When to see a psychologist. When to contact a psychotherapist for help? When you don't need to register

Every person encounters difficult situations, difficult periods of life, crises and conflicts. Sometimes negative emotions prevent you from assessing the problem from the outside, or you lack the necessary resources and experience. When should you go to a psychologist or psychotherapist?

You definitely need to seek help from a psychologist. when you can't cope on your own. If you have been trying for a long time, but you can’t solve an exciting problem and you unhappy with your life. If a difficulty related to your personality, emotions, perceptions, relationships, etc. really interferes with life or impairs quality of life. When some methods do not help, it is wise to use others, including turning to a psychologist. Many people decide to start psychotherapy at such a moment.

You don’t have to put off contacting, trying different solutions for a long time - come to a psychologist at the moment when something just starts to bother. In this case, it may take less time to resolve the problem.

If we talk about what problems people generally turn to a psychologist for, the spectrum is quite wide, from mental trauma and neuroses to problems of mutual understanding. For example, I list a possible range of problems.

You can also consult a psychologist if you do not have an acute problem. If you want to understand yourself better or change something about yourself. Improve something in your life. If you want to realize yourself more fully, but something in yourself is stopping you. Or do you want to get a better feel for your actual goals and desires. You can go to a psychologist in a situation of ambiguity and doubt, without reaching the critical moment.

Often people go to a psychologist for consultation in order to improve relations with others. In this case, working with a psychologist will help you better understand your role in emerging difficulties, help in resolving conflicts and finding new approaches to interaction.

See also - when you can contact and how a psychologist can help.

Sometimes you can hear a common myth in Russia: Only “crazy people” go to psychologists. Our people are embarrassed to turn to psychologists, and more often they would prefer to continue complaining to friends instead of solving problems. This myth is already a thing of the past. Throughout the Western world, turning to a psychologist or psychotherapist is considered natural and reasonable if something in life does not suit you.
In my experience, I am often approached by mentally healthy and socially successful people who are ready to improve their lives by working together.

Good to know: the psychologist does not work with the problems of 3 persons - people who are not at the reception. If your request is related to another person (i.e. you believe that the problem is with him and you want to change him), then we can only understand your position, behavior, feelings and capabilities in this situation, but not change the other person in absentia.

• How long does it take to see a psychologist?

Up to 5 meetings - very short-term work

Up to 20 meetings - short-term

Up to 35 meetings - time limited

Not limited in time (usually 1-3 years) - long-term.

Deadlines vary greatly depending on your problem(as well as how long it has existed, its combination with your personality type, etc.) One or more consultations are usually dedicated to clarifying the problem, possible solutions, etc. What exactly do you want to get from working with a psychologist?. The goals may be further refined.

If your problem is specific and relates to a separate area of ​​​​life (for example, making a difficult decision, a specific conflict, or even a fear of public speaking), work more often short-term. This may take from several sessions.
If the problem concerns your personality as a whole (let’s say you don’t like some traits of your character, you find yourself in similar relationships again and again, you are confused in yourself), work is usually more long lasting. This at least a few months.
But this division is arbitrary: there are many interconnections in the mental sphere, and the line between private and extensive problems is thin. Even behind the “identical” problems, different people have different causes and interfering factors. Therefore, the approach is individual.

The duration of work with a psychologist largely depends on how deeply you are ready to dive into the root of the problem, whether you want to resolve issues related to it and whether you are striving for significant changes in your life. This can be assessed at the appointment - your goals and the possible time frame for achieving them.

But it is important to consider that mental processes have their own pace, you can’t run ahead of the locomotive. For example, it is impossible to completely overcome serious mental trauma in 3 consultations, because... It takes time to process traumatic experiences and strong feelings in order to begin to look at the world in a new way. Your personality has been shaped in a certain way for many years, you have made decisions and formed habits - For many years you have been moving towards the current state of affairs, and it is impossible to change you completely in one moment. And this is exactly what many want. If you really If you want to change something in yourself, you will have to put in your own effort and time. What is discussed in the office still needs to be transferred to life outside the office., and only you can do it.

There is good news: the effect occurs gradually, and the moment when you have enough is determined by you yourself.
Depending on the nature of the problem, how long ago it occurred, the aggravating circumstances of the situation, and the client’s personality type, the timing may vary greatly. Sometimes serious problems are solved in a few meetings, sometimes minor improvements are achieved after a long period of work. But most often, noticeable and tangible changes occur within 5-25 meetings. And in this process, you decide when enough is enough for you.

My summary from experience:
Some come to a couple of consultations who help you understand something about yourself, put it in order, and then prefer to do without a psychologist.
Maybe you'll have enough 3-5 consultations, to see the problem deeper and outline strategies.
You may need 10-15 meetings, for which you can solve an urgent problem or create a foundation for significant changes.
Maybe, 20-30 meetings, during which you will be able to transfer what is discussed in the office into your everyday life, change your approach to problem situations.
Or maybe you decide to take longer work, which will help you make very big changes in your life, will help you deal with deep-seated personal difficulties, and solve the most important tasks in your life. For example, psychotherapists themselves are required to undergo more than 100 hours of personal individual therapy in order to maximally solve their own difficulties and know themselves well.

Don’t be afraid of the words “long work”: you need to understand that meetings are usually scheduled once a week. A month of work is only 4 meetings.

There are usually about 40 meetings per year.

You can read more about the formats and duration of work in this comprehensive article.

• Psychological counseling and psychotherapy - what is the difference?

It is traditionally believed that - assistance in solving a local problem, informing, constructively finding ways out of the current situation, finding ways to achieve a goal or get rid of an unnecessary phenomenon, and psychotherapy– deeper work associated with changing the very reasons that cause problems, with changing the approach to life in general, the perception of oneself and other people. Usually psychotherapy lasts longer (see above -).

Those. consulting is about how to better understand the problem and find ways out of a specific situation, and psychotherapy- this is about how to stop getting into such situations, how to change something in yourself and in your life.

Sometimes in real work it happens It's hard to draw this line counseling can turn into psychotherapy. Solving a specific problem is often associated with understanding its causes in the client’s personality and with changing broader layers of life. And the work, initially aimed at extensive changes, includes solving very specific problems.

How deep the work will go and how long it will last depends on your readiness and desire. First of all, it is you can decide for yourself when sufficient changes have already happened and then you are ready to move on your own. Sufficient work for you may require several consultations or a year of psychotherapy: it all depends on your situation and the purpose of the treatment.

Even solving narrow problems in consultation with a psychologist can be small steps towards building harmonious relationships with yourself and the world around you, which is the general goal of psychotherapy as such.

If we try to generalize by timing (partly subjective, although many colleagues indicate similar deadlines), psychological counseling this is within 5, perhaps 10 meetings, and more is closer to the format psychotherapy.

• Psychologist, psychotherapist and psychiatrist - what's the difference?

Psychiatrist is a doctor who works with mental illnesses and disabilities. For the most part, a psychiatrist treats with medications.

Psychologist works with healthy people to help solve psychological problems that anyone can face. A psychologist works only with words and psychotherapeutic techniques; he does not have the right to prescribe medications.

Clinical psychologist– in addition to working with healthy people, has the right to work with mentally ill people, engage in psychodiagnostics of disorders and psychocorrection. Because He is not a doctor and also does not have the right to prescribe medications.

Psychotherapist– a psychologist or doctor who has received specialization in psychotherapy.

Psychotherapy— area of ​​practical application of psychology.

Peculiarities of Russian legislation the fact that in our country only a doctor can be called a psychotherapist (this is observed in particular in government institutions). Because of this, they even introduced the term “psychocorrection” for psychologists who, in essence, do the same thing.

In most Western countries a psychotherapist is someone who has been trained in some area of ​​psychotherapy and received a diploma as a psychotherapist. This can be done by both psychiatrists and psychologists. In Germany there is a clear division for this: “medical psychotherapist” and “psychological psychotherapist”.

In accordance with the Declaration adopted by the European Association of Psychotherapy, psychotherapy Not is a medical concept, but represents a separate profession based on the knowledge and methods accumulated within the framework of psychology.

Since Russian psychotherapy associations are focused on the main ones - Western ones, many of our psychologists undergo training in the same way, receive a diploma, and call themselves psychotherapists.

Eventually The concept of “psychotherapist” can mean different things :

Psychotherapist – psychiatrist with additional specialization in psychotherapy. Can work a combination of drug therapy and psychological methods.

Pros: knows well the physiological implications of problems, can make a diagnosis, prescribe medications if the problems are of a clinical level and there is a need for it. Disadvantages: may be inclined to biologize everything, to look at a person as a patient, as a passive object exposed to the influence of a doctor, and not as a subject - a side effect of medical education.
An important point - there are 2 completely different options.: if he has been trained in any area of ​​psychotherapy according to recognized international standards (psychoanalysis, Gestalt, existential therapy, cognitive therapy, etc.) - that’s one thing; if he has received a certificate in psychotherapy, recognized by our state, that is completely different, this is only 3 months of advanced training, his requirements do not even include undergoing personal psychotherapy.

Psychologist-psychotherapist – psychologist with a specialization in psychotherapy (diploma of psychotherapist in one direction or another). Works psychological methods, in a word. Doesn't prescribe medications.

Pros: in my opinion, psychological education is initially more conducive to psychotherapeutic work - psychologists have been studying various aspects of psychological science and areas of psychology for many years, practice as psychologists, study psychodiagnostics (while doctors study more the body and its diseases). They tend to see a person as an individual and communicate as equals. Disadvantages: they may not take into account the physiological aspect of the problem, they cannot make a final diagnosis in case of pathology, they cannot prescribe medications if necessary. Therefore, if there are any doubts about physical or mental health, the psychologist is obliged to recommend seeing a doctor.

Good to know: Many psychotherapists believe that it is better for two different specialists to prescribe medications and do the actual psychotherapy, even if both of them are doctors.

On this topic, see also the brilliant article by a colleague, psychiatrist-psychotherapist

• How does a consultation with a psychologist differ from a conversation with a loved one?

Contrary to popular belief, working with a psychologist is completely different from getting help and support from friends or relatives. It's not just "talk". How does a psychotherapeutic conversation or communication with a psychologist differ from an ordinary conversation? Why is consulting a psychologist more effective than seeking help from loved ones? In the comparison below we will, of course, talk about really professional psychologists (see).

Friends give advice based on personal experience (experience gained under certain circumstances, an experience that matches the particular character and perception of that particular person - perhaps not suitable for you). Friends or relatives can support you, or they can judge you and draw some conclusions about you.

The psychologist takes neutral position. He assesses the situation not by personal experience, but guided by psychological knowledge. Psychologist doesn't give advice, but helps you better understand the situation, find possible solutions and independently decide how to act. He will not judge you, but will impartially assess the situation and help you see it from different sides.

Your feelings are respected here. At an appointment with a psychologist, you will never hear such phrases as: “why are you so obsessed”, “this is nonsense”, “don’t think about the bad, be more positive”, “many people have it much worse than you, and yet you still complain”, “You’re complicating everything”, “It’s your own fault”, “Pull yourself together”, “Just don’t worry”, “But here I am...”

In his work, the psychologist is guided by existing knowledge, professional experience and uses various psychotherapeutic techniques. In addition, special psychodiagnostic techniques can sometimes be used to assess your condition, although more often a professional opinion is sufficient.

Working with a psychologist has certain ethical principles and restrictions, such as confidentiality your problem (it will not be disclosed to anyone), borders(communication takes place only in the office, at a certain time and under certain conditions, and is always aimed at solving jointly set goals), etc.

And this is also a rare situation in life when all the attention in communication is focused on you, and you do not need to worry about the interlocutor (moreover, you can experience any feelings for him and talk about it freely). This time is yours, at this time the psychologist does the best for you that he can at this moment (of course, within the framework of professional ethics).

If you need understanding and support- most likely, you will get this, but this is only the least that a psychologist can give, only the first stage. It is followed (although, more accurately, it is accompanied) by joint work on a problem that concerns you. And perhaps even new horizons will open in your life, a new level of self-understanding.

• How is a consultation with a psychologist carried out?

What to expect from the first consultation with a psychologist, what to say at the appointment? What does a psychologist or psychotherapist do, how does an appointment with a psychologist go? Some see this in an aura of mystery, expecting something special during the consultation, as if the psychologist will do something that will immediately change their situation. Others simply expect to be listened to and given advice, as if they were talking to an old friend. Still others imagine it to be similar to a doctor's appointment in a hospital setting.

What happens at an appointment with a psychologist? Outwardly, nothing special happens. The consultation takes place in a cozy office, the psychologist and the client sit in chairs opposite each other. From the outside it looks like two people are just talking confidentially.

At the same time, this is not an ordinary conversation. This conversation is organized in a special way (for more details, see). The psychologist is present in the conversation in a certain way- not like a friend; listens to you in a certain way, perceives what is happening in different contexts, asks questions in a certain way and leads the process.

The psychologist asks these questions that help reveal the situation from a new perspective, understand thoughts and feelings, find the basis your problem. These are not ordinary questions, they require a lot of knowledge and skill. Knowledge of how the psyche works, principles and mechanisms of disorders, and skills in terms of approaches to solving difficulties. Psychologists and psychotherapists have been studying this for a long time - it’s more and more complex than popular psychology and what everyone “knows themselves.” Psychologist draws your attention on essential points, can explain show relationships, How do your difficulties arise?. And reflects how difficulties manifest themselves in real time. In general, for the entire hour the psychologist continuously tries to do everything to understand you as much as possible, and together with you find the right approach to the situation.

At the first consultation you will need to talk about your situation, what brought you there. No need prepare specially. You say everything you think is important, and the psychologist will clarify and ask. By the end of the meeting, the desired goal of working with a psychologist or an outline for next time can be formulated. You may immediately receive recommendations on what to think about for your next meeting. And sometimes even the first time a new, fresher view of the problem is revealed.

If you decide to continue working, appointments are usually scheduled once a week. The number of meetings depends on your situation and the desired result (for more details, see below). ). I usually first arrange 5 meetings with clients, so that we can then see together how our work is going, what is happening, how and where we will move next. It's like an island that you can swim to and look around.

Further meetings may look like a conversation, various techniques and exercises may be used. For example, you and a psychologist can write, draw, role-play, move, imagine, immerse yourself in imagination or feelings, use relaxation techniques, auto-training, awareness, body and breathing practices (all this is done only with your consent). Depending on the direction of psychotherapy, there may be different techniques. But mostly it's a conversation - More often than not, asking the right question or identifying certain points is enough. I will take the liberty of saying that this defines art - how much the therapist himself can help without auxiliary techniques.

An important part in long-term communication with a psychologist, in psychotherapy, is the relationship with him. The psychotherapist specially learns to build special relationships that are therapeutic with various problems— different styles of interaction are productive with different types of people. It’s not that this is some kind of artificial relationship, it’s just that the therapist knows what points especially need to be taken into account, what to pay attention to and what questions to discuss with different clients. This is a relationship that in real time help the client see, understand and work through their difficulties. Such meetings provide not only new information, but also new experience and new skills to cope with difficulties. Perhaps this is one of the important differences between counseling and psychotherapy.

• How to choose a psychologist?

Choosing a psychologist on the Internet is very difficult. The choice is very large, but there are not so many attentive, sensitive and really good professionals. Some are afraid of making a mistake, wasting time, money, opening up to a stranger and feeling rejected or negatively evaluated. Try to choose a psychologist with whom you will feel comfortable and calm. But don’t forget about professionalism.

How to find a good psychologist? Here I will try to reflect main factors to pay attention to:

1) education - basic higher and additional training (specialization in one of the methods of psychotherapy)

2) personal therapy by the psychologist himself

3) undergoing supervision

4) work experience

5) your feeling about the therapeutic process and methods

6) your feeling from the person, whether he inspires trust.

Let's take a closer look.

1) The education he has received gives him a certain confidence in the qualifications of a psychologist. in addition to basic higher psychological. Having the basics is a must.

Basic education Provides mainly theoretical training. The Faculty of Consultative and Clinical Psychology of the Moscow State University of Psychology and Education (Formerly the Faculty of Psychological Consulting), where I studied, is more or less practically oriented, but still this is not enough. Be that as it may, studying at a university does not provide much for working with clients.

Therefore it is important additional education. A valuable indicator is completion of a long-term training program in one (or more) of the methods of psychotherapy. You need to understand that there are many programs of varying depth and focus, various advanced training is also good. For example, there may be a short course on a narrow topic - working with a specific difficulty for clients. But if the topic is broad, it takes time, short courses in an entire area of ​​psychotherapy are just an introduction, and you cannot be called a psychotherapist after them. Only long-term programs (this is definitely at least 2 years of study) allow you to specialize in any area of ​​psychotherapy.

You can pay attention to the seriousness of the institution that provided the training. The most serious institutions providing such specialization cooperate with international professional communities this approach in psychotherapy. They strictly monitor who they issue certificates to. Most likely, such a psychologist complies with basic work standards.

But education is not the only factor.

Here I would like to note: in contrast to practical psychotherapeutic education, academic degree has little to do with effectiveness in working with clients. Science and practice are far from each other. I myself am in no hurry to become a candidate for this reason: it is prestigious, but has no direct utility for working with clients.

2) Such training (specialization in a specific area of ​​psychotherapy) includes mandatory completion of personal psychotherapy(solving one’s own problems so that they do not affect work), as well as supervision (evaluating the quality of the psychologist’s work by more experienced colleagues). Institutes collaborating with international psychotherapy associations track a fairly large number of hours of personal therapy by specialists. A psychotherapist must, if not solve all his personal difficulties (something will always remain), then be very aware of them in person so that they do not interfere with his work.

3) It is very good if the psychologist has not left practice in the past of his training supervision. This is a presentation to a more experienced colleague (or colleagues, if group supervision) of your difficult cases and the methods of work that have already been used. This is not only an assessment of the work by other colleagues, but also help. Even the most experienced psychologist can have difficult cases and unclear moments in their work, and a fresh look at the client is very important. If the psychologist has little experience, then supervision is all the more necessary and significantly contributes to increasing efficiency.

4) An important factor is experience a specialist in the field of psychological counseling and psychotherapy - he gives some guarantee that the person has already dealt with a large number of cases, has overcome the mistakes of beginners and has mastered his work well (unless, of course, he constantly repeats the same mistakes, which happens with those psychologists who do not continue to improve and avoid supervision). Probably, with a more experienced psychologist, you will be able to quickly select the tools that will help you.

If a psychologist does not continue to develop in the profession, then sometimes with more experience “the eye becomes blurred”, bias and excessive confidence in the truth of one’s hypotheses may appear. A good psychologist is always distinguished by a fresh look, the ability to look impartially, even if he has extensive experience behind him in successfully working with similar cases.

Realexperience- this is the number of clients and the number of consultations, and not just the number of years. Experience in the form of a number of years can mean different things: there may be rare one-time consultations for many years against the backdrop of other work not in one’s specialty, or there may be intensive psychological practice with a large number of clients over a period of not so many years. If we are talking about private practice, then you can only find out from the words of a psychologist. The psychologist’s place of work can also help to understand the intensity of practice: if he spent a long time consulting in some institution, everything is clear here.

Depending on work experience, prices for consulting a psychologist can vary greatly, although this relationship is not always proportional.

5) Psychologists differ in their work methods and psychotherapeutic schools. Depending on this The emphasis in work can be different: on feelings, on beliefs and behavior, on therapeutic interaction, communication here-and-now, etc. Various techniques are used—or not used. Some methods may be more suitable for you and your problem, others less so. But until you try it for yourself, it’s difficult to judge this in the abstract. I think there are no good or bad methods in themselves - there are more and less suitable for specific purposes or a specific person.

6) Most of all, the effect is determined by the personality of the specialist (this was even confirmed by a study in which they wanted to compare the effectiveness of methods) - provided that he has an adequate level of qualifications. Whatever methods are used, it all depends on the specialist’s instincts and observation, the development of his personality, professionalism, elaboration of his own problems and awareness. Education, experience and personal therapy greatly influence professionalism, but a lot of it comes down to personality. To decide on the choice of a psychologist in this regard, you can visit a specialist and trust your intuition, pay attention to your feelings from his work.

There are pitfalls here.

It may be that the psychologist is good, but not right for you. Doctors, lawyers, salesmen, teachers are different - they are all people. In the same way, psychologists are very different. Don't be afraid to look for the right specialist. Look at the photos, look through the texts, call and ask questions over the phone. If it is difficult to decide in absentia about your feelings about a particular specialist, you need to try. In order to understand whether a psychologist is right for you, 1-3 meetings are usually enough.

I have no doubt that there are a lot of not very good specialists . There are psychologists who make serious mistakes in their work. Be careful and take care of yourself. Look for a person with whom you will feel comfortable and calm - after all, he will need to tell you the most intimate things. Don’t despair and draw conclusions about all psychologists after a couple of unsuccessful attempts.(I heard something similar when I worked on a helpline). Some clients in my private practice have shared negative experiences with psychologists in the past - and yet they took a risk and came to me.

However, It’s not always immediately clear whether working with this psychologist is helping you. On the one hand, you should not be disappointed if the desired changes do not occur after several meetings - this takes time. As well as to establish the necessary contact with a psychologist in the work, a therapeutic relationship that contributes to these changes. On the other hand, is it worth visiting a specialist for a long time if you do not feel any progress in your work at all, and there is no contact with him and no sense of understanding. Main do not confuse your own resistance to change with the “inadequacy” of the psychologist. When someone changes therapists many times, colleagues take notice—this may not be a coincidence. It is likely that the problem is with this client, and not with his psychologists.

It doesn’t always get better after consulting a psychologist or at the beginning of psychotherapy. First, new realizations can be unpleasant and difficult at first, and our brains fear change and strive for the familiar. Secondly, when working with a psychologist you have to pay attention to the difficult aspects of life, to negative emotions. If you have previously tended to avoid looking at them directly, this can be difficult and unpleasant. Therefore, as a criterion at the beginning of psychotherapy, one can take any changes conditions against the background of meetings with a psychologist. Something has to start happening. Those. it’s bad if after a certain number of meetings nothing changes at all - perhaps this is worth discussing with your psychologist.

Trust is an important factor in the effectiveness of psychotherapy. You must trust the psychologist enough and talk through doubts and questions with him. A good specialist will be able to answer your questions and explain his view of the problem and his actions. By the way, even at the stage of the phone call, a professional psychologist will calmly answer your questions and will not convince you, give advice or make a diagnosis.

Trust your intuition, look for a professional psychologist that is right for you. If the experience is unsuccessful, don't stop trying.

Psychotherapy is the treatment of mental disorders and help in overcoming mental difficulties. Do you need it? Not obvious. As a rule, a mentally healthy person does not need psychotherapy and can overcome psychological difficulties (bad mood, anxiety, irritability, difficulty falling asleep...). It’s not always the case that when you’re in a bad mood and confused (about something or everything), you need a psychotherapist. Perhaps you need something else, namely psychological consultation. They are often confused, but there is a difference between them, like between a doctor and a wise interlocutor. If you are confused, you need a wise companion, not a doctor. You will not be treated at the consultation; there you will simply figure it out with the help of a consultant psychologist. What got confused and How untangle, you will make the right decision for you (option - become firm in your decisions), and your mood will quickly improve. In any case, before going to a psychotherapist, it is useful to do basic prevention:

• change your lifestyle to a healthier one: sleep more, move more, find an interesting job, work less and get nervous over trifles,
• read books or articles on a topic that has become a problem for you (for example, you can’t come to an agreement with your husband, there is no contact with your children, a bad mood has appeared or continues),
• communicate more with loved ones and friends.

Don't rush to see a psychotherapist.

For many women, visiting doctors and psychotherapists is as much fun as shopping. There are a large number of people who are simply interested in delving into themselves, and working with their fears, for example, is one of their favorite pastimes.

“I’m worried about the fear of heights...” - If you ask how often a young person has this problem, it turns out that once every few years it’s a few minutes of fear. Given the fact that he has a mess in his room and debts at the institute, it seems that for him working with this fear is not the most pressing problem and is rather entertainment that takes him away from real life tasks.

Don't have fun with psychotherapy!

People are interested in psychotherapy just like other entertainments, but this entertainment is not harmless. Psychotherapy, unfortunately, is almost always one or another amount of negativity. And this is always a distraction from life and development itself. And when it becomes too much, when all people do is sort out their problems or deal with their feelings, people become not alive and not working, but sick and fixated.

Thus, couples who are carried away by sorting things out stop living and communicating normally. They find out and sort out what happened a week ago, they figure out how they last sorted out the last problem, they figure out how someone feels about these showdowns... Life ends, and many couples end up in a showdown only with divorce.

Once upon a time I was passionate about the topic of “Conflict Prevention”, developed wonderful techniques and taught people how to behave correctly and successfully in a conflict situation. The methods were effective, people mastered everything well... The result? A sharp increase in conflicts in their lives. They became interested in this, they saw even micro-conflicts everywhere, did not let them pass them by and began to deal with those who started these conflicts... Today I make sure that the trainings in Sinton are aimed not at conflicts, sores and problems, but to build a successful life, happy relationships and effective business. Now, when my wife Marina and I lead the “” group, we make sure that the main topics are not around “how to understand problems,” but how to build yourself and relationships in such a way as to live happily and with love.

What is a reasonable balance between life and psychotherapy? Probably, this ratio may be different for people of different ages and in different states of mind. Offhand, the share of psychotherapy along with any other treatment should not be more than 5% of other things in life.

80/20 is a reasonable ratio of simply life and development. Active and living people always devote 20% of their time and energy to their development, moving themselves forward. However, repair and treatment may be necessary. Offhand, if a person takes care of himself, this is 5% of the time for prevention and 5% for the actual treatment, for doctors and psychotherapy. So, 20% is for development, and 70% is for normal life. For a simple, happy, productive life, without psychotherapy.

Also: be careful, some psychotherapists love to heal, and next to them even healthy people become a little sick. In addition, in addition to healthy psychotherapy, there is also sick psychotherapy: it infects with mental problems.

As a manager, I had to fire employees several times after they went to see a psychotherapist: immediately after that they stopped working. They just sat and listened to themselves. Sometimes, after thoughtfulness, it sounded: “It seems that I don’t want to carry out this order!”...

Psychotherapy can be too much. If you feel that you are being treated where you only wanted to consult, you can stop this process.

On the other hand, there is no need to be afraid of psychotherapy. If you find yourself in a situation that you really can’t cope with, you’ve been crying alone or on a friend’s shoulder for several days in a row, then turning to a consulting psychologist or psychotherapist is good and reasonable. You should definitely contact a psychotherapist if you yourself, despite consultations, cannot cope with life and personal difficulties on your own.

Don't you repair your TV yourself? Well, it’s right to entrust the matter of repairing your soul to professionals.

Suppose you lose your job over and over again and through your own fault. At the same time, all the consultants tell you the same thing, but you cannot follow their recommendations. Others can, but you can’t. This means this is a serious case, go to a psychotherapist. Or maybe you have lost one of your close and beloved people, you are tempted to either kill yourself or get drunk... Urgently go to a psychotherapist. Don’t start difficult cases, don’t wait for “it will resolve itself.” When there are too many “problems”, it becomes difficult to correct the situation, and for you and for everyone it will be too expensive and difficult.

There is no need to be afraid of psychotherapy; it is only important to find a specialist who is suitable for you. A good psychotherapist is like a friend you can always turn to, and often better than a friend, because in his relationship there is “nothing personal”, he works for money. If you are ready to shell out a thousand or several thousand rubles for an hour of emotional communication, then coming to a good psychologist-psychotherapist at least once every six months or a year and “talk about life” is rather useful in any case.

However, one more caution: if you need serious psychotherapy rather than regular psychotherapy, ask yourself if you have special time for this. It is important. If the problems are minor, the situation is not advanced, going to a consultation with a psychotherapist is only useful. If the situation is neglected, there are a lot of problems, then... As long as a person works, lives in discipline, he holds on. And a trip to a psychotherapist usually reveals “everything at once” - and as a result the person becomes incapacitated. Then psychotherapeutic consultations turn out to be harmful.

Psychotherapy is the repair of the soul, and unless it is an emergency, you need to find the right time for repairs. If there are a lot of things in your life, you are in a responsible job and there is no vacation planned in the near future, serious psychotherapy may not be timely for you. If you come to serious psychotherapy in such a situation, the psychotherapist will “disassemble” you, and for some time you will be incapacitated. Do you need this?

It is better not to touch a house that is too dilapidated. It is easier to tear it down than to repair it. When repairs begin, everything starts to collapse... It’s better not to touch it!

If the situation is too severe, a good therapist will not treat anything. He can rather keep an eye on what is happening, so that a person does not do something stupid and does not completely ruin the life of either himself or those around him. Yes, this is not the work of a psychotherapist itself, but if there is no one else to do this and such work is paid, then a psychotherapist can also do this work (rather suitable for a good nurse).

Now, take your time and read carefully: and - these are two very different specialists. If you feel bad, you should see a psychotherapist. If it is important for you to think about the situation and find the best solution, most likely you do not need a psychotherapist, but a psychological coach. Accordingly, if you take your life seriously and are focused on development, then once every six months or a year you will come to a psychologist, but not a psychotherapist, but a coach. Coaching is called Distance, and it may be what you've been looking for for years. If you have been looking for practical and effective psychology to help you with your personal and professional development, That

So I decided to post my old blog post on the site, because I have to send it periodically anyway.

This notewhat, at first glance, may seem like countriesNoah. Why scare away potential clients? May there be many of them - xOROshix anddiff.s. But all inPI grew up in the fact that psychological counseling is a special area where a continuous system of work is impossible by definition. And our joint choice - me as a client and me as a client - is already part of psychological work.

Question one. How do you know if it’s time or not yet? In what cases is it worth and in what cases not worth contacting a psychologist (at least to me)?

NOT worth contacting if:

You're not sure if this is for youit's good. Lack of motivation will not lead to any results.

You are waiting for “instructions,” especially instructions on how to influence someone around you so that they, in turn, will change. Manipulation - in seduction training. A psychologist teaches anti-manipulative behavior. In all senses.

You hope that together with the psychologist you will find the “extreme” in your story - “that bad woman”, “fool boss”, “ungrateful children”, “this irresponsible man”… . For such a case, there are also addresses - these are magicians, wizards and fortune tellers. Their task is to tell you how wonderful you are, but some bad, very bad people have jinxed you, bewitched you,they let the damage happen. The aura will be cleaned, evil people will be punished, and a loved one will be influenced based on a photograph. If you truly believe that this is the recipe for your happiness, then go ahead.

You are driven by the momentary impulse. That is, right now, at this minute, you feel bad, and a little later, when you realize that you have “better”, you plan to cancel the consultation. Free helpline - here.

You hope that over time everything will work out, “it will work out on its own.” It probably makes sense to wait a little longer, and when it becomes completely unbearable, then contact us. But you should always understand that the further you go, the worse it gets. Although there are exceptions.

You perceive a psychologist as a magician who will change your condition instantly. At the very least, in a couple of hours. In one, even a detailed situation, we can understand what led to such a situation; in several meetings, we can understand this more deeply and find other ways of living. A long-term course is for those who want to radically change their lives.

You hope that the psychologist seems like just another specialist who also did not help, like all the previous ones, and you will be able to revel in your exceptional suffering further. Masochism, of course, is difficult to correct. Look at minevideo lecture about this type of relationship, and then decide whether to change or change.

You want to satisfy your curiosity: “How does it work?” Better watch some funny American comedy with a psychoanalyst - and you will have a good time, and you will not distract anyone. Although, in fairness, I note that in the series, for example, “The Sopranos”, shows the very professional work of a psychologist.

The selection criterion for you is the idea “I need the best specialist.” Perfectionism - excellent quality for social success. But when choosing a psychologist, this approach is rather a marker of a lack of desire to change something in your life. Or pursuing a fashion trend.

You want to send someone else for consultation, but not yourself: your wife or husband, adult son or daughter, mother, mother-in-law, friend. Help imposed by someone does not save, but irritates and causes a huge amount of resistance. Think about yourself in similar situations. And just give these people my coordinates, and they will decide for themselves whether to contact me or not.

Do you want to apply for something?in order to agree on the impact on someone from your environment: “Let me come to you, and then I will bring my ex, and you explain to her that she should come back to me.” “And work with my husband, he’s probably gone crazy.” “Irina Olegovna, explain to my daughter how to behave with her parents.” And finally, the best and most familiar, probably to all experienced professionals: “Can I bring a boy to you, my son?” - “How old is your son?” - "Thirty five". The psychologist works according to the tasks of the person who came. He is my client, not the one who “sent” him. Therefore, even if a person contacts you in your direction, do not hope that as a result of someone’s visit you will achieve your goals.

You perceive a psychologist as one of a large number of specialists in the service sector - along with a cosmetologist, hairdresser, massage therapist. If in that sphereIf there is a rule (which, by the way, I debunk at trainings) that the client is always right, then the interests of both parties will have to be taken into account. I value your time, you are mine. I am responsible for our agreements with you, and you are equally responsible for them. In other words, you get in touch when we (together!) agreed, and not when it is convenient or “inspired” for you. You follow certain rules of interaction, and so do I.

The most important conclusion is - do not try to change someone, look for extreme ones and “treat” your environment.

And you should contact me when:

You are ready to learn new things about yourself - both good and not so good.

You at least roughly understand that much of what happens to you is the result of your actions. Maybe you don’t really understand how all this is connected, but you know that there is a connection.

You are ready to change yourself.

But at the same time, you are still ready to get rid of your feelings of guilt.

When you are internally ready to change your thinking style and behavior. Change is not quick and not immediately. Or at least start to figure it out.

Attention site readers! This article is for informational and educational purposes. If you and your relatives, friends and acquaintances have similar problems, then contact a psychiatrist at the psychoneurological dispensary at your place of registration, the emergency room of a psychiatric hospital, the registry office of the Institute of Psychiatry, or the website psychiatry.ru . We do not diagnose or treat psychiatric diseases! We provide individual psychological counseling services.

Recently, thanks to universal education, Hollywood and popular articles on the Internet, the scientific terms “depression”, “neurosis”, “neurotic”, “schizophrenic”, “psychopath” and others have become widely used. Did you cry? - Neurotic. Sad? - She's depressed. Did you shout? - Psychopath! Sociopath!
Let's clarify the situation so that normal people can sleep peacefully, neurotic individuals stop being afraid of discovering schizophrenia, and people with serious mental illnesses receive timely drug treatment. In addition, as we wrote in one of the articles, many serious mental illnesses are either treated or inhibited in their development if treated in a timely manner.
This material will be of interest both to suspicious and anxious people - we will try to calm them down, and to the relatives of a person with “oddities” - they will be able to help in time and protect both the person and themselves. But first of all, this article is directed to practicing psychologists who do not have specialization in clinical psychology.
A particularly important point is that psychologists often doubt: should they refer a “suspicious” client to higher authorities – to a psychotherapist or psychiatrist?
We have put together a checklist of indicators and signs that can be used to roughly understand whether a person should be shown to a psychotherapist or psychiatrist. Issues of drug treatment (for example, depression) are beyond the competence of psychologists. And most importantly: don’t be scared, don’t diagnose yourself and your loved ones indiscriminately. Just see a specialist if in doubt (for example, at the Research Center for Medical Protection of the Russian Academy of Medical Sciences).

Signs of Depression

External signs of depression:

• sad facial expression;
• drooping corners of the mouth and eyes;
• drooping shoulders, head;
• limp hands;
• “dull” look;
• frequent sighs;
• the voice is quiet, slightly modulated.

Clinical manifestations of depression:

• Slow thinking, the client says that it is difficult to think, there is “fog” in the head.
• The movements are slow, the client complains that it is difficult for him to move, he lacks strength, his arms and legs are heavy and too heavy to lift.
• Decreased mood with worsening in the morning (with the exception of psychogenic subdepression, when mood worsens in the evening).

When is it time to see a psychiatrist?

• Lack of improvement during psychotherapy.
• Persistent sleep disturbances and loss of appetite up to its absence.
• The appearance of suicidal thoughts, intentions and plans, an increase in the general feeling of unwillingness to live.

Changes due to drug treatment

• While taking antidepressants (AD) for 7-10 days, the client may experience drowsiness, and the person’s reactions may slow down.
• After abrupt withdrawal of blood pressure, symptoms return and/or intensify.

Signs of obsessive-compulsive neurosis

Under the guise of obsessive-compulsive neurosis, other illnesses may be hidden. Therefore, it is advisable to send people who complain of obsessions (obsessive thoughts) and compulsions (obsessive actions) for additional consultation with a psychiatrist for the purpose of differential diagnosis.

External signs of obsessive-compulsive neurosis:

• various types of tics (twitching of the eyelids, face, head turns), involuntary movements;
• the voice is quiet, sometimes trembling;
• “running” look;
• tense face, tension in the lower jaw;
• there may be severe hand tremors;
• movements are angular, “ragged”.

Clinical manifestations of obsessive-compulsive neurosis:

• Obsessive thoughts that the client constantly “replays” in his head, constantly checking whether the lights are off, whether the door is closed...
• Rituals that “reduce” fears (for example, you need to make five turns around yourself, then the day will go well). See signs of obsessive-compulsive disorder for details.

When is it time to see a psychiatrist?

• Persistent tics and involuntary movements that do not improve with psychotherapy.
• Increased symptoms during psychotherapy.

Changes during treatment

Upon appointment medications within 3-4 days – slight drowsiness, speech impairment (fuzzy, blurred diction).

Signs of bipolar disorder

External signs of bipolar affective disorder:

• alternating attacks of depression and mania;
• during a manic episode, facial expressions are very lively and do not correspond to the meaning of the statements;
• inappropriate laughter;
• rapid speech, “porridge in the mouth”;
• sweeping movements;
• the look is “feverish” (as with a fever), the eyes may be reddish.

Clinical manifestations of bipolar affective disorder

Manic triad:

• accelerated thinking - a person jumps from one thought to another, never finishes, forgets what he was talking about;
• movement is fast, uncontrollable;
• elevated mood background.

When is it time to see a psychiatrist?

In any case, see a psychiatrist!

Changes during treatment

• During treatment with antipsychotics for a week, there is slight inhibition, there may be an inversion of affect (transition from mania to depression and back).
• Differential diagnosis with substance abuse and drug addiction is necessary.

Signs of schizotypal personality disorder

External signs of schizotypal disorder:

• bright external signs Hardly ever.
• In communication - emotional coldness and detachment;
• eccentric behavior, strange eccentric appearance
• poor contact with other people, with a tendency to withdraw socially;
• strange beliefs or magical thinking that influence behavior and are inconsistent with subcultural norms;
• suspiciousness or paranoid ideas;
• obsessive thoughts without internal resistance, often with dysmorphophobic, sexual or aggressive content;
• unusual perceptual phenomena, including somatosensory (body) or other illusions, depersonalization or derealization;
• detailed stereotypical thinking, manifested by strange, pretentious speech, without pronounced discontinuity;
• episodic auditory or other hallucinations, delusional ideas that arise, as a rule, without external provocation.

Clinical manifestations

• Numerous fears, phobias, feelings of persecution that cannot be convinced.
• Thinking disorders (inconsistent thinking, fixation on fears, interruptions in thoughts, emptiness in the head).

When is it time to see a psychiatrist?

In any case, see a psychiatrist!

Changes during treatment

• During treatment with antipsychotics and blood pressure, thinking deteriorates, lethargy for a week, and then usually marked progress in therapy, as thinking is restored.
• Differential diagnosis with abuse of cannabinoids (marijuana), psychostimulants (amphetamine, spice) is necessary.

Signs of schizophrenia

External signs of schizophrenia:

• mask-like face;
• quiet, poorly modulated voice;
• untidiness;
• a tense, frightened or, conversely, “empty” look;
• the movements are monotonous, like a robot or a puppet;
• a person can listen to something.

Clinical manifestations of schizophrenia

When is it time to see a psychiatrist?

In any case, see a psychiatrist!

As a result

In doubtful cases, the psychologist’s task is to show the person to a more highly qualified practitioner. A psychotherapist who was educated after the adoption of the Law on Psychiatry in 2001 must have a basic psychiatric education. Such a specialist is trained to distinguish normality from pathology and, if differential diagnosis is necessary, will tell whom and clients should be shown to a psychiatrist.

There is no point in delaying - by the time the client gets to the psychiatrist, he could have been successfully treated with medication a long time ago. There are organic problems that can be relieved with pills, but years in the psychologist’s chair have no effect.

As for relatives, loved ones, and colleagues, we will give them a number of signs of mental illness that signal the need to see a doctor. Naturally, with the usual caveat - the diagnosis is made only by a psychiatrist-psychotherapist or a psychiatrist.

How to detect mental problems in a loved one?

Does he drink often? Alcoholism is not just a harmful addiction, but also a potential mask for psychopathy and schizophrenia (with violent behavior). Long-term psychotherapy for codependency is indicated for all relatives of an alcoholic.

Alcohol. When should you worry?

You need to worry and make a differential diagnosis between everyday drunkenness and the first stage of alcoholism when someone around you drinks 200 ml (glass) of 40% vodka or other strong alcohol one to three times a week. The diagnosis is made not only by the dose of alcohol, but also by clinical signs (presence of withdrawal syndrome, etc.) But you need to worry and take the person to a psychiatrist-narcologist at this dose.

Same with all drug addictions.– go straight to a psychiatrist! Anything could be behind them. Drug addicts and alcoholics cannot be tolerated - they are destructive for everyone. Ask for help.

If your loved one suffers from severe mood swings, due to which he becomes unable to work (does not go to work, does not work well), consult a doctor. Depressed mood, irritability, euphoria, anger are indications for consultation and diagnosis.

Reluctance to live, suicidal thoughts– see a doctor immediately! Drug therapy is indicated.

Obsessive actions (compulsions) and thoughts (obsessions), obsessively frequent hand washing (50 times a day), so that the skin on your hands peels off from the soap. Differential diagnosis can be made between obsessive-compulsive disorder and a neurosis-like form of schizophrenia. Making a diagnosis requires monitoring the dynamics of the disease over several months.

Any pathology sexual desire- Go straight to a psychiatrist-sex therapist.
Bestiality, pedophilia, fetishism, sadism, masochism, transvestism, transsexualism, exhibitionism, necrophilia, egodystonic sexual orientation - all within the competence of a psychiatrist-sexologist. Egodystonic sexual orientation is part of the concept formerly known as “homosexuality.” In some cases, the pathology of sexual desire may hide serious mental illness, so it is advisable to seek a diagnosis from a specialist. Attention! In the case of homosexuality, seeking treatment from a psychiatrist-sex therapist is only voluntary.

Has your character gone bad? Has a kind and sensitive person become rude, cruel, domineering and humiliating? Sometimes he simply hid his face - a narcissist, a psychopath... And sometimes a sharp and global change in character for the worse signals a loss of personal functions in schizophrenia and other diseases of this spectrum.

Deceitful, manipulative, two-faced, cruel? It could be a type of psychopathy (personality disorder). Carefully read the checklist of signs of psychopathy on our website, compare 1 or 2 factors expressed. The first factor is the answers to questions from the first to the eighth inclusive. The second factor is the answers to questions from the ninth. This is a serious matter.

Laughs at funerals, is hostile, cynical, indifferent to loved ones? Is he promiscuous? And even promotes it? Delirious and hallucinating? Fighting aliens? After a binge, does he go into delirium tremens? Afraid that his relatives want to poison him, and his neighbors want to survive? “Reads minds”?

Basically you will feel that something is wrong. It is important to act calmly but decisively. Seek help from a psychiatrist and you can prevent many troubles. Help your neighbor.

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