There was such a case in my practice. An episode of communication with a client who, right during the consultation, threatened to commit suicide.
I once briefly talked about this incident. Let's take a little more detail about a typical story of too free communication between a client and a psychologist.
In the sphere of private psychological practice, cases of “hazing” between a psychologist and a client quite often occur. A psychologist does not depend on the employer, and practically does not depend on any supervisory authorities.
“You have no methods against Kostya Saprykin” (c)
I received a diploma, created an individual entrepreneur - and the only thing left to do is create a flow of clients.
I know about some cases of “hazing,” if only because this important fact always comes up when consulting with a psychologist. The client will definitely (and very soon) tell you about such an episode from his past. For many reasons. For example, because it was at this stage that the previous “psychotherapy” reached a dead end.... Everyone here will agree that psychotherapy ends quickly.
I'll tell you about one of the first cases in my consulting practice. In 2003-04, I was just starting to consult, after university, at my own peril and risk. I met clients in cafes and other similar places.
By the way, now meetings between psychologists and clients in cafes are as common a practice as counseling on Skype. But there is a first time for everything, and innovations are perceived with hostility by many people. Therefore, now I am even proud of the fact that I did not pay attention to skeptical people then.
During the period of lack of real experience, any meeting with a client made a strong impression on me, but even among these stories there were some that were completely out of the ordinary...
It all started with a standard request from a young girl, like “lately I’ve been feeling exhausted, I’m constantly in a bad mood, I’m confused in myself, I can’t concentrate on work, everything is falling out of my hands.” My mother told me, don’t meet a person without fully understanding his request. But who actually listens to mom’s voice in their head?)
A girl much younger than me, quite pretty, came to the meeting. During the conversation with this client, information about five suicide attempts was revealed (if I had known in advance, I would not have even continued the conversation - only in the clinic such cases are processed). During the hour of conversation, the girl doesn’t really explain much, but tries to lead me to some conclusion and hint at something. In the end, she directly tells me that the previous psychologist was not as insensitive (like me), he helped her a lot (though she found it difficult to formulate how exactly). She often spent the night with him, he even took her on trips with him, and this form of psychological work suits her and this is what she wants from me.
Seeing my confusion and bewilderment, hysterics begin. She continues to talk, switching from crying to unhealthy hysterical laughter, after the laughter there are threats to make another suicide attempt right now. Then again crying, hysterics and again in a circle. I barely escaped.
In general, I was quite impressed. On the way home, I drank three bottles of beer (I was still very young, I can be forgiven)... I didn’t respond to clients’ letters for two months... Fortunately, this was not my main source of income...
Why didn’t I treat her with the miraculous method that the previous psychologist used? My beliefs are simple. They are flexible, of course, but quite stable)
Year of publication and journal number:
annotation
The article is devoted to the importance of establishing a setting by a psychologist and the possible difficulties associated with this process. The work provides an overview of psychoanalytic concepts of setting, examines and analyzes practical situations of violation of the setting by clients, and provides some recommendations for establishing and maintaining the setting for novice psychologists.
Keywords : setting, external setting, internal setting, setting violations, container, contained, symbolization
In relationships between people, boundaries are always established in one way or another, and some regulatory rules are formed. This process is individual and depends on the type, nature of the relationship and the characteristics of the people themselves. In the psychotherapeutic process, rules, frameworks (or in the English-speaking world, setting) describe the basic agreement between therapist and patient. This agreement, necessary for the implementation of treatment, includes terms regarding the frequency and duration of meetings, the amount and terms of payment, the position of the client (on the couch or “eye to eye”), as well as other conditions. The details of the setting are determined by mutual agreement between the analyst and the patient, if possible already during preliminary conversations, individually in each specific case.
Each psychologist, starting his practice, determines the rules of the setting and is faced with issues of its violation: possibilities of cancellation, transfer, delay, client lateness, payment issues, etc. Such issues have to be resolved separately in each specific situation, based on the theory about the role of the setting in psychotherapy and using the supervision of a more experienced psychotherapist. This is often difficult, especially for a novice specialist.
In this work, based on a review of psychoanalytic literature and an understanding of practical cases, the containing function of the setting in psychotherapy is studied, examples of its violation are given and analyzed, and recommendations are given for establishing and maintaining the setting for specialists starting their practice.
In psychoanalytic literature, the concepts of external and internal settings are found. The external structure of the setting (Kadyrov, 2012) includes: a quiet and relatively neutral office, a couch, an armchair, a clearly defined frequency of sessions, a set time for the start, end and duration of sessions, the size and rules of payment; schedule of holidays and vacations. This external provision (Fonda, Yogan, 1998) accelerates the therapeutic process and permanent regression so that psychoanalysis can take into account the infantile analytic material. The internal structure of the setting is embodied (Gabbard, Lester, 2014; Kadyrov, 2012; Yankelevich, 2014; Zakrisson, 2009) in the punctuality of the psychoanalyst, his reliability, stability, openness to the patient’s communications, “acting out” of the patient outside and inside the analysis, as well as in refusal from the analyst’s own acting out in relation to the patient, the analyst’s focus on the client’s psyche, finding a balance of proximity/distance in contact. One of the important elements of the internal setting necessary for the effectiveness of therapy is therapeutic neutrality. T. Drabkina (2004) writes: “...neutrality implies that the therapist has no personal expectations in connection with the client, that is, there is no interest (including conceptual) for him to behave or not behave in any particular way.”
Describing the concept of the internal setting, Michael Parsons notes: “just as the external setting defines and protects the space-time arena in which patient and analyst can do analytic work, so the internal setting defines and protects that field of consciousness of the analyst within which everything “no matter what happens [in the analysis], can be comprehended from a psychoanalytic point of view” (quoted in: Kadyrov, 2012).
Adhering to the correct attitude in the internal setting is not easy, especially for a novice psychologist-consultant, filled with various anxieties. Therefore, compliance with the external framework of consultations is especially important for a novice psychologist - the containing role of the setting falls on the external framework if the internal setting, the internal setting, is not firmly formed.
Many psychoanalytic authors write about the importance of setting and its role as a therapeutic factor in psychotherapy and psychoanalysis. René Spitz (2005, 2006) writes that the analytic situation in many ways resembles the early relationship between infant and mother. According to the laws of nature, the baby is helpless and completely dependent on the care of the mother. In an analytic situation, the patient comes to the analyst feeling helpless because he is unable to cope with his difficulties himself. Certain rules of the psychoanalytic setting reinforce this feeling of helplessness, causing a regression in the patient to early childhood states and developing a transference of the maternal object onto the analyst. According to the rules of the psychoanalytic setting, the patient lies on the couch, not seeing the analyst, only hearing him. He is forced to direct his words and emotions into empty space, like a child screaming in an empty room, not sure if anyone will come to his call. The analyst occupies a higher, sedentary, sort of “adult” position. Moreover, the requirement to say whatever comes to mind, without censorship, is similar to the position of a baby who does not choose or restrain his movements or sounds, his silence or excitement. The ban on social contacts between the analyst and the patient makes the analyst and his private life as mysterious to the patient as the personal life of the parents is to the child.
According to Bion's concept of "contained-contained" (Casement, 2005), it is very important that the mother can take into herself the child's mental suffering, perhaps fragmented and dispersed. She needs to be able to bear being confronted with what the child cannot bear, so that eventually the child can get his fear back, but in a more structured, manageable form, processed by the mother who can cope with it. Bion’s “container” provides the feeling of being in a safe place, inside something good. Winnicott called it "the sensation of being held in an embrace." Esther Bick compared it to the feeling of being wrapped, how the skin protects and envelops you from all sides. Ronald Britton calls this state a refuge. The sense of coherence formed by the basic organizing idea, or “chosen fact,” the meaning that provides internal coherence, Bion characterizes as “contained.” What is contained gives meaning to the environment that contains it. The container, in turn, gives shape and safe boundaries to what it contains. If the first of these properties, “shelter” (i.e., being inside something safe), is lost, a feeling of “endless falling” or a feeling that “there is no floor under your feet” appears. If the second of these properties - internal meaning - is lost, then internal incoherence and splitting are felt. Both may be intolerable to the patient.
Patrick Casement (2005), writes that the child needs an adult, especially a parent, who is able to cope with something in the child that he himself cannot yet cope with, for example, anger, hatred, destructiveness when faced with frustration . If the parents were not capable of such restraint, perhaps the child will wait and look for it in other people, demonstrating difficult behavior, with fits of anger in an unconscious search for firmness and restraint, in setting boundaries, containing. When firm boundaries are discovered, the child gains the necessary security; anger is pacified when it is contained, i.e. feels like being controlled by another person.
Winnicott (1968) writes that a child, feeling strong hatred, can, in fantasy, “destroy” an object represented in the psyche. At the same time, for a real parent or therapist it is necessary to be able to survive this destruction without collapsing and without taking revenge. In this way it will be discovered that the parent or therapist has powers of their own, and not just those that the child has given them in fantasy, to protect them from anything that would presumably be difficult for them to bear.
The analytical frame (Gabbard, Lester, 2014), among other things, creates an atmosphere of security. Strong emotional reactions can be mobilized without fear of punishment or humiliating criticism from the analyst. The patient is given a “space” in which he can regress and express unacceptable unconscious desires and feelings. It is precisely because the rules of the game in analysis are different from other types of interaction in society that the patient may experience himself in a new way.
Paolo Fonda (1998) formulated the goal of psychoanalytic treatment as stimulating the development of the patient’s ability to symbolize, i.e. development of perception of what is simultaneously happening at different levels of reality. This is facilitated by such properties of the setting as reliability and optimal frustration.
Reliability is ensured by the feeling of security that the patient should have in the relationship with the psychoanalyst. For this, the analyst's ethics, respect for the patient's personality, confidentiality, professional secrecy, sincere desire for the good of the patient, as well as compliance with the terms of the contract are very important, in addition, the analyst must avoid actions and separate his private life from the analytic relationship. The need for security forces the patient to test the analyst and explore his ability to protect the patient from his own (the patient's) destructiveness and inability to maintain relationships.
The analytic situation is frustrating for both patient and analyst. The following elements of the setting, while confirming the frustrating real relationship with the analyst, are particularly important from this point of view: limited session time, relational language using the formal "You", payment, the existence of other patients, the private life of the analyst, most obvious on weekends and holiday breaks , and so on. The patient often tries to deny or exclude these aspects. The analyst knows that these moments frustrate the patient, which is why he tactfully and delicately helps him to face them. The simultaneous presence of reliability and optimal frustration, which is part of the structure of the setting, helps organize transference in the client and, at the same time, frustrating with the limitations of the setting, confirms the illusory nature of what is happening, allowing the client to simultaneously be on several levels of reality, which develops his symbolic thinking.
M. Quinodo (2012) writes that the patient's relationship to the frame often becomes a way of non-verbal emotional communication between the patient and the therapist - “a way that, first of all, can be an expression of transferable unconscious resistances that can be interpreted and worked through. In his work “Remembering, Repetition and Elaboration,” Freud made it clear that “the patient “does” before he “remembers” (cited in Goldsmith, 2009). His character and conflicts are expressed in one way or another before the restoration of textual memory occurs. Much of this "action" occurs through "testing" the setting , as a sign of resistance or as an attempt to find out whether the analyst can be trusted. This may manifest itself in ways such as silence, confusion about appointment/payment times, unusual behavior during sessions, canceled or missed sessions or requests for additional appointments, difficulty making regular payments, phone calls to the therapist, and other disruptions to the setting.”
Patients with different levels of mental organization may perceive and react differently to the introduced rules of the setting. Rothmann (2005) writes: “Neurotic patients do not try to challenge the reality and constancy of the setting. They prefer to use the setting as a basis for symbolizing the transference process, to work on the content of their associations.” M. Kinodo (2012) writes that neurotic patients accept treatment conditions without much conflict, as a calm background that allows other, more pronounced, inherently conflicting aspects of treatment to manifest themselves. Regarding more disturbed patients, Rothmann (2005) writes: “More fragile borderline and psychotic patients, for whom safety and integrity are significant issues, are less trusting of the environment: the length of work hours, the frequency of meetings, payment for missed sessions, etc. and confidential support guaranteed by the analyst. Patients for whom constant delays are habitual belong precisely to this group. Using the setting, they tend to act out their anxious mistrust of the object and the language. Such patients act rather than talk. When symbolization is weak, there is a danger that the setting will be misinterpreted by the patient, both generally and in particular cases. In such a situation, a lot of work can and should be done with the problems of the setting.”
McWilliams (2012) writes that “borderline patients may often react angrily to the boundaries set by the therapist, but in any case they receive the following therapeutic information: 1) the therapist views the patient as an adult and has confidence in his ability to cope with frustration, 2) the therapist refuses to be exploited and therefore serves as a model of self-respect. Typically, the life histories of borderline people indicate that they often experienced contradictory influences: they were indulged during regression, and, as a rule, ignored when they were in their age-appropriate state, they were expected to allow themselves to be exploited, and they They allowed me to do this to myself."
Case Study Analysis
Beginning counseling psychologists often experience fears at the beginning of their practice (Cormier and Hackney, 2016). Anxiety can be caused by various factors, for example, doubt in one’s competence, fear of evaluation, competitive situations. A high level of anxiety can lead to “analysis paralysis” - a state in which a novice specialist has difficulty finding the right words, formulating concepts and following the client’s narrative, remembering the content of the session and, most importantly, being attentive to the client, being “present”. In addition, the consultant’s unresolved interpersonal problems cannot but influence the course of the sessions themselves and cause additional anxieties and worries. For example, difficulties associated with personal and professional competence, the desire to please people, problems of establishing and maintaining boundaries, and inadequate self-esteem can imperceptibly shift the focus of counseling sessions from the client to the psychologist. The desire to be a perfect consultant can complicate the consultative process: create distance between the client and the consultant, reduce the experience of empathy and availability.
In connection with these fears, anxieties and doubts, for a specialist starting his practice, situations can be painful and incomprehensible when the client violates the setting: is late, misses sessions, leaves the consulting process without warning, proposes to violate the established order: extend or shorten session, start earlier, reschedule for another time. How should we feel about this? How to behave further, agree or not. What does this client behavior mean? Is this resistance that needs to be dealt with separately or is it a reality that can make its own adjustments? Questions arise about possible mistakes made, doubts about one’s competence. How to behave in a situation unfolding “here and now”? It is difficult to answer these questions, especially for a novice specialist, and if only one or several sessions have taken place.
Turning to supervision can help and strengthen the psychologist in his work. G. Goldsmith (2004) writes “The purpose of supervision is to benefit the patient, but at the same time it also benefits the psychologist by improving analytical skills. Its boundaries are set as if outside the perimeter of the patient/analyst relationship, but they contain these relationships. In a sense, supervision is inseparable from treatment; it can be considered "an extension of the containing function beyond the dyad so as to include someone else's analytic 'co'-listening."
Table 1, based on practical cases, provides a list of various options for violating the setting by a client, describes the difficulties that arise for the psychologist, and reflects on what could help the psychologist in this situation.
Table 1. Summary table of various options for violating the setting
|
Symptoms of Setting Violation |
What could the symptom mean? |
Difficulties of a psychologist |
What helped |
Psychodynamic conflict in the client |
|---|---|---|---|---|
|
Client N. |
||||
|
She came early for the first session and started calling me and looking for me at the institute security guard |
The client experienced anxiety and extreme agitation before the first session |
Feeling of tension, confusion |
This situation only happened once; if it happened again, I would discuss this situation with the client. |
High anticipation anxiety. Anxiety of the "fear of the stranger" type. Conflict between neediness and basic mistrust |
|
Refused to finish the session on time, did not stop talking, raising her voice |
Overwhelmed with emotions, painfully experiencing separation |
It was difficult to withstand strong emotions, it was difficult to end the session, I had to get up and go to the door |
I tried to start finishing it a little earlier. In the following sessions, I talked with the client about how difficult it was for her to complete her work. |
High separation anxiety. |
|
After leaving the office, she continued to talk, followed the psychologist, telling the most difficult things to herself |
Wants to attract the psychologist’s attention, not let go, perhaps punishes for breaking up |
It is difficult to stop the client and difficult to resist continuing the session outside the office |
Turning to supervision provided a feeling of support and a better understanding of the client’s situation |
Fear of separation. |
|
Was 15-20 minutes late in the second and third sessions |
Possible resistance, reluctance to face one’s conditions |
Anxiety in a state of uncertainty and expectation, worries about possible mistakes made |
Thinking about what might be causing this delay and how it relates to past sessions |
Aggression directed at an object. |
|
I arrived early and went into the office without a psychologist (the previous psychologist let me in) |
Does not feel boundaries, perhaps this is penetration into the psychologist’s territory as a manifestation of client violence towards the psychologist |
My own feeling of confusion, then discomfort, anger at the client for violating my boundaries prevent me from getting ready for the session |
This situation happened only once, if it were repeated, I probably tried to organize the sessions in such a way as to avoid such situations |
The desire to capture, absorb an object. |
|
Client A. |
||||
|
Missed sessions without warning |
A. does the same with her friends and thinks that this is normal, she expects that they will remind her about the meeting |
Immediately at the moment of waiting for the client - a feeling of frustration, uncertainty, anger, after, when discussing these moments - as if losing a sense of support |
Talk to the client about these points, draw a parallel between our relationship and her difficult relationships with men |
Aggression towards an object that appears to be separate. |
|
15 minutes before the start of the session I wrote messages about whether everything was in order, and without receiving a quick response, I turned around and went home |
An alarm was raised before the session and an immediate response from a psychologist was required |
Feeling angry at the sudden disruption of the session, |
Talk at the next session about her likely feelings (anxiety) |
Fear, anxiety, intolerance of rejection |
|
She asked the psychologist to call her a day in advance and remind her that the session would take place tomorrow |
Role reversal - as if it is she who needs me, and not she who needs me |
Confusion: it is not clear how to set the boundary correctly |
Returning responsibility to the client, drawing an analogy in relationships with friends |
Desire to control an object |
|
Five minutes before the end of the session she said that the time was up |
Control over the session, perhaps this is how aggression was manifested |
Confusion: should I terminate the session ahead of time? |
Thinking about what might be behind it and talking about it with the client in this or the next session |
Intolerance to separation. |
|
Client M. |
||||
|
Brought a diary to the psychologist |
Search for intimacy, trust in a psychologist, reducing distance, turning a psychologist into a friend |
It’s not clear how to react, how to refuse without offending the client, what to say |
Applying to group supervision |
Desire for merger. |
|
She suggested switching to “you” |
It’s not clear how to set a boundary without alienating the client |
Thinking about what might be behind this, returning to the client, “maybe you want more intimacy” |
||
|
She said important things at the door |
Wanted to extend the session, hold my attention |
There is no opportunity to answer, you have to stay with the client’s words until the next meeting |
Start the next meeting with dangling phrases |
Separation intolerance |
|
She asked me to switch to a regimen of once every two weeks. |
I tried to make it clear that there was something not satisfactory in our work. |
Doubts that it might really be more convenient for the client, it is unclear how to react, how to talk about the need for fixed session times |
It is worth developing a confident attitude towards the scope of work and being able to talk about them with the client |
Intolerance of object dependence |
|
She said that she didn’t know exactly what time she could come next time and would call in advance. |
Perhaps she was looking for firm boundaries, checking with a psychologist to see if she could withstand devaluation |
Intolerance of proximity, dependence on an object. The desire to “throw” the object before he throws it (Fear of rejection). Revenge for the approach of the object and one's dependence on it |
||
Based on practical experience, the following general recommendations for establishing and maintaining a setting for beginners can be compiled.
- Develop for yourself a confident position on the setting of consultations (attitude to a fixed time and place, absences and transfers, vacations, addressing “you” or “you”, etc.).
- Initially, at the first sessions, discuss the rules for conducting consultations (discussion of a contract) and the conditions for their violation.
- Consider situations of violation of the setting as information about the client, his history and relationship with the psychologist (the emergence of transference). Don't ignore such cases.
- Talk with the client about all situations of violation of the setting, linking them with what is happening in sessions and/or in the client’s real life
- Develop and pay attention to your own internal setting (neutrality, attunement to the client, analysis of countertransference).
- Turn to supervision as an additional container for your own feelings, as well as for a better understanding of the client’s material and the reasons behind the violations of the setting.
Conclusion
An analogy can be drawn between the relationship between a psychologist and a client, and a mother-child pair. The mother creates a safe, supportive environment for the child in which the child can live and develop. The psychologist, with the help of the setting, creates a safe space for the client to freely express his emotions and states. The mother absorbs and processes the child's affects, which are unbearable for him, and returns them to him in such a form that the child can cope with his feelings. The psychologist, using his knowledge, clinical experience, relying on the external framework of the setting and supervision, does the same for the client - he contains his unbearable affects, and helps the client understand and withstand them.
For more disturbed clients with a borderline or psychotic personality structure, the setting is much more difficult to tolerate. Under the influence of strong affects, they attack boundaries, destroy the setting, and interrupt therapeutic work. A novice psychologist, full of worries and doubts, has to deal with this, which can be difficult.
The article describes various situations of violation of the setting: missing sessions for no reason, arriving late/early, rescheduling sessions, difficulties finishing the session on time, seeking contact with a psychologist outside of consultations and other situations. Each such moment of violation of the setting was analyzed and, as a result, approximate recommendations for establishing the setting were developed.
Annotation
Difficulties in establishing the setting of the example cases from the practice of beginner psychologist
The article is devoted to the importance of establishing a setting by a psychologist and the possible difficulties related with this process. The paper provides an overview of the psychoanalytic concepts of setting. Practical situations of setting violations are analyzed and some recommendations for setting establishing and retaining for beginning psychologists are given.
Php?ID=2998 (accessed 12/15/2016)
I'm a child psychologist, and sometimes I get terribly overwhelmed. My main problem is the parents of my little clients, who themselves disfigure them. I don’t know - is it just me who is so “lucky” or, in fact, almost half of the children who are referred to a psychologist by doctors or teachers with suspicion of various disorders (this is how most clients come to me) have the same diagnosis: surrounding adults - idiots.
Case No. 1
A first-grader constantly tries to get into other children's pants, sits behind him, simulating sexual intercourse, and persuades girls to dance a striptease. The alarm was sounded by the parents of a girl whom he offered to, I quote, “suck his pussy” for a chocolate bar. Increased interest in this topic at such an early age may be a symptom of several larger problems.
Either the child was corrupted, or he has a serious hormonal imbalance (an adult hormonal set in the child’s body), or some problems with the cerebral cortex. However, it turns out that the child’s father simply considers it completely normal to watch porn on the computer in the presence of his son: “What’s wrong? He's small and doesn't understand anything. And if he understands, let him grow up to be a man, gee-gee-gee.”
Case No. 2
A 6-year-old girl, Sasha, talks about herself in the masculine gender and tries to convince everyone that she is a boy, Sanya. Gender identity disorder? Nevermind. It’s just that mom and dad wanted a second son and have been telling their daughter since infancy what a pity it is that she wasn’t born a boy. To any sign of weakness they say: “What kind of girl are you?!” (hello, garage, your child is actually a girl!), and a request to buy beautiful shoes is perceived as a sign that the daughter will grow up to be a prostitute - she already knows this word very well.
At the same time, the girls rush around their older brother like he’s wearing a dirty bag: he’s a boy. Sasha, naturally, has two options: either forever recognize himself as a second-class person, or try to somehow become a first-class person. She chose the latter option. And this is completely normal for a person with a healthy psyche. It’s not normal to mess up a smart and precocious girl’s head like that even before school!
Case No. 3
A 4-year-old boy behaves aggressively, attacks other children on the playground and offends his little sister. After just 10 minutes of communication with his mother and stepfather, everything becomes obvious. In the family, even adults do not know the words “sorry”, “please” and “thank you”. It is customary for them to communicate by yelling at each other and threatening “I’ll hit you right now.” The most affectionate thing was that in front of me they told the child: “Shut up, you bastard!”
And in general, it seems to the child’s stepfather (an aging gopnik, who according to his passport is over 40, but according to his mind is 13-14 years old) that he should teach the child to respond to any words from his grandmother: “Shut up, you old bitch!” - great witty joke. In general, the boy does not have any disorders, he just looks like his parents.
Case No. 4
A 10-year-old girl literally hates all boys and any hint of intergender relationships. The neighbor at her desk, who said that she was beautiful, was attacked by a fury and broke his nose. We find out that the whole situation arose because of the girl’s mother. This is a single mother. A woman with a stormy, but not very happy personal life. A series of “new dads,” some of whom did not last even three months (and one of them also beat the girl), and “she and I are like friends, I tell her everything.” That is, the mother made her daughter a confidential person.
From early childhood, a child knows which of his mother’s uncles has problems with potency, which has a jealous wife who watches for his mother at work at the entrance, who is “miserly and didn’t even buy a ring,” from whom she had three abortions, and so on. Mom sincerely believes that she is preparing the girl for adulthood. The girl believes that adult life is just endless fights with someone’s wives, abortions and erect penises, and she saw all this in the coffin (and in this case it’s hard not to understand her).
Case No. 5
10 year old boy. Rare case. The mother brought the child with the request: “Do something! He annoys his father." In general, the search for a “magic button” that can be pressed so that the child becomes comfortable is a favorite topic of parents who bring their children themselves. In general, the situation is almost classic: dad from time to time finds a new love and leaves for her, then mom wins him back with borscht and silk robes. For some time the family is idyllic, and then everything repeats itself.
The intervals are becoming shorter and shorter, and the child generally “ruins everything” - he treats his dad as a dad, and not as an Eastern padishah. Recently - just think! - asked a parent suffering from a hangover to help him solve the problem. The boy was sworn at and received such a slap on the head that he flew towards the wall.
My answer: It’s better, damn it, to prescribe healing kick-offs for dad!
Of course, this does not fit into the framework of professional ethics, but this is almost the only thing that can help in this case.
All the cases described are literally within the last month. So far, all these (and many similar) children are just normal kids who were unlucky with their family. But very little time will pass - other people's children, as you know, grow very quickly - and they will turn into fully grown, fully formed ghouls who will cripple the next generation of children. And I don’t know how to stop this conveyor belt for the production of moral cripples...
She came to me in complete despair. Swallowing back tears, she said that she had ruined her career with her own hands. It took her three years to get to her current position, working late and often without days off, and her bosses kept pushing her aside, criticizing and double-checking her.
And yet Polina achieved her goal. It would seem that we can celebrate victory. And already on the third day she wrote a letter of resignation. “I feel so exhausted that I can’t do basic things: read mail or send a letter.” Obvious emotional exhaustion, apathy, decreased self-esteem...
I suggested that she let go of the situation: not make any decisions for two months.
But Polina suffered most of all from the thought that in such a “disassembled” state she was letting her colleagues down. And she blamed herself for everything. She carried an excessive load for a long time and at the same time experienced unfair aggression from management... At the cost of enormous stress, she still “made it to the airfield” - and broke down due to extreme overwork.
Perhaps she should have stopped earlier, but now there was no point in discussing it. Explanations often have a calming effect on the client. I described to her the dynamics of emotional burnout, explained that self-blame is one of the symptoms of this disease, which means they are simply meaningless.
“Imagine that you get chickenpox,” I said, “wouldn’t you blame yourself for having a rash on your body? Self-blame is the “rash” of depression.” After this conversation, Polina agreed to use the rest of her will to stop blaming herself.
I suggested that she let go of the situation: let everything go as it goes. For two months, do not make any decisions, go to your relatives in the village, relax there, sleep as much as you want, take care of yourself, treat yourself with exceptional tenderness. In a word, just let yourself survive. And in two months, come to me, and then we will discuss what to do next.
Victor, 55 years old
A serious, respectable man completely lost sleep and peace due to a difficult situation at work. Victor lives in a small town near Moscow, works in the accounting department of a state corporation, and has always been in good standing. And so the new boss announced that there was a contender for his place, a relative of this boss.
“So he said directly: “You better leave yourself, otherwise I will survive you!” Imagine what a humiliation it is to drive me like a puppy! Not to mention that I have five years left until retirement! Where will I get a job?! And why on earth should I leave? Naturally, I refused indignantly. Then this impudent person began to survive me, shamelessly and openly. He publicly scolds me for minor mistakes, slanders me behind my back, deprives me of bonuses - in general, he creates the impression among management that I am a bad employee. My colleagues sympathize with me on the sly, but they can’t help me...”
Telling his story, Victor broke into a scream, his lips trembled, he was filled with anger and despair. I explained to Victor that he was a victim of bullying and he had to fight for himself. Bullying is psychological terror, the aggressive persecution of one person by another or a group.
Bullying is scary because drop by drop it undermines the health and psyche of the victim, leading to emotional burnout
Since the client was in a fighting mood, and life experience allowed me to hope that he would pass the test, I offered him a proven method - start keeping a bullying diary. She explained that his task is to carefully record all episodes of bullying, including even the smallest ones: the boss pointedly ignored, ridiculed, made a rude remark in front of everyone, forgave others for the mistake, but not Victor.
Each of these episodes may seem insignificant, but what makes bullying so scary is that drop by drop it undermines the health and psyche of the victim, leading to emotional burnout. Therefore, the fight against it must be just as scrupulous. Each case is recorded on a separate sheet of paper, divided into columns: date, time, what happened, who is the witness. The consequences should be written down in a separate column.
For example, “The pressure has risen” or “I have lost my bonus.” Collected together, these pieces of paper look like a serious evidence base. Victor is a smart man and understood me perfectly. Neat and methodical, he began to meticulously collect this dossier. And this alone helped him become much calmer.
A month and a half later, when enough sheets of paper had accumulated, he brought this folder to the boss’s office and said: “I don’t want a scandal, but if you don’t leave me alone, I will send these materials to the management of the corporation.” Bullies are usually cowards, and this was no exception. He no longer remembered that he wanted to accommodate his relative, and left Victor alone.
Kira, 36 years old
At the first consultation, I literally couldn’t get a word in - she needed to speak out. Kira said that in the morning she doesn’t even want to wake up - she’s so sick of the thought of work. A true workaholic, now she experienced only constant fatigue and emptiness.
At the same time, her career is quite successful - she is a manager of a large international company. The current boss invited Kira to this position after noticing her in another department. “He said: “I see that you are not appreciated there, but you are so talented!” These words inspired me, because I doubted myself. He is a brilliant pro, I learned a lot from him. Where would I be now if it weren’t for him!” - Kira said.
Diligent and creative, she not only mastered new functions perfectly, but also constantly gave her boss some ideas. And I unexpectedly discovered that the boss was not at all happy about it. Moreover, every now and then he began to set Kira up. Either he “forgot” to include her in the list of invitees to a meeting with the corporation’s management, or he did not indicate among the executors of the project for which he himself received an award.
Kira, in spite of everything, was still grateful to him, believing that she owed her career to him alone, continued to admire him and endure all the injustices. A year passed before she decided to come to a psychologist with a question about how she should continue to work.
His compliments are just a form of manipulation, a way to get her to do what he wants.
Listening to her, I understood that the boss is most likely a narcissistic person and uses people for his own interests. Power is more important to him than good relationships and business interests. Seeing how well Kira copes with her duties, he realized that in fact she could very well take his position.
That's why he started ignoring her, belittling her successes. I suggested that Kira think about it. And this explanation came as a great relief to her. But accepting that it wasn't her was not easy. This pointed to her traumatic childhood experiences. Indeed, she was raised too strictly in her family. No matter what Kira did, she was always “not good enough” for her parents. And as an adult, I continued to feel the same way. She became a brilliant professional, but low self-esteem prevented her from moving forward.
Our job was to ensure that Kira learned to look at her boss realistically. It took her a long time to admit: in front of her was an ambitious, not very honest man who loves to show off in front of his superiors, without any remorse attributing to himself the merits of others.
Gradually, from a reverent, admiring attitude, she began to move on to a balanced analysis: what kind of person he was and how to behave with him. It became clear to her that the compliments he occasionally bestowed on her were just a form of manipulation, a way to get her to do what he wanted.
Andrey, 45 years old
The deputy general director of a regional corporation came to the consultation completely depressed. The problem he came to me with was that the director constantly humiliated him in front of his colleagues.
At the same time, they worked together for several years: the director pulled Andrei along the career ladder, each time receiving a new appointment, he took him on as his deputy. For what? Andrei believed that the boss needed him as a “whipping boy,” and, of course, he suffered in this role. Well-mannered and delicate, he did not understand what caused such treatment, and increasingly lost faith in himself.
When we discussed the situation in more detail, it became clear that Andrei’s role in the boss’s life was much more important. The director did not know how to communicate constructively with employees, was afraid of conflicts, and did not respect the point of view of others. But Andrei was able to do all this well, who, in essence, for years served as a real leader, winning the respect and authority of his subordinates with his communication style. In fact, he became a buffer between the director and subordinates.
I showed Andrey with examples that without him the boss would not have lasted in his place for even six months and that he was well aware of this weakness. That's why he simply needed such a deputy. Essentially, Andrei had enormous power over his boss without even knowing it. The boss needed him much more than the boss needed him.
This turn came as a complete surprise to Andrey. For him, resolving conflicts, and in general, leading a team was not difficult at all, so he was not aware of how valuable his qualities were. He saw the whole situation differently, realized that he enjoyed authority among his subordinates, who perfectly saw his merits and correctly assessed the character of the director. A kind of insight occurred, everything became clear to him. And he admitted with relief that a heavy burden had been lifted from his soul.
About the expert
Svetlana Krivtsova- Director of the International Institute of Existential Counseling and Training.