Positive psychotherapy is a direction for which there are no ethnic and cultural boundaries

The Nobel Prize is not awarded for achievements in the field of psychology. Despite this, the list of psychologists who have received it is quite extensive. Since there is no direct nomination for them, they are awarded for discoveries in medicine, literature and even economics. At one time, Pavlov, Dale and Loewy, Hess, Camus, Sartre became laureates.

In 2009, Professor Nossrat Pezeshkian, a German neurologist, psychiatrist and psychotherapist with Iranian roots, was nominated in the section of medicine and physiology. His brainchild, positive psychotherapy, brought him worldwide fame and many awards. And most importantly, it effectively helps people overcome the conflict situations in which they find themselves every now and then.

What it is

Positive psychotherapy is a direction centered on conflict, which is resolved with the help of the abilities (innate and acquired) of the person himself. It is widely used in both psychology and psychiatry for the treatment of serious personality and behavioral disorders. Rooted in transcultural psychodynamic psychotherapeutic methods. Initially, Pezeshkian called his brainchild differential analysis. The basis is a humanistic point of view.

Pezeshkian positive psychotherapy has been actively promoted in Germany since 1968. But she received recognition much later. In 1996 it was declared an effective and official direction by the European Association of Psychotherapy. Following her in 2008, the same thing was proclaimed from the high rostrum of the World Council of Psychotherapy.

Professor Pezeshkian in the last years of his life (died in 2010) constantly traveled around the world with seminars, symposiums, and public lectures. Conducted interviews with the press, television and radio. To date, more than 40 positive psychotherapy centers have been opened in different countries. For the active implementation of his method, the doctor was awarded many awards:

• Germany's main medical award "Richard-Martin-Price" for quality assurance;
• Ernst von Bergmann Prize;
• Order of Merit of the Federal Republic of Germany;
• International Avicenna Prize for Ethics in Science;
• Nobel Prize nomination.

Many of his books have been translated into Russian:

1. "Positive psychotherapy - theory and practice of a new method."
2. "Positive family psychotherapy."
3. "Psychosomatics and positive psychotherapy."
4. “Psychotherapy of everyday life: conflict resolution training.”
5. “The merchant and the parrot. Eastern stories and psychotherapy."

Pezeshkian created positive psychotherapy based on transcultural studies of more than 20 world cultures. Therefore, many call his direction innovative and interethnic.

In everyday life you can find different names: positive dynamic psychotherapy, differential analysis, transcultural psychodynamics and others.

Complexities of etymology. Despite the fact that in PP there is a moment that provides the patient with an exclusively positive attitude, the name of the direction has nothing to do with the Latin word “positivus”, which translates as “positive”. It goes back to another Latin concept - “positum”, which means “occurring, actual, given.”

Positive family therapy

Per. from English L. Trubitsyna

Chapter I. Introduction to the Theory of Positive Family Therapy

1. The situation in science, religion, education and psychotherapy
2. What is "family therapy"?
3. What is “positive family therapy”?
4. Reader's Guide

Chapter II. Transcultural psychotherapy

(EAST - WEST concept)

1. Social changes in human image
2. Practical aspects of the East-West concept in family therapy

Chapter III. From family therapy to positive family therapy

1. Family is like hell
2. Family is like heaven
3. Family is like destiny
4. Family forms
5. Family balance
6. Family therapy? who needs to be treated
7. Family or clinic
8. Development of family therapy
9. What does positive family therapy deal with?

Chapter IV. Positive Family Therapy Methods

1. Three Pillars of Positive Family Therapy
2. Positive starting point
3. What is “positive family therapy”?
4. Positive image of a person; unity in diversity
5. Literature on basic abilities
6. Opportunities for reinterpretation
7. Practical application of “positive reinterpretation”
8. Help change your perspective
9. What are "concepts"
10. Positive family therapy doesn't fix anything.
11. Patient as therapist
12. Positive procedure in the therapeutic process

Chapter V. Content and dynamics of the conflict

1. Four forms of conflict processing and how they work
2. Using the Four Forms of Conflict Processing Framework in Positive Family Therapy
3. Four Dimensions of a Role Model
4. Four Role Models in Positive Family Therapy
5. Current Abilities
6. Microtraumas. The so-called little things
7. Specification of content
8. The importance of current abilities
9. Actual abilities as signs of transcultural differences
10. Using a differential analytical questionnaire
11. Actual conflict and basic conflict
12. Three stages of interaction

Chapter VI. Five steps of positive family therapy. How they work.

1. Observation/Distancing Stage
2. Inventory stage
3. Situational reward stage
4. Verbalization stage
5. Goal Expansion Stage
6. Positive Family Therapy Strategy
7. Interaction between therapeutic models
8. Positive Family Therapy: Language and Social Classes

Chapter VII. Positive family therapy practice

1. Concepts and Applications in Positive Family Therapy
2. Concepts in therapeutic work: changing perspective
3. Stories and sayings as a means of changing perspective

Chapter VIII. Concepts and their influence in positive family therapy

1. Frigidity: the ability to say “no” with your body
2. What do stomach diseases have in common with frugality?
3. My parents raised me wrong
4. Obesity
5. Cardioneurosis
6. “What will people say?”
7. Literary Concepts: Who is your favorite author?

Chapter IX. Family tradition and identity

1. Traditional neurosis
2. Staying true to concepts or changing them
3. Unresolved generational conflict
4. Until death do you part
5. The wrong way
6. Delegated Concepts
7. Old ban
8. Dangerous tea
9. Is it possible to hurt people?
10. Deliverer
11. Conceptual family tree
12. Tradition of symptoms

Epilogue

Application

The essence

The whole essence of positive psychology is revealed in the etymology of the term. It works with the problem that exists at the moment and which requires an urgent solution right now. Nosrat Pezeshkian believed that while in other directions they were getting to the bottom of the true causes of the conflict (psychotrauma, disorder), precious time was wasted. Then it is also spent on the possible elimination of provoking factors. And only after that the work begins directly with the problem itself. And during this period it already manages to grow, take root and move into an advanced stage.

Considering these moments to be a clear disadvantage of most psychotherapeutic directions, Nossrat Pezeshkian created positive psychotherapy with a completely different goal - to work directly with the problem situation. Without delving into childhood behavioral patterns and long-standing psycho-traumatic factors, he tried to quickly rid a person of anxious thoughts, depression, nervousness, and personality-behavioral disorders before they became advanced.

This gives excellent and fast results. People get a solution to their problem in just a few sessions, without going deep into the past and without bringing up unpleasant memories in the recesses of memory. While maintaining peace of mind, they also learn to independently get out of difficult situations later.

The main objectives of positive psychotherapy:

• psychotherapeutic aspect - treatment of personal behavioral disorders;
• pedagogical aspect - education and prevention of deviant behavior and social maladaptation of children and adolescents;
• transcultural-social aspect - development and improvement of intercultural consciousness (study of national traditions that influence the behavior and internal state of their bearers);
• interdisciplinary aspect - interaction and integration (as far as possible) of other psychotherapeutic areas under a common auspices.

Such a variety of aspects that specialists have to work with makes it even more attractive.

What are the basic principles of dynamic psychotherapy?

Dynamic psychotherapy (DBT), known as psychodynamic or psychoanalytic psychotherapy, combines several types of psychotherapy based on psychoanalysis and existential psychology. At the forefront of understanding mental processes and personal behavior, dynamic psychotherapy places the sphere of the unconscious and the past life experience deeply hidden in it, starting from childhood, sometimes even infancy. The main elements of such an impact are the characteristics of thinking (cognitive defense (more about cognitive behavioral therapy)), interpersonal relationships and the perception of other people through the transfer of experience hidden in the subconscious to the surrounding reality. Why dynamic? Perhaps many will think that this definition refers to the speed and intensity of this area of ​​​​psychotherapy. But no, indeed, from a technical point of view, dynamics means force, energy and movement, but when applied to mental activity, the term dynamic indicates the development of the mental sphere of the individual, as a struggle between the internal processes of the psyche and the conflict inherent in certain circumstances between instincts and the ego of a person resisting them. According to Freud, it is this conflict that underlies the development of neuroses. He believed that their cause was of a sexual nature, and the development of neurotic states was subject to such basic principles as dynamism, structure, development and adaptation. The entire psychoanalytic model is based on the following basic principles: • The main role in mental processes belongs to instincts and their transformation as a result of suppression and resistance to their painful manifestations for the psyche. • There is a constant struggle between physiological instincts and the defense mechanism of the Ego (“I”, which mediates communication with the outside world) - instincts are suppressed by moral standards and norms of behavior existing in society. • The suppression of instincts itself is of a sexual nature, therefore the main etiological factor of neuroses is considered to be incorrect psychosexual education and, accordingly, distorted libidinal desire. • The sources of such pathological development are located in the rather distant past, in psychological traumas received in childhood, associated, for example, with the Oedipus complex (unconscious erotic attraction) to a parent of the opposite sex. • The presence of internal resistance to identifying this complex. • Mental determinism, i.e. the conditioning of behavioral and mental phenomena by previous events that consciously or unconsciously influence the characteristics of the psyche and behavior of the individual. In general, the chain of cause-and-effect relationships in the development of neuroses according to Freud can be represented in the form of the following diagram:

Attraction → Anxiety → Defense mechanism.

Freud's dynamic model expanded the understanding of the human psyche, explaining its individual characteristics by the presence of conflicting thoughts, emotions, and behavioral reactions, which can be either adaptive in nature or be the basis for psychopathological disorders. By the way, the conflict of forces can be located at different levels, both deep in the unconscious and in consciousness.

Advantages

The “here and now” principle is actively used in neurolinguistic programming, psychodrama, client-centered psychotherapy, Gestalt therapy, and non-directive hypnosis. And yet, work in these areas takes too long, since they practically do not draw on a person’s internal resources, helping him with external methods. Most of them are focused on eliminating the symptoms rather than the conflict itself.

Given all this, it is not surprising that positive psychotherapy has had such success. Its advantages over other areas:

• conflict-centered rather than symptom-centered;
• short-term: on average, 20 sessions within the framework of psychology and no more than 50 sessions of psychotherapy (taking into account the final recovery from quite severe disorders);
• universality: specialists do not have to look for different methods, techniques and techniques - here everything works to eliminate the conflict almost instantly;
• internationality: this is cross-cultural psychotherapy that integrates the philosophy and intuitive wisdom of the East and the rationalism and science of the West;
• active involvement of the patient in the process of working through their conflicts;
• working with a person as an integral system, and not with his individual thoughts, experiences, conflicts;
• active use of parables and metaphors as a psychotherapeutic tool for working with patients;
• future-oriented, despite the “here and now” principle: positive psychotherapy teaches how to cope with problematic situations in the future.

In addition to all these advantages, this direction also offers methods for working with problems that arise for psychotherapists themselves. For practicing specialists this is a significant advantage. One of the most attractive points for patients is that short-term positive psychotherapy allows you to eliminate conflict in a minimum number of sessions. Where Gestalt therapy takes six months, PP is managed in one and a half months.

Short-term psychotherapy: myths and reality

Head of the Department of General and Clinical Psychology of BSU, Professor of the Department of Psychiatry and Medical Psychology of Bashkortostan State Medical University, Doctor of Medical Sciences V. A. Domoratsky

Each time has its own neuroses and each

time requires its own psychotherapy.

V. Frankl

In recent decades, two trends have been clearly visible in psychotherapy. Firstly, there is a desire to bring together different methods and the emergence of a number of integrative-eclectic approaches that are gaining an increasing number of supporters. V.V. Makarov (2000) believes that eclecticism is the main path for the development of psychotherapy in the 21st century, since a huge, almost unlimited number of methods and schools of therapy leads to the need to borrow the most important and effective in each direction and school.

Secondly, this is the development of short-term, problem-oriented methods of psychotherapy. These include Ericksonian psychotherapy and Ericksonian hypnosis, short-term strategic psychotherapy, neurolinguistic programming, desensitization and processing by eye movements, positive psychotherapy, etc. In our opinion, the use of a short-term format of psychotherapy in most cases is completely justified. Focus on the main problems, clear goal setting, structure, therapeutic pragmatism, cost-effectiveness and fairly high effectiveness in work, which distinguish short-term methods of psychotherapy - exactly what is most relevant and in demand when providing psychological and psychotherapeutic assistance in modern conditions. Especially when it comes to psychotherapy carried out in a city clinic, neuropsychiatric dispensary or psychiatric hospital. In the public health care system, any other psychotherapy other than short-term therapy will simply be a profanity, because existing standards do not at all imply long-term therapy. For example, given the average length of hospitalization and medical workload, it is difficult to imagine that a patient with a neurotic disorder will undergo more than 10 psychotherapy sessions during his hospital stay. However, even in private practice, short-term methods of psychotherapy create a good basis for successful work with the most common neurotic and psychosomatic disorders, as well as addictions.

The main goal of short-term psychotherapy is not to find out hidden motives or profound changes in personal characteristics and emotional responses, but to provide specific assistance in overcoming clients’ current life problems, including correcting their dysfunctional behavior and/or thinking and eliminating painful symptoms. Ultimately, all this ensures the restoration of the mental and physical well-being of people in need of psychotherapeutic help to an acceptable level for them, which they subjectively experience as a state of relative (more or less) mental comfort. This kind of psychotherapy is limited in time, and the maximum number of psychotherapeutic sessions does not exceed 20–24 (usually 6–10). We emphasize that any short-term approach can be used again if the patient subsequently turns to a psychotherapist to work on other problems.

The development of short-term psychotherapy occurred in fierce competition with other, primarily psychodynamic and humanistic approaches. K. Grave (1994) classifies them as revealing, i.e. looking for answers to questions about why and how problems arose for the person asking for help. On the contrary, all short-term methods of psychotherapy are supportive: they are focused on the patient overcoming current life problems, eliminating painful symptoms, and developing more adaptive forms of behavior. In our professional environment, there is a persistent myth that only long-term psychotherapy, based on carefully developed theories of personality and psychopathology, can provide a stable therapeutic effect, since it helps clients better understand themselves, their motives, values, goals of their behavior and aspirations. A prerequisite is to achieve insights. At the same time, short-term psychotherapy is often interpreted as superficial, manipulative, and lacking a fundamental theoretical basis.

M. Twain said: “In the hands of a man with a hammer, everything around him looks like nails.” Professionals who have firmly grasped that the main goal of psychotherapy is personality reorganization will, first of all, strive to teach the client to trust his feelings, take responsibility, think more rationally, etc. If for the psychotherapist symptoms or dysfunctional behavior are a reflection deeper, hidden disorder, then he will be interested not in their disappearance, but in changes in personal characteristics, emotional experiences, self-esteem and cognition, which is, in their opinion, undoubted evidence of deep therapeutic elaboration.

An alternative point of view belongs to M. Erickson, who can be considered the founder of “new wave psychotherapy”, short-term and focused on achieving adaptive changes in the client. He wrote: “The therapist should not so disrespect his patients as to be unable to accept natural human weakness and irrationality.” (M. Erickson, 1980). And even more specifically: “It is necessary to recognize the fact that for some patients complete and exhaustive psychotherapy is generally unacceptable. Their entire general pattern of survival is based on a long-standing inability to adapt to the environment, the cause of which is their imperfection. Consequently, any attempts to correct this maladaptation will be undesirable or simply impossible. Therefore, the correct psychotherapeutic goal is to help the patient to function adequately and constructively to the extent possible, taking into account all his internal and external shortcomings that form an integral part of his life situation and real needs. (M. Erickson, 1954). By the way, Erickson considered insight to be only one of the ways to achieve mental health. His practice is replete with many examples where positive changes in patients occurred as a result of using multi-level communications in a hypnotic trance, as well as performing homework specially designed for them without a deep awareness of the existing problems.

Let us emphasize once again that what psychotherapists consider changes indicating the effectiveness of therapy primarily depends on their theoretical positions. The existential psychotherapist will try to eliminate the client's primary anxiety caused by the person's conscious or unconscious attempts to cope with the harsh realities of his existence. Because existential anxiety often hides behind the façade of presented symptoms. A short-term strategic psychotherapist will focus his efforts on identifying and transforming those cognitive constructs and behavioral patterns that contribute to the emergence and maintenance of neurotic symptoms and dysfunctional behavior.

The question of what is considered positive changes in psychotherapy is far from clear, since the ideas on this issue among the psychotherapist, the client and his relatives can vary greatly. For example, a 22-year-old man sought counseling at the insistence of his parents, who were concerned about his lack of interest in girls. The psychotherapist found out that he was experiencing homosexual attraction, which, despite doubts about its “correctness,” he had already repeatedly realized in the company of male acquaintances. In the light of modern ideas, psychotherapy in this case should consist of helping the young man accept this feature of his sexuality. But this may not suit his parents at all if they are quite conservative and adhere to traditional views on intimate relationships.

Different types of psychotherapy, depending on the theoretical concept, focus on individual changes in personality or behavior. W. Styles, D. Shapiro and R. Elliot (1986) argue that psychological normality is heterogeneous and lies in a fairly wide range. In their opinion, numerous psychotherapeutic approaches actually represent different paths to achieving mental health. Each direction in psychotherapy offers its own definition of mental norm, and different individuals may correspond to this definition to a greater or lesser extent. It is quite possible that there are many ways to be mentally healthy and each of the traditional theories will be a model of one of these ways. M. Erickson also emphasized: “Each person is unique. Therefore, psychotherapy should be carried out in such a way as to meet the needs of this particular person, and not try to adapt the individual to the Procrustean bed of one or another hypothetical theory of human existence.

However, in order to reach some kind of consensus about the effectiveness of psychotherapy, at least in clinical practice, there is an urgent need to identify desirable changes, focusing on partial or complete elimination of behavioral problems and symptoms that are reflected in the corresponding diagnostic headings of ICD-10 . It does not follow from this that when constructing psychotherapeutic tactics, we should rely solely on the “label” of a psychiatric diagnosis, which does not give a clear idea of ​​the psychogenesis of a neurotic disorder and the patient’s psychological problems that require resolution. Just a phenomenological classification, which is the ICD-10, can be used to consistently state those specific changes that occur in a patient as a result of psychotherapy. In addition, this allows us to at least get closer to mutual understanding between the orthodox psychiatric lobby and psychotherapists practicing in the clinic.

Another important support in assessing the changes achieved during psychotherapy is undoubtedly the comparison of data obtained using validated and standardized psychodiagnostic techniques before and after treatment. And finally, working with very subtle, subjective matter, which is the mental activity of a person, in assessing the results of our work, we cannot completely ignore the opinion of our clients. Because all our good intentions will remain just intentions if, outside the psychotherapy room, the patient himself does not feel any positive changes in his mental and physical state. People come to us without the slightest idea of ​​the psychological theories that try to explain how and why their problems arise. But, experiencing severe mental discomfort, the most advanced of potential clients at some point come to a psychotherapist with the hope that he will help them find psychological comfort and/or improve relationships with other people. Moreover, in our complex and dynamic times, most of them crave changes for the better in a very limited time frame. This largely explains the continued popularity of alternative specialists, among whom are many outright charlatans, always ready to take on an immediate solution to almost any problem.

The main goal of short-term psychotherapy is precisely to provide specific assistance in overcoming the most significant life problems of patients, which ultimately helps to restore their mental and physical well-being, as well as improve interpersonal relationships. It is short-term methods of psychotherapy, in our opinion, that can provide real competition to short-term alternative approaches, which are offered in abundance to potential consumers of psychotherapeutic services in the post-Soviet space. While the psychotherapeutic community will continue to patiently wait for “ignorant” patients (among the latter there are many quite educated and wealthy people) stop flocking to psychics and magicians, and finally come to their senses and line up to see the “right” psychotherapists for unhurried, but very solid and deep therapy, based on sophisticated scientific theories, the number of our poorly educated, but extremely virulent competitors is unlikely to decrease. We probably need to be more flexible and offer people more widely the format of psychotherapeutic assistance that is currently most in demand: problem-oriented and short-term. At the same time, there is no doubt that among our patients there will always be a certain (not too large) number of people for whom, due to their personal characteristics and the nature of the problem, long-term insight-oriented therapy is more indicated.

To date, many studies have been conducted to evaluate the effectiveness of certain short-term methods of psychotherapy.

For example, F. Shapiro (2002) reviewed the results of 13 controlled studies of the treatment of psychological trauma using eye movement desensitization and reprocessing (EMDR), which included 300 patients. She found that the results of using the method were significantly superior to no treatment and that its positive effects were not inferior to those using other psychotherapeutic methods with which comparison was made. All but one of the most recent studies of EMDR psychotherapy with civilians reported that between 77 and 100 percent of victims of single trauma no longer met diagnostic criteria for PTSD after just three 90-minute sessions.

A significant reduction in fears was found in the vast majority of patients suffering from agoraphobia, specific and social phobias after 2-3 sessions using NLP techniques (S. Forman et al., 1988).

A study of the results of therapy in the model of short-term strategic psychotherapy showed that when monitoring 97 patients who completed an average of 7 psychotherapeutic sessions, 40% reported complete relief from the existing problem, 32% reported significant improvement and 28% reported no progress (P. Watzlawick, J. Weakland, R. Fish, 1974). In 1987–88, at the Center for Strategic Therapy in Arezzo, G. Nardone and his staff conducted an analysis of the cost-effectiveness and effectiveness of PCB. They found that the average number of psychotherapeutic sessions in 119 patients with neurotic disorders and relationship problems ranged from 12 to 17. The exception was 13 patients with psychotic conditions: each of them received an average of about 23 sessions, and 2 of them achieved complete, and in 7 – a noticeable improvement in mental state. In the group of patients with neurotic disorders, the effectiveness of therapy ranged from 67 to 95%, and in those with partner problems it reached 100%. Overall, a positive treatment outcome was reported in 83% of cases, and the relapse rate was low during one year of follow-up.

Brief positive psychotherapy (PTPT) is widely used for almost all behavioral disorders and in any therapeutic format (working with an individual, couple or family). It is emphasized that narrow focus (focus on the solution) is especially valuable when helping people with adaptation problems (D. Araoz, 1996). There are indications of the effectiveness of CPT in chronic mental disorders (C. Martinez et al., 1994; J. Prochazka and J. Norcross, 2005). It is quite difficult to determine the overall effectiveness of this method, but if we proceed from the CPT postulate that it is the client and no one else who must evaluate the results obtained, then, based on the opinion of those who have undergone therapy, we can talk about the positive changes achieved in approximately 80 - 90% cases.

In the period from 1972 to 1988. More than 70 studies have examined the effectiveness of rational emotive therapy (RET) in treating a variety of disorders and populations. The results were summarized through meta-analysis (L. Lyons, P. Woods, 1991). It was found that RET provided significant clinical improvement in 73% of treated patients compared with those who did not receive RET.

Thus, short-term methods of psychotherapy are in demand, economical and quite effective, which suggests a further increase in their role in the provision of professional psychotherapeutic assistance in Belarus and other CIS countries. This must be taken into account when developing postgraduate training programs for doctors specializing in psychotherapy.

Basic principles

Positive psychotherapy is based on three “pillars” - three basic principles. Each of them corresponds to a specific technique.

The principle of balance

It corresponds to the methodology of meaningful differential analysis of personality psychodynamics. The name just sounds so scary, but in reality everything is simple. Positive psychotherapy works with a person’s innate (primary) and acquired (secondary) abilities. The specialist tries to identify and differentiate them at the very first sessions.

Most often, the problem arises due to the fact that the former turn out to be undetected and rebel somewhere from within, while the latter, although lying on the surface, do not find a field of application. The task of the PP is to harmonize and literally “bring out” innate talents and at the same time help to actualize acquired ones.

Principle of Hope

It corresponds to the method of a positive approach in seeing innate and acquired abilities, as well as human capabilities. There are patients whom one or another referral refuses because it does not have the necessary tools to work with it. But here psychotherapists do not have the right not to believe in a successful outcome. Even if the case is unique or advanced, it is necessary to act as if recovery will come tomorrow. Moreover, most of the hope is placed on the internal resources of the patient himself.

The principle of self- and mutual assistance

It corresponds to a metamodel that involves 5 steps. Its goal is to harmonize, adapt and develop any personality in the shortest possible time. And if at the very first sessions the work is carried out mainly with the patient himself, then at the end he is given an algorithm on how to improve the life of not only himself, but also those around him. Moreover, this list is quite impressive: loved one, family, business partner, colleagues, employees of the organization, community. The humanistic orientation of positive psychotherapy manifests itself most clearly in this principle.

However, these principles do not exhaust the methods of positive psychotherapy. In the hands of specialists there is a much richer toolkit.

When is pediatric therapy effective?

As noted above, pediatric therapy can be effective for a wide range of problems. If a parent is unsure whether a child needs counseling or not, the list of symptoms below may be a good guide. If a child experiences one or more of these symptoms in combination with parental concern, it may be worth taking action.

The following are symptoms that may indicate a problem:

• unjustified aggression;
• incontinence;
• difficulties associated with social situations;
• frequent nightmares and sleep problems;
• a sharp deterioration in school performance;
• constant anxiety;
• loss of interest in activities that previously brought pleasure;
• reports of voices in the head;
• social isolation and desire to be alone;
• alcohol and drug use;
• complaints of fatigue.

In addition to these problems, the child may be dealing with:

• feelings of sadness and apathy;
• constant anger;
• preoccupation with one's appearance;
• inability to concentrate;
• inability to sit still.

If you decide to contact a specialist, ask him the following questions:

• Why is psychotherapy recommended?
• What results can I expect?
• How long will my child remain in therapy?
• How much does a therapy session cost?
• How do we (parents) know about our child's progress and how we can help?
• How soon can we expect changes?

Only after this and having convinced yourself of the appropriateness of the event can you discuss the issue with the child himself.

About abilities

Innate and acquired abilities are key concepts. Moreover, we are talking not so much about talents, giftedness or genius, but about universal human values. For example, from the point of view of the PP, from birth, everyone has two leading abilities (needs) - to know and to love.

The ability and need to know

This is the rational, intellectual essence of man. The left hemisphere of the brain is responsible for it. Firstly, it is more developed among mathematicians, physicists and people in other specialties related to the exact sciences. Secondly, given the integration of cultures, from the point of view of positive psychotherapy, this ability is a priority for residents of North America and Western Europe.

This is what becomes the main focus when resolving a conflict, for example, for a chemist or a German. The therapist invites them to eliminate it through logical thinking. Constant quarrels with your wife? Because of which? Doesn’t cook, doesn’t wash or iron clothes, doesn’t look after the children, demands a lot of money? Are there any positive moments in living together with her? What is more: advantages or disadvantages? With the help of such leading questions and recording clear answers, a comparative table at the end of the first session, the rationalist sees that there is no longer any point in being with such a spouse and the only way out of this situation is divorce (or vice versa).

The ability and need to love

This is the emotional, sensual spiritual essence of a person. The left hemisphere is responsible for it. It is developed among representatives of humanitarian and creative professions, as well as among residents of the East and South America.

If an artist or a Japanese man comes to a positive psychotherapist with a family problem (quarrels with his wife), it is useless to ask them those clear, rational questions that worked so effectively in the previous case. The answers to them will be vague, long and indefinite, which will only further confuse the client about what he wants and delay the session.

This requires other methods and techniques. For example, metaphors or parables. Seeing his own family life as a damaged canvas or dried out paints, the artist will be able to decide for himself whether to revive them or replace them with new ones. Having heard the story about the stupid wife, the Japanese will understand how to fix everything.

"Supermen"

The most difficult thing to work with is people who have a mixture of physiological abilities and cultural and historical predispositions. For example, with a Chinese computer scientist or an English musician. On the one hand, they are driven by the most developed hemisphere. On the other hand, ethnicity. In such cases, it is necessary to identify the dominant of these factors and work with an orientation towards it. In this case, it is necessary to eliminate the eternal internal conflict between these two entities.

This intercultural approach allows positive psychotherapy to work with a person of any nationality, taking into account his ethnic and cultural-historical predispositions. This gives excellent results.

Techniques and exercises

One of the benefits of Pezeshkian positive psychotherapy is the ability to use some of the techniques and exercises on your own. They will help cope with excessive emotional and physical stress, internal disagreements and complexes, and obsessions.

Sanogenic thinking

It will be especially effective in the case of those people who like to exaggerate problems, “making mountains out of molehills.” Encourages you to see the good in everything that happens around you. Yes, sometimes it is difficult, but nothing is impossible, especially when you understand what it is for.

Let's imagine that you suddenly feel ill in the middle of the working day. It would seem that what good could happen in this situation? Any discomfort is a signal from the body that something is wrong with it. This means you have the opportunity to undergo an examination and identify its cause in time. It happened before, but, you see, rarely does anyone regularly go to the hospital and undergo a medical examination. But the sooner you contact a qualified specialist and start treatment, the fewer consequences (often irreversible) there will be.

Perfect day

This exercise is recommended for those who have not received joy from life for a long time, have forgotten what happiness and peace are, are mired in problems and, as a result of all this, have fallen into depression. It is recommended to perform this a couple of times a week.

So, take a blank sheet of paper and a pen. Write in as much detail as possible how you would like to live tomorrow. Don't miss the slightest detail. Write into your plan what you want to eat for breakfast, who to call, what TV show to watch or book to read, where to go and who to meet. And then try to live the day as you wrote it, as accurately as you can.

Positive Labels

This exercise gives excellent results, although it seems difficult. You need to clear the space around you of labels with negative connotations. What does it mean? For example, your neighbor is not old and fat, but wise over the years and with appetizing curves. The boss is not a tyrant, but a person who simply has a rather interesting and difficult character.

At first, you can repeat these statements out loud, and then move on to mental formulations.

Clew

Don't worry, you won't have to knit here. The tangle needs to be unraveled. Very often we lump everything together. And then it seems that there are more and more problems, but there is not enough strength to fight them. Take several sheets of paper and write a different difficulty on each one. Let’s say one has problems at work, the second has problems in the family, the third has a lack of time to spend with children, etc. Describe them in as much detail as possible, but under no circumstances mix them up. In the same way, proceed to the solution separately.

Stages and methods

Stages

In resolving any conflict, positive psychotherapy takes the patient through five mandatory, sequential levels:

1. Distancing from the situation that provoked the conflict.
2. Its detailed study.
3. Situational agreement.
4. Verbalization.
5. Expanding the boundaries of goals.

All these stages have only one goal - here and now to save a person from a problem, help him cope with it and move on without an aggravating load. All patients, without exception, undergo this regimen. Regardless of what they came with - an ordinary domestic quarrel (interpersonal conflict) or serious behavioral deviations (mental disorder).

Methods

At these stages, psychotherapists use different techniques, techniques and methods to achieve the goal at each specific level. Some of them are universal and are actively used in almost all areas of psychology, pedagogy, and psychotherapy:

• question-answer technique;
• speaking;
• visualization;
• identifying current abilities using the survey method.

But in the arsenal of positive psychotherapy there are also specific techniques and techniques developed specifically for it:

• formalized diagnostic interview with closed questions;
• stories, fairy tales, parables;
• metaphors;
• multicultural approach;
• complementary approach strategy;
• a selection of examples of such conflicts.

How was the history of the development of dynamic psychotherapy?

Dynamic psychotherapy is a logical continuation of the classical psychoanalysis of Sigmund Freud. Its most common variants were Jung's analytical psychology, Rank's volitional therapy, Sullivan's interpersonal psychotherapy, Adler's individual psychology, Wohlberg's hypnoanalysis (more about hypnosis), Myasishchev's personality-oriented, otherwise reconstructive psychotherapy, widespread in Russia, and many others. By the way, reconstructive psychotherapy is a purely domestic scientific product and is based on the teachings of V.N. Myasishchev about neuroses and the principles of their psychotherapy, as borderline states. It should be noted that the development of the dynamic approach in psychotherapy followed three fundamentally different directions: 1. Freudian, based on the conflict of innate instincts, which gradually intensifies during psychosexual development. Conflict arises between opposing instincts, between instincts and the environment, and between the immediate satisfaction of the child's needs and the world, which opposes and delays this process. 2. Neo-Freudian, represented by G.S. Sullivan, K. Horney and E. Fromm and considering internal conflict not as programmed by innate instincts, but as formed by interpersonal and social relationships. They consider the child’s basic need for safety, acceptance and approval of his actions by significant adults. Children's inherent curiosity, energy, innocence of bodily desires, potential for growth and development, as well as the unlimited desire for complete possession of a loved one do not always meet the requirements of nearby adults. This is the main children's conflict. If parents, for various reasons, are unable to ensure the safety of the child and create conditions for realizing the potential of his growth, then he has a real danger of developing a severe mental conflict, including a delayed one. 3. Existential, in which the conflict arises due to the confrontation of the individual with the givens of his existence, the so-called inevitable final factors of the individual’s existence. There are only 4 of them: • Death is a terrifying and completely conscious final reality. Its inevitability is opposed by man's strongest desire to continue to exist. Even on his deathbed, a person strives to live. This is confirmed by the classic case when an incurable, severely suffering patient asked the doctor for euthanasia. He left pills near his bed, explaining what dose could be fatal. In the morning he found the patient in the same condition, but not a single tablet had been taken from the package. • Freedom is a less obvious, but no less significant reality. The attitude towards freedom is ambiguous. In general, it is regarded positively if a person tries it on himself, but since we all live in society, the freedoms of different individuals can come into confrontation with each other. Therefore, a structured community in which rules and standards of behavior operate opposes the so-called absolute freedom, creating a support and basis for security for a person. The loss of such support and the realization that there is emptiness in its place inevitably gives rise to an internal existential conflict. • Isolation is seen not as a feeling of loneliness and isolation from other people, but as a more fundamental reality. We come into this world alone and we leave it alone. No amount of human intimacy can overcome this barrier. Therefore, a conflict arises between absolute isolation and the need for protection, contacts and a person’s sense of himself as part of the larger human world. • The meaninglessness that is generated by the first three data. If we all die, we are responsible for our own universe and are alone in this indifferent world, then what is the meaning of our existence, why do we live and how can we continue to live? This dynamic conflict is caused by the search for the meaning of life by a person who finds himself in a world that is meaningless according to his ideas. The task of an existential psychotherapist is to clarify the nature and causes of deep-seated personal conflicts. This is quite difficult to do, since most often the symptoms presented by the patient are similar to a motley mosaic, and the root cause of mental problems is deeply hidden under many layers of repression, replacement, denial and symbolization of painful memories for the psyche. The previous scheme of the dynamic approach proposed by Freud in existential psychodynamics radically changes the content and can be presented as follows:

Awareness of the final reality → Anxiety → Defense mechanism In both formulas, anxiety is of key importance for the emergence and development of mental disorders, triggering conscious and unconscious processes of mental activity as a defense mechanism. This mental activity is the basis of various psychopathologies. According to the characteristics of each direction, the methods of dynamic psychotherapy used in psychotherapeutic practice also differ.

Difference from long-term approaches

Brief therapy differs from other schools of therapy in that it emphasizes:

1. Focus on a specific problem
2. Directive interventions (the therapist's direct intervention in the client's process of change)

In short-term methods of psychological assistance, the therapist takes responsibility for working more actively with the client in order to quickly heal clinical and emotional-subjective conditions.

The short-term psychotherapist also insists on accurate tracking of changes, the client's use of his internal resources, and a temporary suspension of disbelief in considering new “maps of reality” and multiple points of view on the client's problem.

Instead of a formal analysis of the historical causes of distress, the main approach of brief therapy is to help the client see the present in a broader context and use a more functional understanding (not necessarily at a conscious level). Through awareness of these new perspectives, clients de facto undergo spontaneous and generative changes.

Brief therapy is often highly strategic, exploratory, and solution-oriented rather than problem-oriented. She is less concerned with how the problem came about than with the current factors that support it and prevent change.

Brief psychotherapists do not adhere to one “right” approach, but rather recognize that there are many paths, any of which may or may not, in combination, prove ultimately beneficial. All this together pushes the therapist towards a multimodal approach.

Thus, it is not the client who is pushed into the mainstream of some theoretical school or direction, but the therapist, as an “experienced hacker,” selects the keys to solving the client’s problem (which does not relieve the client of responsibility for his own changes).

Founding Supporters

Milton Erickson practiced short-term therapy using clinical hypnosis as his primary tool. To a large extent, he gave birth to this direction of psychological assistance.

His approach was popularized by Jay Haley in the book “Uncommon therapy: The psychiatric techniques of Milton Erickson MD” (in Russia published as “The Unusual Therapy of Milton Erickson”).

Erickson uses the analogy of a man who wants to change the flow of a river. If he resists the river, trying to block it, the river will simply bypass him. But if he takes the power of the river and directs it in a new direction, the power of the river will cut a new channel.

Richard Bandler, one of the founders of neuro-linguistic programming, is another strong proponent of brief therapy. After many years of studying Erickson's therapeutic work, he wrote:

“It's easier to cure a phobia in ten minutes than in five years... I didn't realize that the speed at which you do things is what makes them last... I taught people how to cure phobias. They did part of it one week, part of it the next, and part of it the next. Then they came to me and said: “This doesn’t work!” But if you do it for five minutes and repeat until it happens very quickly, the brain will understand. This is part of how the brain learns... I have found that the human mind is not a slow learner. He learns quickly. I did not know that".