it, then I, thereby, sign my own non-criticality, because I find myself untenable in assessing the person opposing me.» 9
Here is his description of the features of the «dialectical mode of action, i.e. the position avoiding any methods’:
«The therapist is no longer an active subject, but a witness of the individual development process. (…) The analyst here is not a superior, competent, judge and advisor, but a participant in the dialectical process as well as (now) the so-called patient. (…) In the relations «doctor-patient’, two mental systems are mutually correlated, and therefore any sufficiently deep penetration into the psychotherapeutic process will inevitably lead to the conclusion that due to the individual originality of the participants, the «doctor-patient’ attitude should be a dialectical process. (…) It is clear that more complex, spiritually higher standing natures cannot be helped with complacent advice, suggestions and attempts to appeal to a particular system. In such cases, the doctor is better to remove the armor of methods and theories and rely only on the fact that his personality is strong enough to serve the patient as a point of reference and support. At the same time, it is necessary to seriously weigh the probability that the patient’s personality may surpass the doctor in mind, spirituality, breadth and depth… in all such cases, the doctor should leave open the individual path of healing, and then the healing will not lead to a change in personality, but will coincide with the process of individuation, i.e. the patient will become who is in essence». 10
On the North American continent, Carl Rogers and other humanist psychologists have proclaimed confidence in the client’s own abilities for personal growth.
Significant development of this principle is in the NLP, offering to refrain from meaningful instructions and limited only to formal.
Following the client’s process is a fundamental principle of process-oriented psychology.
The risk of affirmations
Reflecting on the danger of affirmations, and even more on suggestion (in particular, in the process of psychoanalysis), V. T. Kondrashenko and D. I. Donskoy note: “There are certain difficulties in the use of suggestion. One of them is that the patient gets used to this regressive form of support and uses it as a prosthesis. The second difficulty arises if the suggestion is used without its subsequent realization. In this case, the suggestion of the analyst is not analyzed and, as a result, the patient may develop a new neurotic symptom complex. Most often this happens when the interpretation is presented to the patient as a dogma.” 11
Thus, suggestion, struggling with one complex, can give rise to another.
To sum up the above, there is a tendency to increasingly trust the capabilities of a person undergoing treatment in determining the process of psychotherapy. The principle of , , is becoming clear. A two-way process occurs when two people come in contact, although one is called a therapist and the other is a patient. There is a search for a solution to the problem when combining efforts. To achieve success, the therapist does not need to play a Superman, all knowing and able to do everything for the patient. interactionrather than impact
A person is a self-organizing system with sufficient resources. All they may need is some assistance in the use of those resources. This is the principle of psychocatalysis which is contrary to the principles of doing something for the patient, whether interpreting their condition or the selecting more useful areas of activity for them.
Somatopsychotherapy (I will try to show) implements this principle to the greatest extent possible. The instrument of «doing’ are . But before we talk about them, we will pay attention to some more general problems related to the self-training of a psychotherapist. questions
Pitfalls
“The clinic drives a psychotherapist,” said prominent Russian therapist S. Konstorum. "…The philosophy of human life… directs the life of the therapist and forms the spirit of their therapy,” K. G. Jung stated with him in unison.
What can prevent us from the realization of these truly golden principles? There are probably reasons for possible failures in their implementation, depending on the patient, but we will analyze what depends on the therapist. «Physician, heal yourself first» (the Church. – Slavic) is a long-known principle. Before you start healing others, follow the advice of the Delphic Oracle «get to know yourself.» (And change yourself – A.E.)
The merit of the introduction of the principle of preliminary and parallel analysis of the analyst themselves belongs to Jung. The need for this was also recognized by Freud.
A somatopsychotherapist, no less than the psychoanalyst or the Gestalt therapist, needs to study their own state, to know the tendencies of their reaction and the nature of their character.
Tendencies of character
In accordance with your personal character: mainly schizoid, cycloid or epileptoid – you may need to track tendencies for: . complication, self-admiration, domination and for commanding
The presence of asthenic traits in the nature of the therapist can lead to the development of the patient’s parasitic traits.
Neurotic complexes
It is obvious that the psychotherapists’ own traumatic experience and the presence of their unresolved life issues can complicate the process of psychotherapy. It is discussed in detail in different literature, and I will not dwell on this further.
Cultural stereotypes
Having accepted the fact that psychotherapy is not an area of self-affirmation for the power-loving, nor an area of self-gratification for the sweet-loving. It is also neither an area where excessively smart people feed their pride (nor an area of self-torture for a “good’ one), nor indeed, a sphere for solving neurotic problems of the psychotherapist, let us pay attention to the following:
Even if we assume that a «perfectly balanced’ person, who has undergone a long personal psychoanalysis or other thorough therapy, is engaged as a psychotherapy practitioner, that is to say, this person is pure in the sense of the absence of any tendencies to solve their own psychological problems when in contact with the patient; this «ideal’ psychotherapist still risks falling into «activism’.
It is difficult for a doctor to trust the «uneducated’ mind of a patient. They are used to being an expert, a specialist. They know the terminology to denote the patient’s different states. They are competent to prescribe and cancel medications, discharge the patient to work or leave home. They are responsible for the life of the patients almost more than the patients themselves.
For the psychologist it is not easier to tune in to a trusting attitude towards the client. Although initially, they are more «consultative’ and can imagine that, as a specialist, they must be «smarter, stronger, more agile’ than their ward.
For me, falling into all these «traps’ as a result of being interested in my self-development of the «purity of doing’, it became important to track my characterological response, my own neurotic problems and tendencies, which had appeared in the course of my previous professional life.
Below are some examples of my self-analysis (in the manner of «somato-analysis’). I also mention some of the experiences that I have gained through participation in a special program.
Remarkable school
For me it was a remarkable schooling to observe and then participate in the practice of addressing the problems associated with alcohol abuse (and complex problems) according to the methodology of Croatian psychiatrist Vladimir Hudolin. I got acquainted with this approach (called ecologic, family, systemic) in Italy, where I was invited thanks to the inter-confessional cooperation of the Russian Orthodox and Roman Catholic churches.
The so-called operators consider themselves to be a of the process of staying sober and sees their task as so much doing something for the families, but rather to create conditions in which the families themselves, having problems associated with alcohol consumption, can do what will save them. facilitator
If an «active’ approach is used, the alcohol addicted patient is usually «coded’, «torpedoed’, if not sent for the «compulsory treatment’ to the institution of a prison type. The new program of the environmental approach sometimes suggests leaving such a patient alone and start the treatment by changing someone in their family.
The essential point is the «return of responsibility’ («recuperare la responsabilita» in Italian) to the members of the club (the community of families) for the process they are going through. Practically this is achieved in the following way: meeting, «chronicle’, support to absent participants (patronage), the preparation of tea and other things are conducted by the members of the club at a time. The operator only cares about the safety of the atmosphere in which all this is done. Developing the pooling of experiences and resources of club members, they ensure that forces are not wasted on talking about politics, football, etc., thus restricting the simple rules of life in this community of self-and mutual aid: to just talking about the present and to rely on their own collective experiences.
In contrast to the common methods of «healing in one day’ (such as the above mentioned «coding’ or «torpedoing’), this environmental approach gives much slower results, but is incomparably more reliable. The result of the club meetings is directed to the future, to the life of the descendants of the club members. This result is not limited to a period of 12 months or 5 years.
In connection with my participation in that Italian program, I thought of a «plant’ agronomic metaphor. What will the gardener take care of while planting beets in his garden? About the soil and light of course, but he will not try to grow it himself instead of a beetroot. Likewise, it is especially important to the doctors to understand the limitations of their competence and not to overdo it. In the end, the patients are saved by their own effort, not only by the activity of the doctor. This is my conclusion.
Get some rest!
The doctor see the problems in the form of objects, like a psychic, or guess their location from the “weak signals’ or detect them by testing or infer their presence in many other ways not unlike famous detectives. On the other hand, psychocatalysis specialists will refrain from the open use of their “brilliant abilities’ and their trained “clinical machine’. During work sessions with patients, they will leave their knowledge and intuition out of the equation, trusting the abilities of the mentee. By answering questions, the patient develops the ability to visualize and can even find a path to enlightenment. Questioning is of crucial importance to the process of somatopsychotherapy. can
Of course, this does not negate the importance of the training of an «assistant’. Both clinical and psychological preparation is extremely important. Understanding the human character, the peculiarities of nosology classification, the dynamics of experience significantly accelerates the therapy: the ability to ask relevant questions is a great art. However, trust in the patient’s ability to respond in any case remains truly relevant.
One of the components of the internal training of the questioner, including the key to their ability to withstand the intonation, to provide the choice of an answer to a patient, is the understanding that . This is one of the postulates of the patients are able to determine their own feelingstherapy through questions about body sensations.
The research tool
The technique of the « falls under the category of indirect methods. This means that it «includes’ the initiative of the patient and activates his ability to determine and change his state. The solving of this problem is based on the amazing, but usually unused human objectification of feelings’ability to self-diagnose their own condition as specific images of objects.
This process is called psychocatalysis, by analogy to a catalytic chemical process: there is a «substance’ that can change its state – a petrified emotion – and there is a psychotherapeutic influence (the catalyst) without which this process is difficult, slow or stuck. When they are combined, a «miracle’ occurs.
The patient’s attention is the main active element but is expedited by the catalytic effect of psychotherapist’s questions.
There are two main questions in the diagnostic phase: WHERE and WHAT.
“Obstetricians’
Socrates, with his “skill of midwife’, more than 2000 years ago showed the effectiveness of asking in a philosophical conversation: “People, when being asked right questions, decide themselves what is necessary…». The discovery of the role of questions as “birth attendants’ is perhaps as significant in the field of interpersonal communication as the discovery of the wheel in technology. 12
The effectiveness of questioning, instead of stating, was noticed by many wonderful masters not only in philosophical circles but also by the medical «maieutic’. (The Socratic Method, also known as maieutic is a form of cooperative argumentative dialogue between individuals, based on asking and answering questions to stimulate critical thinking and to draw out ideas) .
I mean not just ancient the Zen Buddhist teachers with their unanswerable questions («How does one-palm clap sound?»), or the Sufi sages, or Orthodox saints, who, by asking questions, revealed the «soul problems’ of their disciples, spiritual children, no worse than a surgeon with a scalpel reveals ulcers. I am also talking about the masters of psychotherapy.
It would be difficult to describe their work here. After all, even a benevolent silence, a willingness to encourage and to support the mental movement of a patient is also a kind of a question – silent and at the same time the deepest one. «Tell me anything you want.» When I talk about such silence, I mean the empathic acceptance of Carl Rogers, creating a space for safe expression of a client, or a «gap’, the willingness to patiently wait for the manifestations of a patient’s activity, of Arnold Mindell, as a fisherman waits for a bite. 13A question creates an area of negative pressure that is ready to take into its form what it is waiting to be let out. The task of a psychotherapist is to model capacities for meaning.
Questions are a natural part of the life process
We are going to talk about the questions that people can ask their body, but I have no doubt that the body itself is able to ask questions. In particular, with the help of dreams. Wakefulness is the “answer’ to dreaming. The dream poses a problem and real life serves its solution. You can say the opposite: a dream is a response to wakefulness. The life itself is questions and answers.
Psychotherapy and somatopsychotherapy, as part of our life, does not invent anything unnatural, it does not deal with something artificial. It only cleanses and gives patronage to everything natural.
The terms «facilitation’ and «amplification’ are well known. I use the term «’. The fact, that psychocatalysis applies to the inner body sensations, became an important opening of the Russian school of BEST by E. I. Zuev and the basis of the development of this «question’ therapy. psychocatalysis
«Ask me questions,» a patient often says, dropping themselves into a therapist’s chair (as if surrendering»). Who will do it, how will it be done, and what for?
The Key question
We can say that each system of psychotherapy has its own key question. (This does not automatically mean that it works by questions – and yet…)
The question of clinical psychotherapy: dynamics of what constitutional genetic type manifests itself in the experiences and events of this person’s life?
The question of psychoanalysis: when, under what circumstances, what affection of Id and prohibition by Super-Ego encountered in Ego and provoked the complex?
The question of Jungian therapy: what kind of distortion in the conscious life of the patient makes their subconscious mind «to take measures to equalize the situation» and «what exactly should a person do to regulate their relationship with the unconscious?» 14
The question of Gestalt therapy: what is the need of the body which makes the «figure’ now, what is the «background’, what prevents the Gestalt from «closing’, what unfinished actions prevent a person from living «here and now’?
The question of NLP: in what modalities and submodalities there is the information that affects a person, how they «manage’ to be upset or, on the contrary, spirited. And so on.
The SPT question
At the diagnostic phase of SPT, a that deranges the patient’s consciousness focusing the energy of the body on itself (the substance “heat-heaviness’) is found. charge
The question that helps to find to this «charge’ is usually very simple: where is the sensation associated with a particular episode of life, with a particular fragment of a dream, with a particular picture, which the patient drew on the instructions of the doctor? At the level of head, chest, abdomen, or anywhere else? Is it something big, small, light, or dark? What is it «made of’? And so on.
Below we will take a closer look at the options of talking to patients, depending on how they declare their problem.
In fact, SPT offers the patients to think about a simple thing: how are their sensations distributed when they solve problem? Or simply? this: how are their sensations distributed? Is there anything that disturbs the optimal distribution of sensations in the body? Is anything missing to feel good
Where does the heat in the arms and legs reach? Are there any uncomfortable sensations concentrated at the level of an area of the body?
I will allow myself a short historical excursus.
Do not wait for any hair to appear on a tortoise shell
Before somatopsychotherapy I had a few years of practice in clinical psychotherapy.
What are its obvious advantages? Firstly, it is the interest in the constitutional and genetic basis on which certain mental processes are developed. A clinical psychotherapist at the first stage of communication with a patient finds out the specific features of the mentality of the latter, and at the last stage they help a patient to see the world as a meeting of different forms of life, each of which has their own purpose. The ultimate achievement of successful clinical work is the patient’s inner peace and tranquility based on self-acceptance as a certain natural entity, endowed with their own character, accepting others as well! «Do not wait for any hair on the shell of a tortoise,» says Taoist wisdom, quite «clinical’ in its essence). This is a substantial part of the work of a clinical psychotherapist, but I would like to draw your attention to something else.
“Storytelling’
A clinical psychotherapist pays much attention to the baseline state in which the communication between a doctor and a patient takes place. Even the most correct messages can be received by the patients only when they have a free resource for this. The fact is that their resources are mostly spent on tension and neurotic experiences.
Johann Schultz is known to have researched and described the basic sensations that a person experiences in the process of relaxation. They were named «six exercises of autogenous training’. A pleasant and fill up the body then turning into a pleasant lightness and freshness. beats calmly and evenly. is free and even. emits warmth. is slightly cool. heavinesswarmthThe heart BreathingThe solar plexusThe forehead
The state of the patients when «pleasant warmth reaches their fingers and toes, and the roots of their hair’ is healing in itself. In clinical psychotherapy it is also the background for the patients to accept themselves, the situation and to adjust to a successful way out of difficulties.
It should be noted that sometimes this part of the work is not the second, but the first one: instead of talking to the patient in their «abnormal’ state, the therapist invites them to the session, which is called «learning auto-training’, «hypnosis’ or something else. Only after nonspecific calming in a cozy environment, under the influence of relaxing music, words of «comfort’ with the lulling intonation, and storytelling, the patient is «taken’ to more specific work.
The psychotherapeutic “swing’
At the early stage of my professional development my working combination was . After discussing with the patients their important issues, I offered them to close their eyes and . Partly, that was the pre-system of the work I am describing now. conversationplus relaxationlet the feelings to be distributed
– this rhythm began to seem more natural and important. It is a kind of a . The second part (hypnotic and auto-training) changed its tone in the process of «working out’ this practice. If, at first, I tried to imbue something to the patients at that phase (based on the material of the previous study of their problems), then later I refused to be directive and often offered just to observe the sensations after the conversation, to let them «lie down’. Conversation-relaxation-conversationpsychotherapeutic «swing’
The questioning observation: question without question
Offering patients to observe what happens after a usual empathic hearing often leads to surprising results. Patients connect to their body sensations, fall into a kind of trance, and undergo a series of transformations, often spontaneously describing the process that, in fact, is organized by in. psychocatalysis somatopsychotherapy
The stones of unease can be detected and disintegrated, sensations can move actively from one area of the body (overfilled) to another (devastated), completely new and optimized contours of sensations can be formed. The convalescents get into the new spaces, from which they come back renewed. It is like . Conciliation, calming down, and rebalancing occur spontaneously, in accordance with the «program’, which the body choses itself. auto-trainingwithout instructions
He sat down and began to describe
Recently, I was impressed by a kind of echo of my old “mute’ practice (mute, because it has a minimum number of questions with maximum confidence in own healing process of the body). This story is about the transformations that a twelve-year-old boy began to experience, as soon as he sat down on a chair and heard the words: “Close your eyes. Describe what you feel.”
The boy had a weakened immunity of unclear genesis. He had been suffering from furuncles for a long time. The last two months he was continuously treated for submandibular lymphadenitis (there was a crack in the corner of his mouth, through which he, apparently, got the infection). Two operations under general anesthesia were unsuccessful. He underwent a lot of bandaging, and there was constantly a tubule for drainage in his wound. Of course, he had to forget about going to school.
The boy was brought to me just after he had been bandaged once again. He sat down on a chair and fell into a special state of connection with attention to inner sensations – a kind of trance. He began to describe his sensations in detail without any instructions from me, except for the most general one: «Watch and describe.» The boy understood the main instruction perfectly, though it didn’t say: «Heal.»
The movement of sensations was very intense. The terrible heat was gathering in his chest and there was the feeling of a huge furuncle.
«Will you let him break through?»
«No.»
The boy felt as if he «put his hands in the oven’, then two dinosaurs were fighting in front of his eyes. Then, after a bright flash, everything disappeared.
First, his head «weighed 300 pounds’, then his legs did. Then «a worm slid on his hip and jumped out,» and «a turtle with a small shell, a long neck, big eyes and a silly smile made him laugh’. At last, being weightless, he began to «flip’ in the air.
«Count how many times.»
«Five.»
He began to «flip’ in the air again. This time he had ten «flips.»
A series of transformations, which lasted for about thirty minutes, ended with the formation of a sensation of even heat throughout his body, and the boy felt the opportunity to open his eyes.
A lump of cottage cheese
I was interested in following the outcome of his healing after that process of spontaneous self-regulation. I asked about the condition of the boy in a month. He was healed. Two months later I met him once more.
He maintained balance in his sensations. He enjoyed playing with his friend. «Everything is good. I can play and jump,» he said. Only a small crimson scar under his jaw reminded about his former problems.
«Scars adorn a man,» I remarked.
«I have got enough of them,» my little patient said proudly
The boy reproduced the dynamics of recovery: steady internal heat remained after our meeting. «We were going to take him to the regional center for a more massive operation, but the need for this somehow disappeared by itself. The wounds began to heal,» his mother added. We communicated with him on February 8, and on March 8 he was already at school. Later his health was improving steadily. His relatives noticed that in he also became calmer. thth
At the end of my communication with the boy his aunt expressed a desire to talk with me about her problems. It was an indirect sign of recognition of the connection between the session and the recovery by the boy’s relatives. A large lump of fresh cottage cheese, which I brought to Moscow to my children, seemed to me a great reward for my modest question: «What do you feel?»
When you can let happen transformations like those, described by my little patient, nothing else is necessary.
In a few other cases, the challenge is to . Such transformations are the essence of therapeutic achievements. make the sensations flow
Do not talk
To tell the truth, sometimes I almost fall asleep when the patient tries to describe in detail the story of his suffering, not hurrying to work through it. It happens not only to me. In the “Technique and practice of psychoanalysis” Ralph Grinson especially considers such cases when a psychoanalyst accidentally falls asleep during a psychoanalysis session. He recommends not to blame the patient. I can cope with it even without pinching my own hand, but I do not tend to overestimate the effectiveness of this method of psychotherapeutic session and try to warn the patient about the uselessness of just listing the facts.
To avoid this, at the of a significant event for the patients, which left a mark in their soul, I prefer , to verify the expediency of its storage, instead of being limited to a simple listing the imprints of events in their soul. I call it . first mentioningto work through the consequent of their experiencesthe non-slip principle
Though it is possible to talk as well
However, I must note that there is no need to impose a rather closed, non-objective language of body sensations, when a person calls for an open conversation on existential topics and the balance of their state is not in doubt. Indications for SPT method are very wide, but not unlimited It is needed in almost 100% of cases, but it is not the only thing that the patient may need. Thus, the psychotherapist is not obliged to use the methods of SPT always and everywhere. . It is the way to restore the resource of a person.
We will continue to talk about situations where the balance of the human condition still raises doubts.
The ending – to the beginning
With the time, the phase of communication between the doctor and the patient, conventionally called the “relaxation phase’, became increasingly valuable. I learned to perceive it as a kind of goal, the culmination of the process of psychotherapy,
I once noticed that I was not at all inclined to talk to a patient. Of course, I mean «conversation of minds.» Taking into consideration the importance of the influence of affective charges on a patient’s thinking, I found out that it made sense to «talk to the boss’ (unconscious), in the words of M. Erickson, and not with subordinates (thoughts of conscious mind).
It was easier to find «the boss’ by the sensations in the patient’s body.
The direct appeal to the sensations from the very beginning of the work marked the opening of a unique opportunity to change the state directly (in the usual meaning of this word). The old formula «conversation – relaxation – conversation’ was replaced by a new one: . , without talking«relaxation – conversation – relaxation’
The idea, that the analysis of the patient’s circumstances was usually given an exaggerated value, began to strengthen. In fact, , but It is important to help a person to take a different position in relation to the circumstances, to find another their state. The further is the matter of their own life. not these circumstances are so importanthow the patient «stands’ in them.
The second phase became the first.. Somatopsychotherapy is an exceptional care for the patient’s condition. Conversations began to start with the analysis of a condition, instead of a situation
Separation of the concepts of “patient’s condition’ and “patient’s problem’
Often the conversation with the therapist flows into the area of discussion of the patient’s problems. I think this is a minimally productive approach. But firstly, let us define what there is besides the patient’s problems.
«The patient’s problem’ is what makes the body react. The perceived information about the situation inside or outside the body, deviates from the optimal. So, the persons consider the restoration of its optimality to be their vital task. This is the basis for their concern.
What is meant to solve the problem is the patient’s state. This is the life resource, the certain configuration of sensations in the body.
Perceptions of situations and responses to them vary widely. What is a difficult problem for one, is nothing for the other; when ones react with all their beings the others can stay completely indifferent. This observation makes you think about the in which a person perceives the situation, evaluates it and forms a reaction to it. The constitutional and genetic factors, the early history of the individual and so on, play an important role in the formation of the patient’s state. It is important that by the time of the meeting with the psychotherapist, the result of the life of this particular person (with his genes, personal history and education) is presented in the form of a state with a certain configuration of internal sensations. initial state
Temperature above 39 degrees
There is a number of situations when the patient’s condition itself (for example, tension) is a problem. As the temperature in case of inflammation goes above 39 degrees. The increase in temperature is natural, of course, but not to such an extent.
Entering the psychotherapeutic room, the patients do not always know what they did it for: in order to solve their problems, or to change their condition. (The third option is the question of how to constructively apply their condition to the problematic situations without changing it a lot). In fact, the problems of the patients are solved outside the therapeutic room. They come here and to optimize it. to rate their state of mind in which they try solving the problems
Psychocatalysis of body sensations is and restoring their resources. It is not about solving their problems, unless, we consider the state of their health a special problem. In this case it is a «metaproblem’, the solution of which determines the solution of all other problems. a method of changing the patients’ state
Separation of the concepts of “psychotherapy’ and “exchange of experience’
