Text: Ekaterina Sigitova
A CAMPAIGN TO A PSYCHOTERAUTIST many still experience it as a serious overcoming, almost a revolution. In American films, heroes go to psychotherapists as if they were going to work; in Russia, making an appointment is a turning point, which not everyone dares to undertake. And in vain, because conditions like depression are not a whim that you have to cope with on your own, but a disease that can be treated. Choose good doctor In general, it’s not easy, and finding a suitable psychotherapist is doubly difficult. The market has not yet formed - there is a big risk of running into charlatans or simply incompetent people. The costs of making the wrong choice are very high: the patient will suffer psychological trauma and will have difficulty accepting even qualified help in the future. We asked Ekaterina Sigitova, a psychiatrist and psychotherapist, to tell us how to avoid mistakes.
What kind of education should a psychotherapist have?
A good psychotherapist must meet a set of mandatory criteria - have a kind of “minimum package,” a package of guarantees necessary for the healing process to begin at all. In countries with strict legislation, therapists who are unable to pass these procedures are eliminated or given additional training so that over time they “grow” up to the standard.
The psychotherapist must have training in psychotherapy itself or psychological counseling. International level implies no less three to four years training. This education can be obtained from scratch or in addition to higher education: psychological, medical, or any other. It is important that higher education in itself and even specialization in psychiatry do not provide an opportunity to work as a psychotherapist.
Exist certain features training and work of psychotherapists in Russia. On the one hand, there is a clear definition: psychotherapist , according to the law Russian Federation, this is a professional with a higher education medical education and two specializations (in psychiatry and psychotherapy) for a minimum of nine months. On the other hand, in everyday life the word “psychotherapist” is used to refer to everyone who has something to do with working with the psyche, including psychiatrists, psychologists and consultants.
The more clients a psychotherapist has, the higher the likelihood of effective help.
It’s very good if a specialist has already led and is leading clients - then the likelihood that he will be able to help you increases. The more clients there are, the higher the likelihood of effective assistance, because with experience not only knowledge accumulates, but also the number of hours of supervision and personal therapy increases. If the specialist has focused counseling experience (for example, working with pregnant women or with victims of abuse), then this is an additional plus for those whose situation is similar.
Unfortunately, the legislation regulating psychotherapeutic services in Russia is in its infancy. No requirements for professional level, no clear code of ethics, no uniform certification procedure, no state register specialists. There is no protection at the legal level, both for clients and for the consultants themselves. As a result, the number of strong professionals corresponding international standards, in Russia is small.
Why do psychotherapists undergo therapy?
Experience in your own personal therapy is required. To obtain a certificate as a psychotherapist, in most cases, 50–100 hours of personal therapy are sufficient, for membership in associations of psychotherapists - from 200 hours. This minimum required so that the therapist's own problems are not unconsciously brought into the work with the client. Personal therapy is also important in the context of a professional’s stability, his safety for clients and himself, and compliance with ethics and laws. How more hours therapy, the less likely it is to engage in unethical behavior and abuse of power. Many psychotherapists continue personal therapy for many years.
Another important criterion- supervision, during which a professional, together with a more experienced psychotherapist, analyzes work with clients, comprehends the methods used, exchanges experience, and understands how to correct mistakes. Supervision is mandatory for all practicing psychotherapists, both beginners and experienced ones. 40–50 hours are sufficient for certification, but 100 hours or more is good, and 200 hours of supervision is required for membership in therapist associations.
Personal therapy is needed so that one’s own problems are not unconsciously brought into the work with the client.
A supervisor is an external observer, and that's what he's for. Any phrase or question uttered by a psychotherapist during a session may come from his personal experience and personal “picture”; of course, they may be relevant and adequate to the client's experience and goals. But this does not always happen; the probability of a coincidence is not 100%. This is not scary and does not always lead to any damage, but it is difficult for a psychotherapist to see and realize this while being inside the situation. Therefore, the supervisor catches such “controversial” moments in sessions and discusses them with the therapist. He also evaluates how well the work complies with the principles - including ethical ones - of psychotherapy. In some countries, the supervisor is responsible with his license for the safety of the clients of the therapist he supervises.
What ethical principles should he follow?
Compliance ethical principles psychotherapy means that the specialist does not go beyond the scope of his competence, openly and honestly talks about himself and his methods of work, ensures the confidentiality and safety of patients, and complies with the laws. The ethics of a psychotherapist is the main thing that confirms the safety of interaction with him. If the ethics are in order, then you will receive all the information you need to make a decision about whether to become a client.
What else wouldn't hurt?
The rest are bonuses, and their absence does not affect the quality, efficiency and safety of work. However, if they exist, this can add points to the selected specialist. For example, an academic degree of candidate or doctor of science; however, it does not always mean practical benefit in working with clients when we are talking about science in pure form. To find out for sure, take an interest in the topic of the work - professionals whose dissertations are practice-oriented will be happy to mention them. For example, I openly tell patients that my doctorate is on bipolar disorder.
Certificates from seminars and conferences show that a specialist is constantly studying new methods and approaches - which means he is aware of the latest research, constantly improves and communicates with colleagues. Please note that not everyone has the actual opportunity to travel somewhere regularly - so if your specialist does not do this, this does not speak badly about his competence. Perhaps at the same time he writes articles - it makes sense to read them in order to get an impression of the approach and style of work, since the personality of the therapist plays an important role in treatment.
The therapist's personality plays
not the least role
in treatment
Additional education in other areas of psychotherapy is a definite plus, allowing you to combine methods and techniques. But education also requires a serious investment of time and money, and not all psychotherapists have such opportunities. Membership in associations or work in psychotherapeutic centers - important point, meaning recognition of a specialist by the professional community. Psychotherapists who are members of associations and work in well-known centers and consulting studios have, as it were, passed a “filter” of their colleagues. If a psychotherapist is avoided by colleagues or he himself avoids them, this may be an alarming sign.
What if the psychotherapist is a beginner?
Every experienced professional was once a student, and everyone had their very first clients. Many people do not want to contact beginners and, of course, they have the right to do so, because such work has its disadvantages. The main thing is little or no experience. Such a psychotherapist is, of course, able to work and help, because he has learned this, but he will still have certain limitations and difficulties. Another disadvantage is that you can hardly find information about it. He does not yet have a reputation, recommendations and reviews from clients, or recognition from colleagues. It is unknown how he observes ethics and how he relates to something that is important to you personally.
But the advantages of psychotherapy for a novice specialist or student are also significant. First of all, it is low cost or even free work, which is important for those who cannot highlight big budget to an experienced consultant. The second plus is, oddly enough, safety: beginners often work very carefully and delicately, carefully undergo supervision and personal therapy, and do not use provocative methods. The third plus is great personal involvement: beginners sincerely invest themselves in the work process and try to give their best.
Sometimes, in order to get all these benefits, you have to take some risks. Moreover, many professionals with many years of experience successful practice do not meet absolutely all of the above criteria or international standards. Perhaps it makes sense to soften the selection, because it is better to receive help than not to receive it at all due to the fact that we had to weed out all the “undesirable” specialists.
When should you contact only experienced psychotherapists?
There are cases when you need to be very careful and even strict when choosing a specialist: these are severe psychological trauma, experience of relationships with violence and abuse (including in the family), mental illness, addictions, disorders eating behavior, suicidal and auto-aggressive behavior. In all these cases, it is better to choose experienced, high-level specialists with all the required criteria, and, ideally, undergo therapy in person, rather than via Skype.
Remember that you deserve care and respect. You have the right to ask what is important to you and choose a therapist based on the answers you receive. There is no shame in being picky and picky; a meticulous client does not cause aggression or anger in a professional. It’s nice to answer thoughtful questions, because a serious approach to choosing a consultant you can trust means seriousness in the work process itself. The main thing is that doctors and patients are on an equal footing - and both sides can freely choose.
Search good specialist- it's always a lottery. You can lose money, time, energy, hopes. You can even worsen what you wanted to improve (for example, your state of mind). This applies to many specialists: doctors, lawyers and, of course, psychologists. The possible costs of trial and error are risks that must be accepted. Otherwise, it’s better to do nothing at all.
However, by taking risks, you need to increase your chances of finding a really good psychologist. How to do it? - a responsible event! Try to follow the following rules, which do not guarantee finding a good psychologist, but increase the chances.
1. It’s great if you turn to a psychologist on the recommendation of friends you trust. This is a guarantee that this specialist is not an obvious amateur or, worse than that, scammer. Those. He has already helped someone. If you don’t have friends who can recommend a good psychologist, you have to look for it yourself. Most psychologists have a website on the Internet. See if there are reviews of this psychologist’s clients on the site. A good specialist should have them. He has something to be proud of and nothing to hide. If there are reviews, see if they look reliable, at least at first glance. If all reviews are written in the same style, and they are not accompanied by a photo or any other characteristic details, then it is possible that they were written by a PR manager this psychologist or even the psychologist himself. What do you want?! In the market of any services (and in psychology too), unfortunately, client deception happens. Be careful! Just don't get paranoid. The world is full of honest, competent specialists. Don't see everyone as a scammer.
2 . Do not really trust well-known, popular psychologists, excessively public people who constantly appear on television, as well as specialists with great scientific merits. Popularity in our time is a matter of “promotion”, i.e. luck and money invested, not competence. And high scientific achievements, as a rule, indicate the practical helplessness of a specialist. It is not for nothing that there is a division between theorists and practitioners. You and this person will not have to deal with science, but with the practical matter of helping your soul! Popularity on television and achievements in science are all good, it inspires respect, but all this has a very distant relation to practical psychological counseling and practical psychological assistance. A practical psychologist who works with clients every day will be much more useful to you than a psychologist who is a television star or a psychologist who is a great scientist.
3. Do not hesitate to ask a specialist psychologist about his education, work experience and his specialization (i.e., what exactly does he do in psychology). There are a huge number of pseudo-psychologists on the market: healers, teachers, psychiatrists, sociologists, TV presenters, etc. After all, it is very easy to declare yourself a psychologist. Most of these people don't mind making money from you. Do you need this? A good specialist psychologist, as a rule, has a diploma from the Faculty of Psychology of a reputable university, practical (!) work experience of three years and a specialization (or advanced training courses) in the area that interests you. Excessive breadth, when a psychologist deals with “psychology in general,” usually indicates a low competence of the specialist.
4. You came to a psychologist for a specific result - an improvement in your state of mind. You pay money for this, waste time and hopes. So, after each visit to a psychologist, look to see if there is at least a minimal intermediate result of your efforts. If not, don’t believe in any “later”. In Freud's time, the number of sessions before the first noticeable results was measured in tens, or even hundreds. And now assistance technologies have stepped far forward. The first changes that are noticeable for the client occur at the first, or maximum at the second, session of psychological assistance. If this does not happen, look for another specialist! Many psychologists also like to prescribe huge (dozens of sessions) courses of psychotherapy. In addition, meetings must follow a schedule that cannot be violated. The commercial logic of such “psychotherapy” can be understood - a regular client and regular income. But over twenty years in practical psychology we do not know many cases where such large courses psychotherapy would REALLY be needed by the client. And in order for a psychologist to have serious grounds to assert that this is what you really need, he must, at a minimum, know you well: psychodiagnostic data, your life history, your psychological trauma, the characteristics of your social environment, etc. And if a psychologist claims at the first meeting that you need a large, serious course of psychotherapy with dozens of sessions or psychological training, stretched out over months, then the chances are very high that the psychologist is simply trying to use you as a “cash cow”.
5. After reading previous point, do not fall into extremes of demanding egocentrism. Do not demand from a psychologist that he quickly solve all your problems for you: personal, social, economic, etc. (One client of ours asked for an island as a gift). This will never happen anyway. Solve problems together with a psychologist! Solve problems step by step one by one! Subject to the competence of the specialist, reasonable time spent and mutual cooperation you will definitely receive effective assistance. And remember that effective psychological assistance is always the result of the work of two parties: the psychologist and the client. If help is not provided or is provided poorly, then perhaps it is necessary to change the psychologist, or perhaps it is time for the client to start following the psychologist’s recommendations. Unfortunately, sometimes people go to a psychologist not for changes in themselves, but to “just talk” or to draw attention to their experiences. (They don’t follow through with anything recommended; they don’t even mind the money spent). Of course, we can talk. Attract attention too. But there is no help. What they came for is what they got.
6. Make sure that the psychologist does not project himself and his personal experience onto you. That is, so that in a specialist’s speech phrases like: “But I’ve had it in my life!”, “I know for sure from myself!”, “But my wife (husband, children)...", etc. .P. Analyzing your personal and family life experience, a specialist cannot say anything for sure about you. All people are different! This is called helping others from your own own problems or, to put it professional language, the phenomenon of projection. Run away from such a specialist. Let him first deal with himself and his problems, and only then try to help others.
7. Avoid psychologist-gurus who immediately understand everything with you literally after half an hour of conversation. Of course, it’s good if a specialist “sees right through you,” but it’s bad if he tries to quickly classify you and “label you with a diagnosis.” This is not always adequate even in psychiatry. And in psychology we deal with, as a rule, healthy and always very complex people. If a specialist quickly categorizes you, then he inevitably simplifies everything. Then he is unlikely to understand the subtleties of your soul. Such a psychologist, as a rule, is more occupied with his greatness and abstract insight than with the psyche real client. Look for a specialist with whom you will explore your personality together. If a psychologist is ready to honestly admit that something in your psyche is not completely clear to him, this is very good sign!
8. A competent specialist in the field of psychological assistance must be non-judgmental. For him, you are neither bad nor good, but a person in need of help (no matter what you have done before). So let him keep all his moral judgments to himself and go about his business - saving you from a mental crisis.
9. If you receive psychological help in a group of your own kind (group psychotherapy or group training), then you should still feel individual approach and personal attention to you. Be a reasonable egoist in this matter. What is more effective, group forms of work with a psychologist or individual ones is a question that does not have a universal answer. In some cases group classes are better, and in others individual meetings with a psychologist. But in any case, you should feel that at the moment of work, for the psychologist, you are the center of the Universe. This does not mean that the psychologist indulges your every whim. This means that the psychologist concentrated all his intellect and all the strength of his soul on helping you.
10. For a good psychologist, the time he spends on you is limited to the end of the working day (and then very approximately), and not to hours and minutes in the client’s appointment schedule. All people are very different! Nobody knows when a psychologist will be able to break or outwit the “donkey stubbornness” of your psychological defenses and help you despite the fears and resistance of your tormented psyche. A good psychologist is at the same time a scientist, an artist, and a doctor for your soul. The result that you and the specialist will receive at the end of the session cannot be time-regulated in advance. If a psychologist is ready to interrupt a psychological assistance session simply because the time allotted to you in his schedule has ended, then perhaps such a psychologist is a good manager or good businessman, but what do you care about that?! You need help, not the business success of a psychologist!
11. If the psychologist is a private trader, then the psychologist has an official work permit, a cash register, etc. – this is the relationship between the psychologist and the state, and not with the client. It’s good if the psychologist has all this, because... this undoubtedly characterizes the stability of the presence of this specialist in the market of psychological services. If a psychologist has already spent time, effort and money on official registration and taxation, then he does not expect to work until the first dissatisfied client, and then quickly disappear. He strives for stability. Such a psychologist is more trustworthy. But, strictly speaking, this has nothing to do with the competence of a psychologist. In reality, the state has no control over the competence of private psychologists. But an official work permit indicates at least the psychologist’s relatively long-term plans, and that he is familiar with the sense of responsibility.
12. If a psychologist works in a serious psychological center, this does not mean at all that he is competent. Any organizations and corporations (psychological and non-psychological) hire and fire specialists for a variety of reasons, very far from their competence. Be realistic. We live in Russia.
13. Preference for a private psychologist at home or a hired psychologist in a psychological center is more a matter of ideology and faith than the real advantages of one or the other. Focus on your personal impression of the person, and not on his place of work. It is reasonable to come for a short, easy consultation and then draw conclusions about the specialist. This will not ruin you and will protect you from serious mistakes. A mistake in choosing a psychologist can really be dangerous for your well-being.
Well, and there is also just luck, intuition and a burning desire to get rid of your psychological problems. Then the person will still achieve his goal. Because, “if the patient wants to live, then medicine is powerless!”
© Authors Igor and Larisa Shiryaev. The authors provide advice on issues of personal life and social adaptation(success in society). You can read about the features of the analytical consultation “Successful Brains” by Igor and Larisa Shiryaev on the page.
2012-01-02Analytical consultation Igor and Larisa Shiryaev. You can ask questions and sign up for a consultation by phone: +7 495 998 63 16 or +7 985 998 63 16. E-mail: We will be happy to help you!
You can also contact me, Igor Shiryaev, at in social networks, instant messengers and Skype. My social media profile is personal and not business, but free time I can chat with you on social networks informally. In addition, perhaps it is important for some of you to first formulate your idea of me not only as a specialist, but also as a person.
In previous publications in the “” section, we have repeatedly focused on the fact that of the many difficult situations It’s much easier and faster to find a way out by turning to a specialist for help. And if you - at least theoretically - already assume that someday you yourself or your family members will turn to the help of a psychologist (psychotherapist, psychoanalyst), then the following interview will be useful for you.
Our regular guest, , will tell you exactly what problems a specialist of this profile helps solve, and what problems he will never take on. How is the interaction between a psychologist and a client built, and on what does the success of psychotherapy depend? How to choose the “right” consultant and the direction that will most effectively help you deal with your internal contradictions?
Psychologist – who is this?
— Alexandra, in Russian society Traditionally, there is prejudice towards psychologists and psychotherapists. What do you think this might be connected with?
— First of all, with a lack of knowledge about this profession. In the West and the USA, psychotherapy in the 20th century. I've already done this confident steps and brought revolutionary results, and in the USSR, society knew psychological scientists who put forward theories, carried out experiments and conducted testing. Then a stream of all kinds of psychological and pseudo-scientific theories, concepts and techniques poured into the new Russia. Everything was “new” and was accepted with trust and delight, without filtering or criticism: hypnosis, sect-like associations that save the soul, tests, teachings about leaving the body, S. Grof’s matrices, feng shui, psychoanalysis... There was not enough information on systematization and adaptation of these approaches in our conditions, and many people have a mess of different (often contradictory) psychological concepts, theories and “recipes” formed in their heads.
Psychology training in Russia at this moment It’s not built quite adequately, in my opinion. Some people can, after completing a two-month course, receive a diploma in psychology and conduct counseling not only without sufficient knowledge of techniques, but also without knowledge theoretical basis and methodology. Many work alone, without consulting difficult cases with colleagues, without undergoing a certain number of hours of personal psychotherapy, which is unacceptable. In addition, charlatans are still doing a good job of fooling people who are ignorant of psychology, since they simply do not know what to expect and what they can demand from a psychologist. Many people now also confuse a psychiatrist, a psychoneurologist, a psychotherapist and a psychologist, although the differences between them are significant ( more details in – approx. ed.).
So public mistrust is quite natural: it is caused by a lack of knowledge (who psychologists are, how they work, what happens during sessions, what the results may be), superstitious fears about psychologists (“they see right through them”), misconceptions about the goals and possibilities of psychotherapy (“they will hypnotize and find out my secret or force me to give up the money”, “they will help me change my husband for the better”), encountering unprofessionalism, as well as historical bad experience distrust of strangers ( Stalin times). Therefore, I would like to debunk some myths about psychologists and talk a little about this profession. Let me make a reservation right away: by the word “psychologist” I mean a psychologist who does his job well and honestly.
- So what is the work of a psychologist?
— Essentially, a psychologist is a living instrument for working with the human psyche, its normal and pathological manifestations. This is an ordinary person with professional training who uses modern knowledge and techniques obtained in educational institution, as well as as a result of attending educational seminars, trainings, self-study, one’s own psychotherapy and personal experience to work with the client’s personality.
The psychologist “tunes in” to the client in a certain way, together with him he identifies his request, i.e., he specifies the unwanted (now) and desired behavior or state for the person, then with the help special technicians interaction helps the client carry out internal work that changes state or behavior in the necessary direction. With the help of a psychologist, a person can reconsider the current life situation and change it or change his attitude towards it. The task of a psychologist is to help the client identify the currently most relevant blocked needs, behavior options, goals and accompany the person on the path to the desired changes, making this path as fast and comfortable as possible, providing support and helping to find the strength to overcome emerging obstacles. That is, it is mainly the client’s psyche that works, and psychotherapy broadly understood speeds up the process natural development. What a person can achieve on his own for years can be done in psychotherapy in more than short term. In this case, the initial impulse always comes from the client; psychotherapeutic work is possible only with sufficient motivation, since wandering through the inner world of another without a goal is useless and energy-consuming.
— That is, psychologists do not undertake to work with clients with insufficient motivation, e Did the person come, for example, out of curiosity, or because he was pressured?
— If an adult is “brought” to a psychologist, unfortunately, the prognosis for this case is the most unfavorable. The initial message, we wrote, should be with the client, this is the basis of the therapeutic relationship and maintaining motivation for difficult work. If a person himself is sure that everything is fine with him or treats psychologists with strong prejudice, or (attention!) does not pay for psychotherapy himself, there is simply no point in it. The therapeutic relationship is very specific, and it requires certain conditions to be met: the person feels discomfort and lack of happiness; he wants, but cannot, change his condition; he is ready to ask for help to a certain person, find a place and time for this in your life; he is ready to take an active part in the work and pay for the work of a professional to improve his condition. Failure to comply with these conditions undermines the possibility of establishing a therapeutic relationship or (if established) does not bring beneficial changes to the person (especially when others are paying for it).
— Is it important for a person to clearly formulate the problem himself, to set goals for himself before visiting a psychologist? Or can this happen during joint work, and for the “patient” the main thing is a purely emotional desire to change something in his life?
— Defining and formulating the problem and the desired changes is, of course, desirable. This is where the first meeting with a psychologist will begin, so it’s useful to first think about why man walking to a psychologist, what does he want to get from him? But, in fact, a clearly (and most importantly, correctly) formulated request is quite rare. Typically, what the client presents as a problem at the beginning undergoes significant changes by the end of the first consultation, again thanks to the skills of the psychologist guiding the client's thinking.
— Besides working with insufficiently motivated clients, what else does a psychologist not do?
— The psychologist does not work to change the client’s loved ones (the above-mentioned “help change your husband”), the psychologist will work only with the client himself, his system of relationships. Some, of course, only come to “cry,” but usually psychologists do not encourage such manifestations and are more willing to discuss the desired changes.
A psychologist cannot change a client's life without cooperation and consent on his part. A psychologist is not a guru, he does not give advice and does not know how to do it correctly. Together with the client, he understands which behavior option is preferable for this client, based on his value system and needs. Two clients in a row who come with similar problems will leave with different results that best suit them. In general, a psychologist does not give guarantees and cannot promise to achieve results in advance, because the work is carried out in pairs, together - by the psychologist and the client.
— If psychotherapy is work in pairs, then who is responsible for what?
— The psychologist is responsible for the process of psychotherapy, for its safety and success, for selecting suitable techniques, for working with the client’s condition, for the frequency of meetings. Different psychological approaches have different ideas about the optimal frequency of meetings for successful work. Thus, in psychoanalysis, clients undertake to visit a psychologist at least three times a week; in the Gestalt approach they talk about two, sometimes one meeting a week. In general, everyone agrees that the frequency of visits once a week is quite possible, and meetings with a two-week break are rarely effective; the psyche has time to “forget” new developments and “gets back on track.”
The client is responsible for his motivation for change, as well as for everything that happens to him outside the psychologist’s office, that is, for bringing the ideas he has gleaned to life, completing tasks that the psychologist sometimes gives, final result psychotherapy. The number of meetings is also determined by the party in need of help - the client. If he has achieved what he wants or, on the contrary, does not see results, he has the right to talk about stopping work. Psychologists believe that the client knows better when it’s time for him to stop, since internal regulation can be developed and improved endlessly.
In contact with
— What exactly is happening on psychological consultation?
- IN in the narrow sense– conversation, including dialogue, questions and answers, finding interesting logical connections or inconsistencies, telling stories, discussing feelings, thoughts, internal mechanisms and intense work with them, exercises with imagination, discussion of dreams and fantasies, playing mini-scenes (sometimes involving objects), creating comparative lists, tables, graphs, drawings, sand paintings, and other creative products. In the very in a broad sense– interaction, communication, meeting of two worlds, a journey in depth with unexpected discoveries and interesting meetings.
The basis of psychotherapeutic work is that a specially trained person, thanks to special confidential contact, adapts to the client’s personality, analyzes his condition, his own state that arose in response to the client’s condition, notices his “picture of the world” (worldview, values, goals, needs ), features of emotions and behavior, then identifies together with him the main “problem areas” and outlines the steps that need to be taken to eliminate them (the steps, of course, are carried out together). What works here is person-to-person contact, so one meeting with someone can be psychotherapeutic and turning point. an ordinary person, who found themselves on the life path of another at the right time and reacted to it in a certain way. Artificially created by a psychologist, such contact is to some extent predictable, can be regular, has in its arsenal many studied tools for working with the psyche, that is, it represents for a person in need of help, good opportunity get it.
Psychological tools require the psychologist to be precise in their choice the right way actions and moments for its implementation, individual customization for each client and great skill in handling, because the psyche is structured in a complex and non-linear way. A psychologist often has to deal with client resistance (sometimes persistent), internal contradictions, repressed emotions, trauma and in different parts individuals (separated, for example, by a traumatic event). Let’s add here the psychologist’s constant monitoring of the emotional field, the client’s words, and his nonverbal communication. As you can imagine, the kitchen here is very delicate, but the opportunities for a professional are enormous; a lot can be improved in the psyche, although not immediately.
— Does the effectiveness of psychotherapy affect how well and quickly the personal contact between the psychologist and the client is established? Should you pay attention to your purely subjective reaction to the psychologist (whether the person is likable or not), to the ideological coincidence (what books, CDs with music he has in his office) or only to the qualifications, education, and methodology he uses?
— Psychotherapy is all built on communication and subjective reactions, projections of the client onto the psychologist. This is its main tool, and the psychologist is trained to observe and analyze the field of these subjective reactions. The fact is that in any relationship (and with a psychologist too) we bring echoes of our past relationships with significant people. Therefore, many see a mother in a woman psychologist, a father in a man and react to them as their loved ones, which gives the psychologist best material for research than everything verbal descriptions, and helps to change your relationships with different people after working through the problems that arise in contact with a psychologist. When they first meet on a non-verbal level, people “scan” each other in one way or another, and the result of this “scanning” is reflected in their heads: pleasant or unpleasant, worth trusting or not. Although the psychologist’s task is precisely to “adjust” to the client so that he subjectively feels trust. This is what they teach and good psychologist can accept many with respect and adapt to completely different clients - sometimes (due to individual differences) it is not possible to do this, then we can say that a consulting psychologist is not suitable for a person. Well, so that psychotherapy does not turn into a good heart-to-heart conversation and a sweet joint involvement in the client’s problems, of course, you need to pay attention to the education and qualifications of the psychologist. Trusting your intuition or the reviews of friends, determine whether the psychologist is a charlatan (see below, in the section “when to change a therapist”).
Sometimes psychologists talk about themselves first. You can ask about the methods used by the psychologist to determine whether the psychologist works within one psychological direction (or maybe has a certificate in it) or has a wide arsenal of techniques from different areas. This is important only from the point of view of the professionalism of the psychologist; the specialist will be able to adapt to the client using different versions of one psychological approach. In general, the psychologist is responsible for choosing the appropriate technique, and in the case when the client’s request cannot be satisfied in advance by the means of this psychologist, he can himself redirect the client, for example, to his colleagues working in a different psychological approach.
The worldview and personal preferences of a psychologist are not important in work, but they are (if they are similar) good." strongholds» to strengthen relationships.
— Is the general cultural level of a psychologist and his erudition important? Indeed, in fact, many structures human psyche are formed precisely by culture. And, relatively speaking, can a psychologist who has not read Nietzsche successfully correct the experiences that have formed in a patient after reading Nietzsche?
— The general cultural level is, of course, important. I don’t know a single psychologist who would be hindered by erudition. It helps in establishing contact, helps to speak the same language with the client (for a film buff to give an example of the action of a film hero, for a farmer to explain using the example of the growth of, for example, vegetables, for an intellectual to be able to answer with a philosophical parable). If a psychologist has a well-functioning head, in principle, this is not necessary: even the most complex mental constructions of clients are always based on simple, if not primitive, needs and fears. Attentiveness, intuition and sensitivity, good mastery of the art of conversation and psychological methods of interaction are the key to good work.
— Returning to the issue of trust. Many patients are afraid to tell “the whole truth” even to a psychologist due to their own stereotypes and taboos. If a patient lies consciously or unconsciously, does the psychologist notice this and draw any useful conclusions for himself? Is it possible to deceive a psychologist? Or is verbal information itself not the main thing for him?
— The psychologist receives information through several channels and compares it. Verbal information(client’s words) is not so important, because, in addition to the options for conscious lies, it also happens that the brain “inadvertently” distracts from necessary information or leaves out important points. The nonverbal part of communication is very important; it is always analyzed not only in comparison with the verbal, but also in itself. Voice intonation, posture and its changes, unconscious movements of arms and legs, gestures, even bodily sensations (feelings of a “lump in the throat” or heaviness in the stomach) - these are also unique signals for a psychologist; you can use them to determine whether the work is going in the right direction , track the reactions of the personality or its parts, monitor changes.
Therefore, a good psychologist, of course, will immediately notice the discrepancy between the verbal and nonverbal components and point this out to the client. Clients constantly try to deceive a psychologist in the broad sense of the word by substituting important information trivial events, pointing out unimportant problems while ignoring central ones, trying to put some roles and masks on the psychologist and oneself, avoiding emotions, sometimes providing incorrect information about oneself or one’s past. But they do all this unintentionally. Few people like to deceive a person, paying him a lot of money. A professional psychologist is precisely what he does to prevent his client from deceiving. Falling into special, trusting relationships with deep attunement (by the way, it is even easier to see “unnaturalness” and mismatch of information in them), the psychologist nevertheless remains conscious and attentive, constantly monitoring manifestations of the client’s personality, including his feelings, words, and sometimes their multiple meanings, intonation, posture and gestures.
— One of my friends has the biggest complaint about psychologists - that they don’t offer “ ready-made solutions”, but simply characterize the situation, leaving the client with his problem. This is true?
- No, this also speaks of unprofessionalism and unfinished work. Initial stage, indeed, are a reflection of the client's feelings and a summary of the situation. It usually becomes clear: what exactly does the client not like in the situation and what changes would he like, what prevents them from being implemented, and what of all this can be set as the goal of working with a psychologist? Next comes the use of special psychological tools that achieve the goal, checking the result in the client’s life, setting the next goal or chain of steps towards big goal and again work (as long as the client wants to change).
It is completely unprofessional to give advice, since all people are unique, and happiness standards, needs and problems are also unique. Psychology is built on the study of certain general patterns, but never discounts everyone's personal worldview. As for ready-made solutions, not a single psychologist gives them ( famous phrase among psychologists: “we don’t give advice!”). But a good psychologist knows how to competently lead the client to make his own decision independently (as if the person himself suddenly understands what he should do), and also suggest, if necessary, different ways the realization of a previously realized aspiration by the client (for example, a person who tells a psychologist that he would like to become more confident may be given specific “homework” to demonstrate confident behavior in social situations).
Unfortunately, it often happens that there is no initial motivation for change in a person, even if he states the opposite. Such people come to a psychologist to complain, and noticing with displeasure that the psychologist does not sympathize, but talks about the need for changes, they leave. A psychologist is not involved in saving lost souls and will not work if he does not see in a person a real desire and readiness for change, no matter how many problems the client is carrying. Otherwise, it will, alas, be to no avail, because changing your life for the better and becoming happier is a huge inner work which requires a lot of determination and strength. Thus, we separated two concepts: “leaving the client with a problem” and “stating the client’s reluctance to change.”
— Are there any indicators that an adult “patient” can understand that working with a therapist was effective? Can he, on his part, somehow control the quality of the psychologist’s work? On what basis can we conclude that it is worth changing the therapist?
— If, after visiting a psychologist, a person comes to some new conclusions or rethinks the current life situation, changes his life in a direction that suits him, achieves the goals set at the first meetings with the psychologist, feels that he has done quite a lot and does not want to move further, in general feels happier, then we can talk about successful psychotherapy. In general, the result is different for everyone and depends on the request. One client is happy that he got rid of allergies, the second – that he was able to save his family. The main condition is that the client’s real life outside the psychologist’s office must somehow change. Independence may increase, that is, the client, who at first timidly makes changes, ceases to feel the need for the support of a psychologist. This is also a sign that the therapy was successful and is coming to an end.
It is worth changing the therapist if the client does not see real results from visiting him. If the psychologist has failed to establish a trusting relationship with the client and is unpleasant to him, if he gives advice or gives out “diagnoses” and saving amulets, behaves insecurely, expresses himself incomprehensibly, does not know how to work with feelings that arise in the process (leaves the client in an unpleasant mood , cannot cope with the client’s difficult experiences, gets bogged down in emotions), accuses the client of ignorance, of the wrong approach to life, or together with him looks for other “guilty people”. Whatever the psychologist says, if it is not clear to the client and does not lead to change internal state and behavior, then you don’t need to believe this information.
Choosing your path
— Are there any restrictions for undergoing psychotherapy or using certain methods? What are the dangers of illiterate psychotherapy?
— I think that for an interested or at least responsive client, psychotherapy is always possible. Another thing is that the effectiveness of work and the duration of the “course” vary significantly depending on the “disturbance” of the client’s psyche. Working for a month with an autistic person is completely different from working with a man who has a fear of airplanes.
Of course, there are limitations on methods, because what suits one person may not suit another, but a good psychologist usually knows this. He is able to select an adequate technique; all that is important for the client is to find it and come to the psychotherapeutic session. Choosing the wrong technique in 90% of cases simply will not lead to results and will lead the work to a temporary dead end. To prevent the remaining 10% of cases from occurring, the psychologist studies for 5 years. I want to say that psychotherapy, of course, is an intervention in the psyche, to which it reacts accordingly. The psyche begins to defend itself if it feels too intense an invasion or if they are going “in the wrong place.” So psychologists, especially illiterate ones, simply cannot do any harm (for example, the art of bypassing a client’s defenses is quite complex). The psyche, even a very disturbed one, is a structure that is in a certain way balanced and wise. In psychotherapy, it is believed that if the “door” is tightly locked, you must either go into another one or come from the other side. All psychologists respect the client’s inner world and a kind of equilibrium, balance internal processes, which exists even in the most disturbed natures. No one will ever “break” the internal structure of a person; the art of psychotherapy is to help each unique person with his or her characteristics adapt to the world. And ideal psychotherapy will probably intensify personality development and inner freedom with a minimum of intervention.
Many people are afraid of losing control over themselves in a psychologist’s office and becoming a victim of deception or suggestion. Latest actions in principle it is very difficult to accomplish, not so much because technical difficulties(although this requires enormous professionalism!), How much is due to the so-called moral code of a psychologist, which unites all psychologists of all directions. In other words, not to harm with your intervention is the moral attitude of a professional psychologist.
Is there a risk that the client's life will become worse after a psychotherapy session? Life - no, the client’s assessment of his life is possible. If an imbalance occurs, it means that the client’s previous view of the situation is no longer satisfactory. So this is just the beginning great job, movement towards change. However, more often, especially with an illiterate psychological session, neither life nor its perception simply changes in any way.
— What forms and methods of therapy can help an adult in solving different groups of problems?
— In psychotherapy there are many directions, in them - approaches, in approaches - special techniques, techniques for implementing successful interaction with the client. All this, from the ability to establish contact to techniques for working with fears, is still being studied and expanded, has logical or not so logical, but always “working” explanations. Some psychologists are adherents of one school and become “aces” in it, others work in an eclectic approach, using a hodgepodge of different methods, selecting them for each individual problem. Choice psychological technique- a very difficult matter, requiring:
- diagnosing the client's personality, determining his internal structure, defense mechanisms, favorite ways of responding, “weaknesses” and “strengths”;
- a clear understanding of the capabilities and limitations of this technology;
- productions specific task requiring the use of this technique;
- ideas about possible result, expected changes in personality, local or systemic.
All this is included in vocational training psychologists, so we’ll leave the choice of technology to them.
Now about choosing a psychological direction in which a person is comfortable with psychological work. I will indicate several popular directions now, because full list can, in my opinion, only disorient readers.
Psychoanalysis is suitable for intelligent people with a good level of handling words, who like to observe themselves, who are inclined to analyze what is happening, and who are inclined to long-term, gradual and difficult work. A systematic approach allows you to change your personality to some extent. The psychologist often remains personally closed; with the client he maintains the position of an attentive observer and a somewhat impersonal partner.
The Gestalt approach is suitable for many, especially those who want to increase their level of awareness, responsibility for their lives, get rid of fantasies in their perception of the world, establish contacts with people around them and achieve internal integrity. Enough too systems approach, but has in its arsenal many tools for solving specific, private problems. The psychologist is more of a sensitive and aware partner for the client.
Humanistic (client-centered) psychotherapy suitable for those who want to see a psychologist accepting and approving, who want to achieve their goals through a creative search and release of resources, who need internal and external acceptance and a “soft” style of conducting sessions.
Existentialism is more suitable for solving problems of the value-semantic sphere. It may be useful to those who are interested in self-determination, the meaning of life and seeing themselves through their system of values, issues of being and death.
Cognitive behavioral psychotherapy It is especially effective for problems of adaptation to life circumstances or society; it uses work with belief systems, various mental mechanisms that influence the perception of life situations or the perception of oneself. Is short term. The psychologist works together with the client to “work on mistakes” and helps to find rational and effective solutions to specific problems.
Body-oriented psychotherapy involves working with the body, numerous techniques for working with mental components through bodily manifestations. Suitable for people who have difficulty expressing their emotional state, or mentally healthy people who have body problems or emotional trauma.
Hypnosis/NLP deals primarily with working with the client's unconscious, activating it and acting within it. Hypnosis (usually) creates a special altered state of consciousness, in which, at a deep level, most of psychological work, sometimes not fully realized by the client. Both hypnosis and NLP effectively help when working with anxieties, fears, bad habits, psychosomatic problems and neurotic symptoms, but can also be used as a systemic approach.
Art therapy (we’ll mention the popular sand therapy separately) works mainly on unlocking creative potential and activating internal resources, is a “soft” method and a good diagnostic tool. Suitable for those who want to gain inner harmony, learn to express emotions more freely, and is not afraid to create.
— As far as I know, psychotherapy sessions can take place with different amounts"participants". You can come alone, with a partner, there is also group psychotherapy. Which form is optimal for which cases?
— Individual consultations are actually attended by one person, who is the client. From a safety point of view, individual work is not taken outside the office by either the psychologist or the client. This is a very personal act in some way. If, for example, a mother brings her child to individual therapy, she should remain in the hallway and wait for him. And the psychologist will not tell her the secrets that the child told her, or retell what happened during the session. He can generally characterize the child’s main problems for the mother and tell her what kind of work is going on, and give her any recommendations on how to behave with the child. If, by agreement, she attends classes with the child, she will also be a client and will perform tasks and answer questions on the same basis as him. This option will most likely be classified as a stripped-down option. Normal family therapy involves the simultaneous arrival of two or more family members, usually a married couple, or complete family with all its participants. Usually the number of participants in family therapy is agreed upon immediately and depends on the complexity of the problems of family interaction. Sometimes individual work is useful in family therapy, but usually the family therapist for ethical reasons it does not individual consultations clients - family members.
Group psychotherapy is a specific method of psychotherapy (no better or worse than individual one), the peculiarity of which is the use of group dynamics, social interactions group members as models of real life, with an emphasis on human relations. A psychotherapeutic tool in such groups, unlike individual psychotherapy, is not a therapist, but a group of people. Each person can participate in a certain way in establishing relationships with each other and with the psychologist-therapist, bringing their judgments, experiences, experiences and findings into the overall process. The phenomena of group dynamics (social and psychological forces and processes operating in the group), emerging over time, when correctly directed by the therapist, help realize therapeutic goals.
Group psychotherapy can be based on different methodological approaches, it is used in almost all main areas of modern psychotherapy. Therefore, groups can be psychoanalytic, gestaltist, humanistic in their idea. Accordingly, completely different people can come to group psychotherapeutic work with different purposes, but especially successfully in groups all “social” difficulties can be worked out: shyness, uncertainty, dependence on other people’s opinions and inability to establish close contacts, difficulties in showing or restraining emotions among people, weak ability to empathize, problems of rivalry.
More recently, we learned about the profession of a psychologist from Western cinema, where almost every hero had a own psychologist or a psychiatrist. Civilization lies not only in computerization, but also in changing people's consciousness. Today, many people are thinking about seeking help from a psychologist in certain situations.
The market for psychological services is quite wide. Experienced specialists, university graduates, and even people who have undergone psychological courses. How to figure it out complex issue, and not make a mistake with the choice?
Two ways to find a psychologist
First of all, you need to decide where exactly to look for a good specialist. There are two the right way search for specialists:
- by advertisement;
- on the recommendation of friends.
If none of your friends have ever consulted a psychologist, and generally consider these specialists to be charlatans, then you will have to choose from a wide range of offers yourself.
By the way, in this case, you should not share your desires with such friends, as you risk receiving a lot of free advice that discourages you from approaching problems professionally.
Advertisements can be:
- in the Internet;
- in the media;
- on advertising stands.
First, collect your own database of psychologists who become interesting to you. You shouldn’t accumulate a lot of baggage; it’s better to immediately weed out people who somehow confuse you or don’t inspire confidence.
The choice of a psychologist should not be influenced by three factors:
Still, if any of these signs can affect your comfort, then you should listen to your intuition.
The importance of reliable information
So, in your own database there are several psychologists. To choose one, you need to analyze a number of more facts.
- Does the psychologist have a higher professional education? Real specialists are not trained through courses or distance learning.
- How often does a psychologist improve his qualifications? Psychology, as a science, is constantly evolving, so it is important to constantly improve your skills.
- Where does the psychologist work? It is better if the psychologist sees you in a specialized center, clinic or rented psychological office. A true professional will not take it at home, in his own living room.
- Are there any reviews about the work of a psychologist? Study opinions about it on the Internet, preferably not on a special website where reviews can be ordered, but on forums. If you haven’t found any reviews about the chosen specialist, then you should think about whether it’s worth contacting him for help.
When reviewing resumes, pay attention to the psychologist's specialization, as most of them excel in certain areas.
If everything comes together in favor of one specialist, then it’s time to make an appointment.
First meeting: what to pay attention to
You need to understand that a psychologist is not a dentist, and it is impossible to relieve pain with one visit. Therefore, many psychologists make the first meeting free or inexpensive. The introductory consultation lasts 15-20 minutes. This time is enough for a psychologist to establish contact and get to the bottom of the problem. And you need to understand whether you can trust this person. Trust is the main thing when working with a psychologist.
At the first meeting, you need to ask a number of questions:
- What is your work experience?
- What problems do you specialize in?
- How many people have you helped solve problems?
- How long does it take to solve the problem?
- How will assistance be provided?
You will need to part with the psychologist if he:
Ask questions, look around, listen to your sensations and feelings. You should feel comfortable and comfortable, and nothing should distract you from your conversation with a specialist.
Good psychologist
So, you liked the specialist and you decided that you would work with him.
Your feelings:
- You are ready to trust him with your secrets and secrets.
- You feel comfortable and comfortable in his office.
- You are satisfied with the work schedule and session schedule.
You come to the first session, which allows you to understand exactly what kind of psychologist is in front of you.
Good psychologist:
If the first session made you think a lot about yourself, but at the same time made you want to come again, then you were not mistaken in choosing a psychologist. If the words and actions of a specialist caused you doubts, then it is better to return to choosing a new professional.