Neuroses and frustration as objects of work of the psychotherapist

A psychotherapist, a practical psychologist, a consultant, a highly qualified (by international standards) social worker constantly deal with clients suffering from neurosis, and the very suffering from these neuroses is caused by so-called frustration, which they themselves cannot cope with.

Therefore, it is very important from the very beginning of psychotherapy to deal with these concepts.

Let's start with frustration.

Frustration (from the English. Frustration - disorder of plans, frustration ) is a state of strong dissatisfaction, which occurs when our desires and aspirations meet with resistance, do not come true, are not justified, plans fail. The state of frustration associated with mental (and if you go deeper - even with psychophysical) tension, accompanied by depressive states. It can be said that frustration is always the suffering of a certain intensity - from tolerant to practically intolerable.

Strong frustration disrupts the normal course of psychophysiological processes, negatively affects almost all (cognitive, emotional, etc.) processes of an individual, distorts its internal picture of the world, disrupts interaction with other people and the environment.

So, frustration arises when a strong desire, the desire of a person comes up against a barrier that is or seems to him insurmountable.

Here we go to the main starting position of psychotherapy. The psychotherapist should distinguish himself and help distinguish his client, which of the obstacles that caused the frustration are really insurmountable, and which only seem to be insurmountable.

It is neuroses that are the conditions when the obstacles causing frustration seem insurmountable for the client, and are not such objectively.

Such “insurmountable” obstacles most often are the client’s constantly recurring neuropsychic states and his behavioral reactions that he would like to get rid of, but not only cannot do this, and in many cases does not try, convincing himself and others of their insuperability. or, on the contrary, necessary.

We can say that the neurotic behavior or state differs from normal in its irrationality (which the client either does not see or justifies), cyclicality (that is, behavioral reactions are constantly repeated), a waste of energy and “nerves”, and most importantly, their “cunning” that is, these irrational and yet non-stop behavioral reactions are not recognized by the client as neurotic, he is convinced that they are reasonable or at least inevitable.

I repeat, the psychotherapist, in contrast to a psychiatrist, works with mentally healthy people, and when we say that some obstacles are not really insurmountable, but only perceived by the client, then it is a question of a completely normal mentally and almost every person perception of the situation (sometimes even deliberately wrong perception, which we will talk about later).

For example, many of us are regularly late for a certain time at a meeting place or at the beginning of work. The route is the same, the travel time is known. It means that you need to get out exactly as much earlier, perhaps, the alarm clock should be set as much earlier. Who interferes? No one! And nothing happens. “As much as I’ll get up earlier, I’ll still be late for work or college,” many complain. This is a particular manifestation of neurosis - the obstacle is objectively surmountable, no one interferes, but “I can’t do anything with myself.” At the same time every time there is some kind of excuse.

Or another, familiar to many, example of family neurosis. Some spouses even regularly find out family relationships even without any extraordinary reason, declaring 1001 times: “We need to talk.” And they argue persistently about the same thing, proving their case about the same things, the same words, and sometimes even at the same time of the day, and in the same place. Moreover, each of them is sincerely sure that he is absolutely right.

But if 1000 attempts did not bring a positive result (and more often - aggravated the situation), it is clear that the 1001st will lead, at best, only to wasting nervous energy, and at worst - will end with another resentment and quarrel in which everyone will consider himself right. And, even realizing this, we still make the 1001st and 2001th attempts, considering it to be correct.

At the same time, everyone speaks louder and more than is necessary for the other to hear him, that is, he speaks not in order to reach the other, but in order to speak, to listen to himself.

It is clear that this is not normal (the action regularly brings the wrong result, but I repeat it). But at the same time, these or other minor abnormalities in one form or another are present in almost every mentally healthy person.

Therefore, one should not be afraid of the word “neurosis”, as if it is a diagnosis of mental illness, although, of course, under certain circumstances and stubborn reluctance to recognize the incorrectness and destructiveness of the chosen strategy of behavior, the neurosis can develop into neurasthenia with actual persistent mental deviations from the norm.

The psychotherapist must teach the client to act in accordance with ancient wisdom:

“God, give me the strength to overcome what I can.

Give me patience to endure what I cannot overcome.

And give me the wisdom to distinguish the first from the second. ”

As in cases with objectively insurmountable obstacles, and in cases with obstacles that are incorrectly perceived by the client as insurmountable, we are dealing with a certain mental dependence of the client on the frustrating object and should try to destroy this dependence.

Dependence can have different degrees - from such powerful ones as drug addiction and alcoholism to individual seemingly harmless but irrational habits that we would like, but cannot, get rid of .

So we came to the most important condition for overcoming neurosis and getting rid of frustration (dissatisfaction, tension) associated with it: to expose neurosis as irrational, interfering behavior, stop justifying it before others , and most importantly - in front of you, wanting to get rid of it .

Prior to this awareness and active desire, all the work of a psychotherapist is as ineffectual as the compulsory treatment of alcoholics and drug addicts who have not yet come to a firm decision to get rid of the disease.

I often have to conduct family counseling, and I can confidently say that as long as everyone (or at least one spouse) sees the causes of conflict only in the other, and his behavior is fully justified and nothing is changed in him, success is almost impossible .

Only after the recognition of neurotic (that is, irrational, but constantly recurring) models of their own behavior can new forms be created and gradually fixed, bringing success in a given situation, eliminating suffering or at least reducing discomfort to a level that is tolerant as for the internal state of the client, so for his external life.

Both psychotherapy as a whole, and many of its areas, between which (thanks to this single goal) are much more common than different, are aimed at this.

All classical areas of psychotherapy face the same problems and obstacles to their solution.

Questions for self-test

1. The subject and tasks of psychotherapy.

2. The difference of psychotherapy from psychology and psychiatry.

3. Differences of non-medical and medical psychotherapy.

4. Difference of the patient (object of psychiatry) from the client (subject of psychotherapy).

5. What is frustration?

6. The concept and main characteristics of neurosis.