5. Types and types of psychotherapy. Psychotherapy, based on the individual psychology of A. Adler.

Lecture



Plan

  1. The main provisions of individual psychotherapy.
  2. Theoretical Foundations of A.Adler's Psychotherapy

one.

When considering psychological theories and teachings, most of them show a peculiar limitation when the question arises of the scope of their application and means of knowledge. It is as if with deep intent the experience and knowledge of a person are surely rejected and it is as if any value of artistic, creative knowledge, guessing and intuition is being questioned. If experimental experimenters collect or cause phenomena in order to conclude how to respond, that is, they are essentially engaged in the physiology of psychic life, then other researchers order all forms of expression and manifestations of the soul into traditional systems or systems, not much different. At the same time, of course, they again discover here in separate acts the same dependencies and connections that were already introduced by them into the schemes of the soul.

Or, they try to reconstruct mental states and thoughts from individual, not very significant, but subordinate to the manifestations of the physiological character, identifying one with the other. The fact that the allegedly subjective thinking and empathy of the researcher are supposedly excluded here (in fact, they completely permeate his theory), these researchers also consider the advantage of their psychological concept.

These areas, in their method, have the meaning of the elementary school of the human spirit and resemble the obsolete nowadays natural science with its ossified systems, which are now generally replaced by views that aspire both to comprehend life and its variations in interconnections in both biological and philosophical and psychological terms. The same applies to the direction in psychology, which I called "comparative individual psychology." She tries to obtain, from one of the vital manifestations and forms of expression, as one of the options, the picture of the whole, the personality, assuming the integrity of the individuality. In this case, the individual features are compared with each other, their general orientation is derived, and they are assembled into a single generalized portrait reflecting the individuality.

It may seem that this way of considering the spiritual life of a person is completely unusual or looks rather impudent. In addition to other areas, it is clearly manifested in the concepts of child psychology. But, above all, this is the way one can imagine the essence and creativity of people of art: an artist, a sculptor, a composer, and especially a writer. In the most insignificant features of works of human art, the observer is able to recognize the main lines of the personality, his life style, and can recreate what he had already invested in them in relation to the finale. Life in society, life without scientific prejudice, is a phenomenon that has become so captive of the “where?” Question that it would be appropriate to note: despite all the opposite scientific opinions, no one has yet been able to form a judgment about an event, without seems to bind all the mental manifestations of the individual, including his fictitious goal.

When I am in a hurry to go home, the observer sees the posture, facial expressions, movements and gestures that can usually be expected from a person returning home. And this, without any reflexes and any causality. Moreover, my reflexes can be completely different, the reasons can vary - that which can be understood psychologically, and that we are primarily interested in and practically only psychologically and practically is the direction in which a person follows.

Further, if I know the purpose of a person, then I know approximately what will happen. In this case, I am able to streamline each of the successive acts as well, to see them interrelatedly and constantly adjust or concretize my insufficient knowledge of the context. As long as I know only the causes and, accordingly, only reflexes and reaction time, the capabilities of the senses, etc., I will not know anything about what is happening in the soul of this person.

To this we must add that the observed himself would not know what he wants if he were not aimed at the goal. As long as we do not know his life line, determined by the goal, the whole system of reflexes that are available to observation, together with all the causal conditions, cannot guarantee us the next series of his actions: they would correspond to any possible spiritual impulse. This deficiency is most clearly manifested in associative experiments. I would never have thought about one man who had experienced severe disappointment that he would associate a “tree” with a “rope”. But if I know his purpose, suicide, then I will expect with confidence a similar sequence of his thoughts, and so definitely that I will try to remove the knife, poison and firearms from his eyes. Only in the conclusions that a person makes; his individuality, his apperceptive scheme.

If you look closely, you will find the following pattern that permeates the manifestation of any spiritual event: we are not able to think, feel, desire, act, without having a goal. After all, no causality is enough for a living organism to overcome the chaos of the future and eliminate the implantlessness of which we would be a victim. Any act would remain at the stage of indiscriminate feeling, the saving of spiritual life would be unattainable: without integrity, physiognomy and personal need, we would be equal to a living creature of the amoeba rank. Only the nonliving obeys apparent causality. But life is a must.

There is no doubt that the assumption of the target installation to a greater extent meets the requirements of reality. With regard to a separate phenomenon, taken out of context, there is also, perhaps, no doubt. You can easily bring this confirmation. It is necessary only through the prism of this hypothesis to look at the attempts that a small child or mother has made. From the same one who tries to approach things without hypotheses, more often, perhaps, a deeper meaning remains hidden. Before the first step is taken, the goal of the movement already exists, which is reflected in each individual act.

Thus, in all mental movements, you can find that they get their direction due to the previously set goal. But all these transient, tangible goals after a short period of stability in the mental development of the child turn out to be subordinated to fictitious final goals, understood or perceived as a final. In other words, the spiritual life of a person, as if created by a good playwright character, rushes to his fifth act.

The organizational form in which the psychotherapist acts as the main instrument of therapeutic (psychotherapeutic) influence, and the psychotherapeutic process takes place in the doctor's dyad - the patient. In the organizational aspect, individual psychotherapy is considered as an alternative to group (where the psychotherapeutic group acts as a tool of psychotherapeutic influence), collective and family psychotherapy. It is used within almost all conceptual and methodological areas in psychotherapy, which determine completely the specifics of the psychotherapeutic process, goals and objectives, methods of influence, methodological techniques, the type of contact between the patient and the psychotherapist, the duration and other variables of individual psychotherapy.

Individual psychotherapy is performed by one psychotherapist, two (bipolar therapy) or several co-therapists. Often it is an element of complex therapy in combination with other organizational forms of psychotherapy, pharmaco-, physiotherapy, or sociotherapy. In the American literature, combination therapy is distinguished, combining individual and group (or family) psychotherapy by a single psychotherapist and combined therapy, in which the patient is on individual psychotherapy from one doctor and at the same time participates in family or group psychotherapy from other psychotherapists.

Methodologically, individual psychotherapy is closest to psychotherapy in a group of patients using the mechanisms of "infection" and mutual learning of patients for individual purposes (autogenic training, gestalt therapy). The combination with group psychotherapy centered on group dynamics, or even more so family therapy focused on the family microgroup as an integral subject of systemic psychotherapeutic intervention, can be offered to the patient only after careful study of psychotherapeutic goals, taking into account both the therapeutic potential of various forms of psychotherapy and their possible antagonistic Effect.

In the psychotherapeutic process in line with the individual psychology, there are 3 main lines:

  • identification of traumatic experience, which was the starting point for the development of neurosis;
  • research of the fictitious goal and erroneous apperceptive schemes, analysis of the final goal arrangements;
  • development of social interest.


In individual psychology, a detailed outline of the main areas of study of the child has been developed:

1) through questions it becomes clear when and under what circumstances problems arose (changes in the environment, diseases, the birth of family members, the start of school, the appearance of new friends);

2) detection of a hostile attitude, a sense of superiority, in which personal characteristics and behavioral reactions they manifest;

3) the restriction of instinctive activity and the development of the desire for superiority;

4) elucidation of the features of the child's communication and the development of his social interest;

5) relationships with others now;

6) information about the family situation, norms of communication in the family makes it possible to find out the position of the child, his perception and assessment of this position;

7) attitudes towards other people;

8) the hopes and expectations of the child;

9) prototypes of the implementation of the desire for excellence manifested in the preferred games and fairy tales;

10) the tendency to isolation, loss of social interest, passivity, domination of a sense of superiority through the analysis of early memories, dreams;

11) identifying the causes of comic, childish and stupid behavior;

12) identification of physical defects that form an inferiority complex;

13) clarification of the links between striving for success and mistakes;

14) acquaintance with positive achievements. Opportunities and features of the development of psychological functions in different areas.

2

Alfred Adler (Adier A., ​​1870-1937) - the founder of individual psychology. Born in Vienna, died at the age of 67 in Scotland during a lecture tour of European countries. Severe illnesses suffered by A. in childhood affected the choice of a doctor’s specialty and the further development of interest in the ideas of compensation for organic inferiority.

At the age of 18, A. Adler entered the University of Vienna, where he studied medicine. As a student, was interested in the ideas of socialism. After graduation he worked as an ophthalmologist, then a therapist. Gradually, his interests began to shift to the field of neurology and psychiatry.

In 1902, A. Adler was one of the first to join the psychoanalyst circle organized by Freud (Freud S.). In 1910, at the initiative of the creator of psychoanalysis, A. Adler was nominated for the post of the first president of the Vienna Psychoanalytic Society. By 1911, the theoretical differences between Freud and A. Adler became so serious and obvious that the latter was forced to abandon the presidency and leave the Society. He founded his own Association of Individual Psychology, whose ideas began to spread throughout Europe.

In addition to research in the field of psychology and psychotherapy, A. Adler was engaged in pedagogy, teacher training, organization of counseling centers in schools where parents could get advice on parenting issues, family relationships.

A. made lecture trips to Europe and the New World and enjoyed the reputation of an outstanding speaker. After the Nazis came to power in Germany, he left Europe and moved to the USA, where from 1932 he taught medical psychology at Long Island College.

A. developed a holistic system of individual psychology, emphasizing the approach to understanding each person as an integrated integrity in a social context.

The basic principles of the teachings of A. Adler, which are included in the concept of individual psychology, are holism (integrity), the unity of the individual lifestyle, the need for cooperation, or social feeling (social interest), and the direction of behavior towards the goal.

A. Adler argued that goals and expectations affect human behavior more than past experience, and the main motive, moreover, is the desire to achieve excellence and adaptation to the environment. He emphasized the determinative influence of society on each person and the importance of social interests - feelings of community, cooperation and altruism. A. Adler rejected the antagonism of the conscious and unconscious in man. One of the first he drew attention to the role of improper family education - emotional rejection and connivance - in the occurrence of neuroses.

Created by A. Adler (A. Adler), individual psychotherapy was a major step forward in understanding a person, the uniqueness of his unique life path. It is individual psychotherapy that has anticipated many of the positions of humanistic psychology, existentialism, gestalt therapy, etc.

Individual psychotherapy includes such concepts as: life goals, lifestyle, apperception scheme, sense of social and related need for social cooperation, self. A. Adler believed that life goals that motivate human behavior in the present, orienting him to the development and achievement of fulfillment of desires in the future, are rooted in his past experience, and in the present they are supported by the actualization of a sense of danger and insecurity. The life goal of each individual is made up of his personal experience, values, attitudes, characteristics of the personality itself. Many life goals were formed in early childhood and remain unconscious for the time being. A. Adler himself believed that his choice of the doctor’s profession was influenced by frequent illness in childhood and the associated fear of death.

The goals of life serve the individual to protect against the feeling of helplessness, a means of connecting the perfect and powerful future with the anxious and uncertain present. When the feeling of inferiority, so characteristic of patients with neuroses as understood by A. Adler, is expressed, life goals may become exaggerated, unrealistic (the author discovered compensation and overcompensation mechanisms). A patient with neuroses often has a very significant discrepancy between conscious and unconscious goals, as a result of which he ignores the possibility of real achievements and prefers fantasies about personal superiority.

Lifestyle - this is the unique way that a person chooses to realize their life goals. This is an integrated style of adaptation to life and interaction with it. A symptom of a disease or a personality trait can only be understood in the context of lifestyle, as a kind of expression. Therefore, Adler's words are so relevant now: “An individual as a whole being cannot be removed from its ties with life ... For this reason, experimental tests, which deal at best with particular aspects of an individual’s life, can tell us little about his character ... "

Within the framework of his lifestyle, each person creates a subjective view of himself and the world, which A. Adler called the apperception scheme and which determines his behavior. Apperception scheme, as a rule, has the ability of self-confirmation, or self-reinforcement. For example, a person’s initial experience of fear will lead him to the fact that the surrounding situation with which he comes into contact will be perceived by him as even more threatening.

A. Adler understood the sense of sociality as “the sense of human solidarity, the connection of a person with a person ... an expansion of the feeling of comradeship in human society”. In a certain sense, all human behavior is social because, he said, we are developing in a social environment and our personalities are formed socially. A sense of sociality includes a feeling of kinship with all of humanity and a connection with the whole life.

Based on Darwin’s theory of evolution, A. Adler believed that the ability and the need to cooperate is one of the most important forms of people’s adaptation to the environment. Only the cooperation of people, the consistency of their behavior gives them a chance to overcome the actual inferiority or sensation of it.The blocked need for social cooperation and the concomitant feeling of inadequacy underlie maladjustment and neurotic behavior.

The words of A. Adler are aphoristic: "If a person cooperates with people, he will never become a neurotic."

Понятие самости, как и многие категории психоанализа, автор не относит к операциональным. Самость в его понимании тождественна творческой силе, с помощью которой человек направляет свои потребности, придает им форму и значимую цель. Формирование жизненной цели, стиля жизни, схемы апперцепции — акты творчества. Самость руководит и управляет индивидуальным реагированием на окружающее. По мнению А. Адлера, основным недостатком в понимании З. Фрейдом (Freud S.) личности и сущности психотерапевтического процесса была недооценка уникальности человеческой судьбы. Самость — форма реализации этой уникальности, она активно формирует стиль жизни, отвергая одни переживания и избирательно принимая другие.

In the concept of psychotherapy, A. Adler singled out 3 aspects: the patient’s understanding and acceptance of an individual lifestyle; helping the patient understand himself; training and strengthening of social interest, the need for social cooperation.

Как правило, сеанс психотерапии начинается с анализа индивидуального стиля жизни пациента, т. е. поиска тех проблем, которые отражаются в поведении его на разных этапах онтогенеза. Этому помогает анализ самых ранних воспоминаний или наиболее значимых событий детства. Воспоминания, которые первыми придут на ум, по мнению А. Адлера, далеко не случайны, а соответствуют тем психологическим проблемам, которые пациент самостоятельно решить не мог как в прошлом, так и в настоящем. В рассказе пациента найдут отражение негативные обстоятельства, повлиявшие на его личностный рост, а именно — органическая неполноценность, эмоциональное отвержение или избыточное потворство со стороны родителей. Важно также обращать внимание на невербальные сообщения пациента — мимику, жесты, интонацию голоса, а также ключевые слова (глаголы), которыми он выражает прошлые действия (прообраз практики нейролингвистического программирования) .

Сама психотерапия представляет собой процедуру, отличную от психоанализа З. Фрейда. В беседах с пациентом психотерапевт создает атмосферу безопасности, доброжелательности, сочувствия и поддержки. Он собирает материал, интегрирует те части прошлого и настоящего опыта больного, которые ускользали от его осознания. А затем возникшая вновь целостность «с улыбкой возвращается психотерапевтом пациенту». Непременными условиями психотерапии является установление визуального контакта и эмпатического раппорта.

Следующий шаг в психотерапии А. Адлера — оказание помощи пациенту в понимании себя. Что в прошлом опыте переживалось и переживается как слабость, недостаточность, некомпетентность? Какие цели ставит перед собой пациент, чтобы достигнуть невротических атрибутов превосходства? Если когнитивное осознание этих реалий пациентом достигнуто, то он оказывается готовым воспринять этот опыт и эмоционально, а в дальнейшем через выполнение конкретных заданий психотерапевта реализовать его в поведении. Наконец, сотрудничество психотерапевта и пациента становится предметом их совместного обсуждения. Что испытывает пациент по отношению к психотерапевту? Какие переживания из его раннего опыта он проецирует на психотерапевта? Пациент, удовлетворив свою потребность быть услышанным, понятым, принятым, становится способным открыться альтруистическому опыту и осознать собственную противоречивость. Своим новым поведением, интересом к проблемам ближних он инициирует изменения в социальном контексте, от которого, в свою очередь, сам зависит.

Таким образом, схема развития психотерапевтического процесса в индивидуальной психотерапии выглядит следующим образом: 1) вхождение психотерапевта в контакт с пациентом с помощью эмпатии, доброты, поддержки; 2) формирование ответственности пациента за успех лечения (сигналом о готовности его к сотрудничеству с психотерапевтом служит, в частности, желание вспомнить собственное прошлое); 3) когнитивное осознание пациентом жизненного стиля и проблем самости; 4) эмоциональное отреагирование и соприкосновение с ранее неосознаваемым чувственным опытом; 5) проверка в реальности нового опыта.

Цель психотерапии А.Адлера – вернуть человека в человечество.

Задачи – развитие социального чувства: развитие кооперативного поведения, определение жизненных целей (работа, дружба, любовь), коррекция жизненного стиля.

Три основных аспекта терапии: понимание специфического стиля жизни, помощь в понимании самого себя, усиление социального интереса.

Пять источников достоверного изучения личности:

- ранние детские воспоминания;

- сновидения и грезы;

- порядок рождения ребенка в семье;

- трудности детства;

- характер экзогенного фактора, обусловившего данное нарушение или болезнь.

^ Методы психотерапии.

Интервью, метод ранних воспоминаний, качественный анализ ранних воспоминаний, анализ сновидений, опросники и анкеты, анализ неблагоприятных ситуаций в детстве.


Основные предположения А.Адлера могут быть выражено в следующем:

  1. любое поведение происходит в социальном контакте;
  2. развитие восприятия себя частью большего социального целого, чувства социальной вовлеченности, желания внести свой вклад в общественную жизнь на общее благо – социальный интерес;
  3. поведение может меняться на протяжении всей жизни человека в соответствии с требованиями ситуации, с целями, присущими его стилю жизни;
  4. становление – это жизнь человеческой души;
  5. на протяжении жизни человек сталкивается с альтернативами;


Процесс психотерапии по А.Адлеру имеет 4 цели:

  1. отношения – создание и поддержание «хороших» отношений;
  2. analysis - the disclosure of the dynamics of the patient, his lifestyle, his goals, how they affect the course of his life;
  3. interpretation of the data (dreams), the culmination of which is insight;
  4. Reorientation begins with the patient's preliminary, gentle or energetic conviction that change is necessary in his own best interest


Individual psychotherapy in the 20-40s. XX century was very popular in Western Europe and the United States.

Literature.

Main literature.

  1. Yezhova N.N. The workbook of a practical psychologist. - Rostov n / D: Phoenix, 2008.
  2. Malkina-Pykh I.G. Handbook of practical psychologist. - M.: Eksmo, 2008.
  3. Handbook of practical psychologist. / Comp. S.T. Posokhova, S.L. Solovyov. - M .: AST: KEEPER; SPb .: Owl, 2008.

Additional literature.

  1. Feidimen D., Freyger R. Theory and practice of student-centered psychology. - M., 1995.
  2. Adler A. Practice and theory of individual psychology. - M. 1995.
  3. Sidorenko E.V. Experimental group psychology. - SPb., 1993.
  4. Adler A. Individual psychology. / History of foreign psychology. 30-60-ies of XX century. (texts). - M., 1986.
  5. Vitels S. Freud: his personality, teaching and school. Chapter X. A. Adler. - L., 1991.
  6. Draykurs R., Zoltz V. Happiness of your child. - M., 1986.
  7. Christensen OK, Thomas K.R. Draycurs and the search for equality. - M., 1992.

Comments


To leave a comment
If you have any suggestion, idea, thanks or comment, feel free to write. We really value feedback and are glad to hear your opinion.
To reply

The basics of psychotherapy

Terms: The basics of psychotherapy