What is a psychotherapist? This is a specialist whose task is to treat pathological conditions psyche of mild or moderate severity. The causes of such mental illnesses can be psychological trauma received by the patient in childhood, factors transmitted by genetic means, or severe stress conditions.
It should be said that the competence of the psychotherapist does not include the diagnosis and treatment of conditions that have developed against the background of serious brain damage or physiological injuries.
Unlike a psychologist, a psychotherapist, having medical education, is engaged not only in consulting patients, but also capable of making a diagnosis.
He can also prescribe appropriate treatment, including medication. However, the list of drugs in this case is limited to sedatives and antidepressants: prescribing more serious psychotropic drugs is the domain of the psychiatrist.
Unlike a psychiatrist, a psychotherapist only deals with patients with moderate to mild mental disorders. Another major difference between the two is the methods of therapy. The psychiatrist's methods include the use of specialized medications for highly specific areas of the brain, to stimulate them and achieve the desired effect.
The main tool of the psychotherapist is the word, because the essence of his work is to understand what exactly caused the mental disorders and to build treatment in relation to this anchor. Medications are used only as a supplement to therapy, their main task is to relax the patient or, on the contrary, to help him concentrate.
By the way,
it is the psychotherapist who can decide to refer the patient to a psychiatrist in case of suspicion of a serious mental disorder. It should also be said that the diagnosis and any decision regarding the planned treatment or referral to another specialist are made only after passing a full examination. Such an examination is also designed to exclude a history of organic brain damage, otherwise the disease is not included in the scope of the psychotherapist.
Psychotherapeutic treatments
At the moment, psychotherapy already has a fairly wide range of approaches to the treatment of a particular disease of a psychological nature. However, three of them should be emphasized, these are the so-called foundations of psychotherapeutic "art":
Psychoanalysis. The object of work in this psychotherapeutic method is the subconscious, as a concept that has a direct impact on the human psyche and consciousness;
Existential approach. The peculiarity of this technique lies in the complete study of the patient's life and drawing up a kind of life psychological chain. Thanks to this chain, it is possible to determine the roots of a particular human reaction to certain situations, which is further used in treatment;
Gestalt therapy. This technique is based on the principle of self-regulation of the human psyche.
Features of psychotherapeutic influence
As mentioned above, the main tool of the psychotherapist is the "word", that is, treatment through direct communication. Influencing the conscious and unconscious of the patient during a conversation, the doctor exerts the necessary influence on the patient, contributing to this recovery.
At
turning to a psychotherapist, you must always remember that such treatment is, this is a purely voluntary matter, so you do not need to oppose yourself to a psychotherapist during sessions. Moreover, some aspects of treatment can be corrected directly by the patient: this refers to the choice of the method of exposure that will be most suitable for him. A number of such methods of exposure include:
Two-way conversation;
all kinds of coding, also with the use of hypnosis;
NLP;
bioenergetic technique of influence;
psychoanalysis;
cognitive behavioral therapy (anger management, etc.)
Scope of the psychotherapist
As already mentioned above, the psychotherapist's competence includes mental disorders of mild and medium severity, which determines its scope of activity, for the most part, by the following series of psychological pathologies and conditions:
All kinds of neuroses;
help in getting rid of various bad habits, such as alcoholism, tobacco smoking, addiction to social networks and others;
all kinds of psychoses;
help with a way out of a permanent depressive state, regardless of the reasons for its occurrence;
Bulimia and anorexia;
Feeling of frequent weariness anxious states, nervous strain;
Mental states, accompanied by delusional ideas, and attacks of severe anxiety (panic attacks);
All kinds of phobias;
Apathetic states and absolute indifference to what is happening around.
However, not every stressful situation is a reason for contacting a psychotherapist.
The most common reasons for contacting a psychotherapist and the principles of his work
In fact, all of the above conditions are a general description, and the problem of each is unique, like each person.
Can
highlight the main points or the most common reasons for seeking help from a psychotherapist. These include: losses, developmental failures, interpersonal conflicts, symptomatic conditions (various kinds of phobias, anxiety states, and so on), serious personality disorders, excessive use of psychoactive substances.
Quite often it happens that the appeal to a psychotherapist is preceded by a serious loss or some kind of achieved milestone in development. Then it turns out that the problem did not arise yesterday, but something prevented the decision to seek help. In this case, the patient will need serious personality-oriented therapy for a decent amount of time, because treating the symptoms or eliminating the problem will no longer bring a noticeable result. The same principle applies to cases of the presence of several of the above reasons at the same time.
Whatever the root of the problem that is the goal of psychotherapeutic analysis and treatment, the physician must take into account the patient's life stage and the same indicator of his family. This is due to the correspondence of the specifics of the problem to each of the stages of development of a person or a family unit.
In addition to
this, the therapist must always take into account the interpersonal picture of the patient's relationship, its hierarchy. Whether it is related to the problem, and what symptoms relate to this area. Who from the patient's environment can have the greatest influence on him, as well as the level of support available to him. If we talk about the existential side of the issue, then one should pay attention to the patient's values, life and moral, as well as the ability to take responsibility for his life and attitude towards it.
Psychotherapy and children
Child psychotherapy is seen as a separate branch. Considering that the appearance of neuroses is possible at any age, initially a small patient is in the "hands" of a neurologist, who can refer him directly to a psychotherapist only upon reaching 3 years of age.
The main reasons for this direction may be:
Unwillingness to study and poor performance for a long time;
anorexia and bulimia;
constant tearfulness, constantly agitated state, rude behavior;
serious phobias, enuresis, etc.
constant isolation and unwillingness to make contact with someone.
Summing up, we can say: the work of a psychiatrist is psychological assistance during periods of extreme emotional states, in the localization of symptoms of a psychological nature and the subsequent disposal of them, assistance in the event of internal conflicts, especially if such conditions are reflected in interpersonal relationships.
In addition, psychotherapy can provide serious assistance in changing those personal qualities and behavioral habits, the presence of which negatively affects self-realization and relationships of any type.
A psychotherapist is a specialist who helps to overcome psychological difficulties, provides support in difficult life situations, helps to find the causes of psychosomatic diseases and other negative manifestations.
What does a psychotherapist do? The main "tool" of the psychotherapist is conversation, conversation. Such a conversation has little to do with ordinary everyday conversation. The therapist builds the conversation in a certain way and within the framework of the ethics of psychotherapy. His task is to provide support in the process of conversations with the client, to come to an understanding of the causes of problems and to consider options for solving them, to help the client find internal resources to overcome difficulties and achieve goals.
What is a psychotherapist for a client - a mentor, a teacher? No, the therapist does not give ready-made advice, does not "teach". Together with the client, he seeks a solution to problems, helps to understand and accept himself and the surrounding situation, to find the strength to act.
Oksana Barkova, psychotherapist:
“A 35-year-old woman came to the consultation, complaining of insomnia, apathy, unwillingness to live and wake up in the morning, loneliness and difficulty in relationships with men, fear of dying, anxiety that intensifies in the evening, influx of uncontrollable thoughts that capture the mind for several years ... Medications prescribed by a psychiatrist and a neuropathologist partially relieved the symptoms, but in fact nothing changed in life.
When clarifying the reasons that could lead to such a difficult emotional state, it turned out that a couple of years ago her father unexpectedly for his family committed suicide, and it was the client who discovered this when she came home. From that time on, anxiety appeared, insomnia, and further the condition worsened progressively. In the process of working together, exploring and completing what required completion, it was possible to achieve a stable emotional state, sleep, appetite returned to normal, sexual desire, joy and interest in my life appeared, psychotherapy was long, regular for two and a half years. The result, according to the client, is worth it! Of course, this kind of work requires courage and despair from the client to admit his intention to live differently! And from the therapist - a lot of wisdom, patience, compassion and courage, to be near in difficult situations that cause a lot of feelings and embarrassment. We had it all) ".
What does a psychotherapist treat?
The psychotherapist deals with a wide range of problems, the main types of which will be discussed below. In this article, we will look at what a psychotherapist treats in adults. Child psychotherapy is a separate field of activity.
Psychosomatic diseases. This is a group of diseases, the cause of which is considered to be physiological and mental factors. These include, in particular, the following:
- Cardiovascular diseases (hypertension, vegetative-vascular dystonia, etc.)
- Diseases gastrointestinal tract(ulcerative colitis, irritable bowel syndrome, etc.)
- Rheumatoid arthritis.
- Skin diseases (neurodermatitis, urticaria).
- Sexual disorders.
- Respiratory diseases (bronchial asthma).
The list is incomplete. A fairly large list of diseases is referred to as psychosomatic. Since the development of such diseases is influenced by certain features of the human psyche, working with a psychotherapist is necessary measure for recovery.
It is not entirely true to say that the therapist treats these diseases. It is more correct to assert that this specialist works to eliminate the causes of psychosomatic diseases.
Pains, ailments of unknown origin. It so happens that a person is sick, does not feel well, but they cannot be diagnosed with it. One narrow specialist redirects to another, the second to the third, until the circle is closed. In this case, the source of a physical ailment can be a person's inner experiences, often unconscious. The psychotherapist helps the client to realize what is causing discomfort in his psyche. And further work on this problem, thereby getting rid of the physical ailment. Thus, we can say that a psychotherapist "heals" ailments that have psychological causes.
Infertility. Often there is a situation when a man and a woman are completely healthy, but they cannot become parents. The reason may be negative internal attitudes, subconscious fears. Many people know the stories when the spouses "planned, but nothing worked, and then went to the sea together - and it's done." And it's not about the healing effect of the sea air. As a rule, on vacation, people are in a good mood, relax, forget about problems - that is, their psyche at this time is in a different state than at home. Therefore, the result is not long in coming. A psychotherapist, working with a couple, helps to "tune" the psyche to positive result... Remove negative attitudes, fears, relieve anxiety. And finally, become the parents of a long-awaited baby.
Overweight, eating disorders(anorexia, bulimia). Often the cause of overweight or underweight is unresolved internal problems, conflicts. The psychotherapist helps to find the essence of the problem and work it out. The result is the normalization of eating behavior. It is also worth noting that a psychotherapist successfully treats body dysmorphic disorder.
In what other situations does the therapist help?
Depression, apathy, loss of strength, lack of desires. The psychotherapist helps to find resources to get out of the situation, overcome current life difficulties, formulate goals and outline steps towards them.
Loss, grief, loss. There are situations when nothing can be changed, you can only accept reality and find the strength to live on. A psychotherapist becomes a support for a person in a difficult moment in life, helps and supports. In modern society, it is not customary to talk about loss, and often a grieving person is left alone with his pain. The psychotherapist will always listen and hear, find the right words, help find resources and goals for later life.
Phobias, fears, obsessions, panic attacks. Such manifestations do not appear "from scratch" and always have a psychological reason. The psychotherapist, together with the client, searches for and works out this reason. And then the problem goes away. Fighting phobias and similar problems "symptomatically" is useless - you need to find their root.
Dependencies. Anyone who has tried to give up any habit, even the most harmless one, knows how difficult it is. The problem with a habit is that it is rooted in the human psyche. To give up a habit, you need to influence the psyche, and this is extremely difficult to do on your own. A psychotherapist by the power of words helps to gently and painlessly get rid of unwanted addictions - including love ones.
We examined who a psychotherapist is and what he does. This is not a complete list of the problems this specialist is working with. What else does a psychotherapist treat and with what symptoms should I contact him? They come to him in cases when there are symptoms of the disease, but specialists cannot make a diagnosis, as well as in different life situations that are difficult to overcome on their own.
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What is a psychotherapist?
Psychotherapist Is a certified psychotherapist. In turn, psychotherapy is a method of treatment, which is based on the effect on the patient's body through his psyche. The basis of psychotherapy can be based on medical or psychological education. This means that the therapist must initially graduate from either medical University, or any other specializing in psychology. After receiving higher education the future psychotherapist is being certified in one of the areas in psychotherapy. There are many directions and methods in psychotherapy, but they can be conditionally divided into two groups - psychoanalytic and behavioristic ( behavioral).
The main directions in psychotherapy are:
- psychodynamic direction;
- cognitive-behavioral direction;
- humanitarian direction.
Psychodynamic direction
According to this direction in psychotherapy, the inner world of a person is the result of dynamics ( collisions) internal impulses with ideas about reality. Dynamics is understood as movement, interaction and struggle of internal forces. Therefore, psychodynamic psychotherapy understands the processes of the psyche as a result of the interaction of internal forces. This approach is based on the hypothesis that the human psyche is a separate world of energy, living and interacting according to its own laws, and these laws are not reduced to external factors ( that is, do not depend on external circumstances). Representatives of this trend are Alfred Adler, Harry Sullivan, Karen Horney. Within the framework of this direction, such methods as psychodrama, body-oriented psychotherapy, analysis are distinguished.Cognitive-behavioral ( behavioral) direction
Proponents of this trend assume that human behavior is based on his ideas about what is happening. That is, the way a person sees the outside world, and everything that happens in it, depends on the type of thinking. At the same time, human thinking is largely shaped by upbringing, training and certain social traditions. Thus, sometimes people use their negative and erroneous thinking to evaluate what is happening.Representatives of this trend believe that many problems are the result of erroneous ideas, and they, in turn, stem from erroneous thinking.
The main goal in behavioral therapy is the formation of correct thinking, which will guarantee an adequate interpretation of events. The main approaches in the cognitive-behavioral direction include Beck's cognitive therapy and Ellis's rational-emotional-behavioral therapy.
Humanitarian direction
This direction in psychotherapy is radically different from the previous two. The focus of the direction is not on the concept and not on the personality, but on interaction ( that is, communication) between the therapist and the patient. The emphasis is on speech activity.All humanistic approaches are based on such human qualities as improvement and self-affirmation. Therefore, the main point is that a person himself is able to establish his life. To do this, it is only necessary to remove some internal obstacles. Also, according to this provision, the disease ( mental disorder) develops when the process of achieving the goal is blocked by some circumstances. These circumstances can be relatives, parents or public opinion. Most often, it is they who get in the way of realizing any human desires. The task of the psychotherapist in this case is to help a person become what he is capable of.
How do you become a psychotherapist?
There are two ways to become a psychotherapist. The main method involves initial medical education. This method is the longest, but also more complete, since it subsequently gives the right to practice pharmacotherapy ( that is to write out prescriptions). After graduating from a medical university, those wishing to become a psychotherapist must complete an internship ( in some countries residency) in the specialty of psychiatry. The duration of the internship, in contrast to the generally accepted medical education of 6 years, varies from 2 to 5 years. In the post-Soviet space, an internship in psychiatry lasts from 2 to 3 years. After graduating from a medical university and an internship in psychiatry, the future psychotherapist becomes a psychiatrist. The competence of a psychiatrist includes the diagnosis, treatment and prevention of mental illness. Further, if the psychiatrist wants to practice non-drug methods of treatment ( that is, psychotherapeutic), he must take specialized courses. The choice of courses depends on the desired direction in psychotherapy. So, today the most popular areas are cognitive-behavioral therapy and psychoanalysis.
The main methods of psychotherapy include:
- cognitive behavioral therapy;
- positive therapy;
- psychoanalysis;
- family psychotherapy;
- psychodynamic therapy;
- interpersonal ( interpersonal) therapy.
Cognitive Behavioral Therapy Courses ( CBT)
CBT is one of the most powerful and scientifically proven methods. It is widely used for depressive and anxiety disorders Oh. The requirements for the courses are very high. So, according to the European Association for the Accreditation of Cognitive Psychotherapists, training in this method should be at least 5 years. The course should include at least 450 hours of theory and practice, as well as 200 hours of supervision. Supervision means clinical practice with a certain set of patients under the supervision of a specialist in this field.Psychoanalysis training
Psychoanalysis is another method in psychotherapy that was developed by Freud at the end of the nineteenth century. Psychoanalytic training must also take place on a medical or psychological basis. This is followed by training in the theoretical part of psychoanalysis, which lasts 3 years. The theory ends with the passage of the so-called "personal analysis" by a qualified psychoanalyst. Depending on the requirements of various psychoanalytic communities and institutions, this stage can last up to 3 years. At the same time, the student must lead under the supervision of two patients for at least two years. This supervision should be conducted with weekly reports to the supervisor ( a specialist to whom the student psychotherapist reports).Family psychotherapy training
This type of psychotherapeutic influence is the youngest. It originated in the post-war years of the last century in the United States of America, where it quickly became popular. Since then, family psychotherapy has quickly spread throughout Western Europe and only recently came to Russia. A feature of this method is that not one specific person, but the whole family becomes in the center of therapy. According to this direction, the therapy of mental disorders is based on the therapy of interpersonal relationships in a group ( in family).Positive psychotherapy trainings
Positive psychotherapy is a relatively new method in psychotherapy. However, over the past decades, it has gained worldwide recognition. The training consists of training seminars and a separate theoretical part. The course of study should include 300 hours of theory, 150 hours of practical work, 100 hours of personal therapy and 35 hours of supervision.Psychologist-psychotherapist
Psychologist-psychotherapist receives a certificate of psychotherapy based on his psychological education. The main significant difference is that, unlike a psychotherapist, he cannot prescribe pharmacological treatment, that is, write prescriptions. However, this does not prevent him from practicing different methods psychotherapeutic treatment - from psychoanalysis to interpersonal therapy. At the same time, due to his education, the activity of a psychologist, as a rule, is limited to borderline states - neuroses, depression, increased anxiety. The lack of higher medical education does not allow a psychologist-psychotherapist to delve into endogenous diseases - schizophrenia, bipolar disorders.Psychotherapist and psychiatrist, what's the difference?
There is often no difference between the two. A psychiatrist is a medical doctor with an internship ( postgraduate education) in the specialty of psychiatry. The competence of the psychiatrist includes the diagnosis, treatment and prevention of all mental disorders.The most common mental disorders include:
- depression- according to experts, it is this disease that will take the leading place among all diseases in 10 years;
- neuroses- this is a wide group of diseases, which includes panic attacks, phobias ( fears), obsessive-compulsive disorder;
- schizophrenia- pathology, characterized by the disunity of thinking processes, the presence of hallucinations and delirium;
- mental disorders in epilepsy;
- bipolar disorder- pathology characterized by periods of increased and decreased mood;
- borderline personality disorder ( Borderlein type) - personality pathology, which is characterized by impulsivity, low self-control, increased anxiety.
However, a psychologist - a specialist without medical education can also become a psychotherapist. In this case, the difference lies in the boundaries of competence. A psychotherapist without medical education is not competent in diagnosing and medication. He can only practice psychotherapeutic methods of treatment, that is, without the influence of drugs. For diagnosis and further treatment, a psychotherapist may recommend contacting a psychiatrist.
Psychotherapist and hypnosis ( psychologist-hypnologist)
Hypnosis is a condition characterized by a high susceptibility to suggestion and a sharp focus of attention. This state can be induced both by self-suggestion and suggestion from the outside. Contrary to popular belief, hypnosis cannot be induced against a person's will. Also, during hypnosis, the probability of false memories is high, which limits the use of this method in treatment. The method of psychotherapy that uses hypnosis is called hypnotherapy. This is one of the most ancient methods, because hypnosis was practiced in ancient Greece.Today this method is not as popular as it used to be. It is believed that a person himself must find the cause of his suffering and understand himself. However, some specialists practice it in combination with other methods of psychotherapy.
Initially, two types of hypnotherapy are known - classical ( she is directive) and resolving ( Ericksonian). The first uses rigid formulations and guidelines ( directives) and is a pretty tough method. It is widely used in the treatment of alcohol addiction, producing an aversion to alcohol. This method is popularly known as coding. Erickson hypnotherapy is a softer and more gentle method. This method is based on the reproduction of events through images ( pictures). The method can be used in the therapy of fears, neuroses, anxiety states.
What does a psychotherapist treat?
A psychotherapist is responsible for a wide range of mental illnesses - from depression to alcohol addiction. Sometimes psychotherapists specialize in specific aspects. For example, a psychotherapist who works primarily with patients who have been abused or in an acute crisis. As a rule, the field in which the therapist works is determined by his specialization. Thus, specialists in cognitive therapy most often work with neuroses and post-traumatic disorders, psychoanalists - with psychosomatic diseases. The pathologies that a psychotherapist works with include:
- depression;
- panic attacks and anxiety;
- addictions - alcoholic, gambling;
- post-traumatic disorders;
- psychosomatic diseases.
Depression
According to experts, in a few decades, depression will become the most common disease. It is already one of the main causes of disability and the main cause of suicide.Today from different severity depressive disorders more than 300 million people suffer. More than 800,000 people with depression commit suicide every year. The most tragic in this aspect is that the disease affects the young working population. Moreover, in recent decades, depression has been increasingly common among children and adolescents.
Sometimes, to cope with this condition, people begin to resort to the help of alcohol and drugs. Initially, both alcohol and psychostimulating substances cause mild euphoria, and people think that this is how they defeated the disease. However, severe depression develops very quickly against the background of use, because alcohol and most drugs are strong depressogenic ( depressing) substances.
According to the protocol, mild and moderate depressions are currently treated exclusively with psychotherapy without the use of medicines... The most effective and scientifically proven method for treating depression is cognitive behavioral therapy ( CBT). The main goal of CBT for depression is to develop new perspectives on the current situation.
The steps to overcome depression with CBT are:
- Formation of self-knowledge skills. Before this, it is necessary to accurately identify the problem and the events that preceded the development of depression.
- Workout and relaxation. Various techniques will help you cope with increased anxiety at the peak of its manifestation.
- Increasing the number of enjoyable events. A balance must be struck between negative and positive events.
- Confidence training. Initially, it is necessary to identify the events in the patient's life that precede the feeling of uncertainty, after which the development and training of confidence takes place.
- Formation of social connections. Closeness, isolation and social avoidance always go hand in hand with depression. It is necessary to maximize the expansion of those activities that lead to socialization ( for example, going to the cinema with friends), and reduce the activities that prevent this ( for example, watching TV).
Antidepressants used in the treatment of depression
Name | Mechanism of action | How to apply? |
Sertraline | Has a pronounced anti-anxiety effect. It is used for depression, panic attacks ah, obsessive-compulsive disorder. | The starting dose is 50 milligrams ( one tablet) per day. The drug is used once in the morning. Further, the dosage depends on the characteristics of the clinical case. For anxiety depression, the dose is 100 milligrams ( 2 tablets), once a day. With obsessive-compulsive disorder, it can reach 150 milligrams ( 3 tablets). |
Fluoxetine | It has a pronounced activating effect, it is used for depression, obsessions, bulimia. | The starting dose ranges from 10 to 20 milligrams per day. Further, the dosage is gradually increased to 40 milligrams. The maximum dose is 60 to 80 milligrams per day. The drug is also used once, in the morning. |
Venlafaxine | It has anti-anxiety and sedative effects. It is used for anxiety depression, accompanied by agitation and insomnia. | The starting dose is 75 milligrams per day. Further, it is increased weekly by 75 milligrams. The maximum dose is 375 milligrams per day, the dose is divided into 2 - 3 doses. |
Panic attacks and anxiety
As a rule, increased anxiety occurs in the frame of depression. Some experts in this field argue that there is no depression without anxiety and anxiety without depression. Nevertheless, there are clinical cases when both panic attacks and anxiety proceed in isolation.Psychotherapy is also recommended for panic attacks. However, most often it takes place in parallel with drug treatment. If the anxiety is expressed as much as possible, then the psychotherapist initially recommends only medication. If he has a medical education, then he can prescribe drugs himself. If he received a certification based on psychological education, then he will not be able to prescribe medications. In this case, it is also recommended to consult a psychiatrist. After the anxiety subsides and it will be possible to fully cooperate with the patient, psychotherapy sessions are scheduled. Behavioral therapy is also recommended for panic attacks and increased anxiety.
Addictions - alcoholic, gambling, narcotic
Psychotherapists also work with various kinds of addictions - drug, alcohol, play. It is important to realize that people are not born with these flaws, but acquire them by various reasons... Most often this is a "flight" into some kind of addiction. When they are severely depressed or in a dire crisis, many try to numb their mental pain with alcohol or drugs. There are also times when people try to control their emotions with the help of alcohol or drugs. This is observed in borderline personality disorders ( Borderlein type) or for bipolar disorder. These pathologies are manifested by abrupt changes in mood, euphoria and outbursts of anger. At these times, patients can start drinking, using drugs and playing.In addiction, motivational and interpersonal therapy and hypnosis are widely used.
Post-traumatic stress disorder
Post-traumatic stress disorder ( PTSD) Is a mental illness that manifests itself in a complex of symptoms, which, in turn, developed as a result of a stressful situation. This disorder should not be confused with an acute stress response. In this case, fear, anxiety, panic attacks, and insomnia are also present. However, the reaction is present in the first days after stressful events. PTSD, on the other hand, develops a year or more after stress. Key hallmark is the presence of obsessive memories of a past event, which periodically emerge in the mind of a person ( flashback).Psychotherapy will help to overcome the formed fear and get rid of obsessive thoughts. Psychotherapy sessions are aimed at developing the ability of patients to accept the realities of life and create certain behavioral patterns. A common technique for PTSD is the flood technique, as well as desensitization and eye movement processing. In the first case, the patient creates in his memory a picture of past events and is completely immersed in it. The second method was invented by the psychotherapist Shapiro specifically for the treatment of PTSD. It involves focusing the patient on disturbing memories while simultaneously focusing on alternative stimulation from the therapist. This can be guided eye movements, auditory stimuli, or hand patting. In this case, the psychotherapist asks what associations the patient has at this moment. The main point in this case is to maintain double attention - on personal experiences and on alternative stimuli.
Psychosomatic diseases
Psychosomatic diseases are pathologies in which the human psyche plays a key role, while it is manifested exclusively by physical symptoms. Translated from Greek, "psycho" means soul, and "somato" - body, which literally means mental illness.Psychosomatic illnesses include:
- neurodermatitis, eczema, psoriasis;
Child psychotherapist
A child psychotherapist is a specialist who is competent in the diagnosis and treatment of mental disorders in individuals between the ages of 3 and 18. Like an adult specialist, a child psychotherapist can initially be either a doctor or a psychologist. However, due to the fact that child psychopathology is more complex and specific, child psychotherapists, as a rule, are also doctors. Most often, child psychotherapists practice cognitive behavioral therapy. This method has proven itself more than others in the correction of mental disorders in children. Also, child psychotherapists practice interpersonal and psychodynamic therapy - methods that have proven to be effective in borderline disorders. The most common mental illnesses in children include:
- anxiety;
- obsessive compulsive disorder;
- depression;
- suicidal behavior;
- borderline disorder ( Borderlein type).
Anxiety disorders are no less rare in children. They can take the form of panic attacks, nightmares, and bedwetting. Treatment of anxiety disorders often requires not only psychotherapeutic treatment, but also medication. For this purpose, the psychotherapist ( if it is also a doctor) can recommend anti-anxiety drugs.
Obsessive-compulsive disorder belongs to the category of neuroses and occurs mainly among adolescents. This disorder is manifested by obsessive thoughts and actions according to the type of rituals. The most common rituals are hand washing, touching certain things with your hands. Treatment for this disorder is usually complex and includes both medication and psychotherapy.
In recent decades, depression and suicidal behavior has become increasingly common among children and adolescents. According to recent studies, the treatment of mild to moderate forms of depression is limited exclusively to psychotherapy and medication is prescribed only for a severe depressive episode. There are several explanations for this. Most antidepressants have an atypical effect on adolescents and young adults under the age of 25. The most dangerous side effect is the inversion of affect and the induction of suicidal behavior. Thus, instead of normalizing the emotional background, antidepressants provoke outbursts of anger and suicidal thoughts. Such by-effect can provoke any antidepressant, but most often it is induced by antidepressants from the group of serotonin reuptake inhibitors ( paroxetine, fluoxetine).
Another argument in favor of psychotherapy for depression in adolescents is the fact that most psychotropic drugs are age limited. There is only a small group of drugs that are approved for use in children ( for example, sertraline, which can be prescribed as early as 6 years of age).
There is also no standard drug regimen for borderline disorders. Borderline or Borderlein disorders are no less common today and are characterized primarily by low self-control. In the clinical picture of such adolescents, self-destructive behavior comes to the fore - they injure themselves, cut themselves. Interpersonal therapy is the gold standard in treating this disorder.
Psychotherapist with neurosis
The psychotherapist is the main specialist who deals with the treatment of patients with neuroses. The disease itself is a mental disorder in which the patient long time is in a depressed state, accompanied by gratuitous crying, anxiety, resentment. A person with neurosis complains of emotional and physical exhaustion, increased sensitivity to external stimuli ( loud sounds, bright light, minor problems).Stages of treatment by a psychotherapist
Psychotherapy for neurosis pursues a number of goals that are achieved in several stages. The sequence and methods of achievement are determined individually, depending on the form of neurosis and other factors.There are the following stages of psychotherapy with neurosis:
- Establishing the type of disease. Neurosis has a large number of manifestations and in some patients it can provoke mild anxiety, while in others it can cause a pronounced disturbance of both mental and physical well-being. The treatment strategy depends on the type of disease, therefore this stage is the first and one of the most important in the therapy of neuroses.
- Determining the cause. A neurosis can be provoked as one specific event ( often it's a loss loved one, accident, dismissal from work) and a number of unfavorable circumstances. Determining the cause, along with establishing the form of the disease, is the main factor that the psychotherapist focuses on when drawing up a treatment plan.
- Elimination of symptoms. In some cases, the manifestations of neurosis are so strong and constant that they interfere with a person's work, greatly complicate relations with others. Therefore, during psychotherapy, the doctor teaches the patient techniques that help him cope with anxiety and other symptoms of the disease. Sometimes the doctor prescribes special medications.
- Correction of patient behavior. This stage is one of the longest in the treatment of neurosis. Using various techniques, the doctor helps the patient to change the attitude towards the problem or situation that caused the disorder.
- Correction of some of the patient's personality traits. As a rule, neuroses are diagnosed in patients who have similar character traits. Such people are distinguished by increased suspiciousness, suggestibility, self-doubt. In order to prevent relapses ( re-exacerbation) illness in the future, the doctor is working to correct the characteristics of the patient's character.
Methods of psychotherapy for neurosis
There are many psychotherapeutic techniques that can be used to help a neurotic patient. Most often, not one, but several methods are used in treatment. They can be carried out sequentially or in parallel to each other.With neurosis, the following psychotherapy methods can be used:
- Behavioral therapy. The purpose of such sessions is to correct the patient's behavior in situations that provoke neurosis or may do so in the future. Also, the doctor teaches the patient self-control skills so that he can cope with stress, negative circumstances.
- Cognitive psychotherapy. This technique is often used in conjunction with behavioral therapy. The task of the doctor is to identify destructive attitudes and to correct them. An example of such an attitude would be the patient's belief that he should never be wrong. In this case, the psychotherapist is working on correcting this statement so that the patient realizes that making mistakes is not a reason for strong negative emotions, since all people are wrong.
- Hypnotherapy. Hypnosis helps the doctor determine the cause of the neurosis ( for example, when the patient does not remember some important details of the situation that triggered the disorder). Also, hypnotherapy is used to correct the patient's behavioral model - in a state of hypnotic trance, new rules of behavior are instilled in him ( for example, "I stop feeling anxious").
- Personal psychotherapy. Such treatment is indicated for patients who are dissatisfied with themselves or the surrounding circumstances without objective reasons. The psychotherapist helps the patient to form a positive perception of his personality and current events. Also, sessions of personal psychotherapy are carried out with self-doubt, excessive emotionality, suspiciousness.
- Relaxing techniques. This area of psychotherapy includes meditation techniques, breathing exercises and other activities that help the patient get rid of stress, anxiety.
Family psychotherapist
Family psychotherapy is the youngest trend among all psychotherapy schools. According to this direction, the cause of certain symptoms is interpersonal relationships in family. The object of therapy in this case is the family. It is a single organism made up of various elements. It is important to understand that problems are not the result of an individual ( family member), and the relationship with him. The family comes to an appointment with a family psychotherapist in its entirety, even if there are family members who are not worried about anything. The problems with which they turn to a family psychotherapist can be very different - from banal difficulties with children to divorce.
Problems that are addressed to a family psychotherapist include:
- behavioral problems in children;
- conflicts between relatives;
- fears, phobias in one of the family members;
- problems in the relationship between husband and wife;
- various addictions - alcoholic, drug, gambling.
The main "root of evil" in any family is the so-called misunderstanding. It is from here that daily quarrels and scandals, betrayals, problems with alcohol and drugs grow. The result of a sick family atmosphere is that children tend to take the hit. Unconsciously, they begin to "save" the situation in the family by their behavior. Most often they start to hurt ( "Flight into illness"), thus trying on relatives around him. Also, children can show antisocial behavior, aggression or somehow demonstrate themselves in another way.
The goals of family therapy
The main goal of family psychotherapy is, of course, the preservation of the family. But it does not follow from this that this method helps to resolve only family conflicts. Very often there are no open conflicts in families, that is, ordinary quarrels and abuse. However, they have constant infidelity, addiction and, as mentioned above, often sick children.The main goals of a family psychotherapist are:
- overcoming family conflicts;
- elimination of unhealthy relationships between spouses, between parents and children;
- family preservation;
- entering into a new relationship after a divorce.
Also, family psychotherapy helps to change or strengthen the values of each person in the family. Realizing the value and importance of each member, the family will function in harmony and harmony. So, after qualified support, everyone will be able to feel positive changes both in themselves and around.
Principles and methods of family psychotherapy
Since family psychotherapy solves a very wide range of problems, it uses a variety of methods and practices.Family psychotherapy methods include:
- Family discussions, during which the existing problems are discussed. The psychotherapist acts as an observer and mediator, using the technique of active silence, confrontation, and paraphrasing.
- Role-playing games, during which the roles of each family member are played. A feature of this technique is that a specific task is set for family members. For example, a psychotherapist puts forward a version of the son's misconduct and demands from other family members as many versions as possible to argue for this act.
- Family sculpture technique. Family members create a frozen pose for each other, while playing emotions, movements, favorite poses.
- The technique of conditional communication. The psychotherapist introduces a new element into the family dialogue. This can be a communication rule, an exchange of notes, or a color signaling ( each color symbolizes some emotion). The purpose of this technique is to correct habitual conflicts ( violations).
- Directives ( or instructions). Specific and direct instructions from the psychotherapist in relation to certain actions. This can be a directive to change your place of residence or to live separately. Directives can be of three options. The first option is to do something, the second is to do something differently, and the third is not to do what was previously done.
Reception ( consultation) at the psychotherapist
You must make an appointment with a psychotherapist in most centers in advance. As a rule, an individual consultation takes 45-50 minutes, family psychotherapy can last up to 2 hours. Reception begins with clarification of the main complaints and problems. It is not always possible to find out immediately. Often, a person who comes to an appointment needs to establish contact with a psychotherapist before opening up to him. In turn, the psychotherapist must find out what the incoming patient expects from the therapy. Psychotherapist help
The help of the psychotherapist consists in resolving and overcoming the problems with which the patient turns to him. After the main problems have been identified, further tactics of therapy are determined. It should be noted right away that psychotherapy is a long and laborious process. As a rule, no specialist will initially say how many sessions are needed. This is explained by the fact that initially it takes time to establish a certain emotional contact between the specialist and the patient. Further in the course of therapy, other problems may be "revealed", which later will also have to be dealt with. In general, psychotherapy is divided into short and long-term. The first can last for several months, while the second drags on for years.The types of help a psychotherapist can provide include:
- Help in a crisis situation- that is, to survive an acute crisis period. This can be an acute reaction to stress, difficulties with adaptation, and so on. In different stressful situations, people behave differently. The degree of reaction in this case depends on the functioning nervous system- some may exhibit acute psychotic reactions, while others tolerate the cataclysm outwardly calmly, but then develop post-stress disorder. To cope with an acute reaction, be it a natural disaster or a family disorder, consultations with a psychotherapist will help.
- Help with post-stress disorders, or PTSD for short. A disorder that can develop from a single or repeated traumatic situation. PTSD develops no earlier than 3 months after the injury. Any stressful situation can act as a trauma - sexual violence, physical trauma, natural disaster, military action. For this ailment characterized by symptoms such as increased anxiety, recurring events in the memory of trauma, avoidance behavior.
- Help with grieving. Every person experiences loss at least once in his life. The most difficult is the death of a loved one. Through the stages of loss, from shock and denial to accepting the loss, psychotherapy sessions can help.
Where does the psychotherapist take?
The psychotherapist accepts in a doctor's office, which is part of a state-type medical institution. This specialist may be on the staff of a hospital that specializes only in psychiatric diseases, as well as a general institution such as a district or city hospital. Also, a psychotherapist may work in a private hospital or other organization that provides health services. In addition, a psychotherapist can conduct a private practice, accepting patients in own office which is not part of any hospital or clinic.How to choose a psychotherapist?
Today, on the Internet and in the media, you can find many offers for the provision of psychotherapeutic assistance. It should be noted that the success of the treatment of any mental disorder largely depends on the professionalism of the doctor. With help pharmacological preparations only some of the symptoms of the disease can be eliminated. But the elimination of the cause of the disorder and its prevention in the future is based solely on the knowledge of the psychotherapist. Therefore, the choice of a doctor should be approached responsibly, taking into account, first of all, the availability of professional training.A specialist who provides psychiatric care, must have a higher medical education. Therefore, before starting treatment, it is recommended to make sure that the doctor has a psychotherapist diploma. It will not be superfluous to familiarize yourself with the reviews of the former patients of this doctor, which can be found on the Internet on specialized resources.
Psychotherapist Center
A psychotherapist center is a specialized institution that provides care to patients with mental disorders... As a rule, psychotherapy centers are not a state structure, but function as a private enterprise. Depending on the size and direction of work, the centers can provide not only counseling of patients, but also their hospitalization in cases where the treatment requires constant medical supervision.In addition to the main psychotherapeutic treatment, many centers provide additional services that are primary ( to prevent the development of the disease) or secondary ( to prevent relapses) prevention. An example of such services would be emotional support groups that include survivors ( violence, care of a loved one). In such groups, people share experiences and, under the guidance of a doctor, carry out various mental health promotion activities.
Jokes about the psychotherapist
At a psychotherapist's appointment, a woman with tears in her eyes says: - Doctor, I'm sure my husband has a mistress.
- Why do you think so? The psychotherapist asks.
- Because every Monday he disappears in an unknown direction and returns happy and cheerful. Then he quickly loses interest in me and all week again without mood.
- Don't worry - the psychotherapist says - he comes to see me!
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At the reception with a psychotherapist:
- How are you? What are you complaining about?
- Things are fine, everything is fine!
- Why did you come then? Before use, you must consult a specialist.
Asked Sep 17, 2018
Hello!
Tell us who is a psychotherapist, what does he do, who and what does he treat? The difference between a psychotherapist, psychologist and psychiatrist is also of interest.
Thank you in advance!
07/08/2019, 23:00 answered the question " A psychotherapist - who is he and what does he treat?"
Hello! Let's try to explain.
Psychotherapist: who is he and what heals?
A psychotherapist is a specialist who does not treat mental illness and physiological trauma, but is able to help the patient cope with pathological mental conditions caused by overwork, stress, psychological trauma or inherited predispositions.
Basically, those who suffer from:
- various neuroses and psychoses;
- bulimia and anorexia;
- chronic fatigue;
- anxiety and panic states (attacks);
- all kinds of phobias;
- apathy towards the world and people around;
- bad habits (drug addiction, alcoholism, smoking, and so on).
Treatment approaches differ from specialist to specialist, as psychotherapy becomes more extensive every year. However, there are three basics of any practice:
Psychoanalysis is a work with a person's subconscious, attention is directed to his instincts, associations, motivations and defense mechanisms, thanks to which the specialist receives all the knowledge necessary for further treatment.
The existential approach is a technique that includes a thorough study of the patient, his personality and lifestyle, after a detailed analysis of each period of life, a kind of psychological chain is built that helps to find the root of the problem and highlight solutions.
Gestalt therapy is based on awareness of oneself, responsibility for oneself and regulation of one's own psyche, aimed at countertransference and closing anxious situations.
Whatever one may say, a psychotherapist treats with a conversation, therefore, during the sessions, it is recommended to open up as much as possible and in no case oppose yourself to a specialist.
Medication is not the mainstay of therapy, but a supplement that helps you relax, focus on the task at hand, and feel better in a short time.
How does a psychotherapist differ from a psychologist and psychiatrist?
The psychologist has a higher education in the humanities, and the psychiatrist has a higher medical education. It follows from this that a psychologist is a specialist who is engaged in the selection of personnel and consults absolutely healthy people who do not have any mental disabilities. Even if a psychologist-psychotherapist conducts private practice and identifies symptoms, he has no right to diagnose and prescribe treatment to a patient. The psychiatrist-therapist, in turn, has the right to treat mental illness and prescribe drug therapy.
Both can work in hospitals or privately, including online consultations. Many specialists prefer to choose a narrow focus, for example, narcology and sexology. Or they focus on non-standard treatments like art therapy or play therapy.
Read more about the difference in these professions.
Life modern man filled with various stresses and experiences. We are constantly in a hurry, do not sleep well, we are faced with negative emotions and other not the most pleasant factors of social interaction. This, as you yourself understand, does not have the most favorable effect on our psyche. Therefore, sooner or later, almost every person has to deal with a psychotherapist. What kind of doctor is this, and when is his appointment required - read on.
Who is a psychotherapist and how does he differ from a psychologist and psychiatrist
A psychotherapist is a doctor who deals with various anomalies of a psychological state. This specialist allows his patients to cope with mild to moderate mental disorders.
It is worth noting that this doctor does not treat mental illness that has arisen due to brain injury. Indeed, in this case, more serious treatment may be required, and even surgical intervention.
People often confuse the concepts of psychotherapist and psychologist. However, the difference between these specialists is great. A psychotherapist is a doctor who has received medical training and can diagnose and prescribe medications. The psychologist is not a health worker, he is more a specialist in words.
There are specialists very similar in name, such as a psychologist, a psychotherapist and a psychiatrist. Let's see how these specialties differ.
How does a psychotherapist differ from other doctors working with mental disorders:
- A psychologist is a specialist who has no medical education. He does not prescribe drugs or diagnoses. A psychologist helps a person solve various problems in his life, for example, to understand why a child does not want to listen to his parents or how to behave in a particular situation. That is, such a specialist helps rather with words and teaches to live correctly.
- The psychotherapist also mainly uses verbal influence in his appointment. However, he has a medical degree and is a doctor, and therefore can diagnose and prescribe medication. Such a doctor can treat real mental problems that do not pose a danger to society.
- A psychiatrist is a physician who primarily treats his patients' problems with medication. He deals with serious mental disorders, and works with patients who are dangerous to society. Often, treatment with such a specialist takes place in a hospital environment.
That is, a psychotherapist is a doctor who has a medical education, and therefore can diagnose and prescribe ancillary drugs. He works with real non-severe mental disorders, however, he mainly works with words, and not with drugs.
Appointment with a psychotherapist: what does the doctor do
We are all afraid of doctors, especially if we do not know what is happening at their appointment. Therefore, it is very important to know what exactly the therapist does when the patient visits him.
The psychotherapist works in various centers. For example, such institutions as a center for working with difficult teenagers, institutions for the adaptation of special children, prisons and other similar institutions cannot do without such a specialist.
When a patient comes to a psychotherapist, the doctor first examines the presence of mental abnormalities, and then prescribes necessary treatment... Let's see how an appointment with a psychotherapist goes.
How is the appointment with a psychotherapist:
- First, a psychoanalysis of the patient is performed. For this, the specialist performs various physiological tests to determine the work of reflexes. Also, a conversation is conducted, and the patient is offered tests to determine the work of the psyche and awareness.
- The course of a person's life is also studied. This is necessary in order to understand the cause of his problem.
- Next, the patient is treated. First, conversation and hands-on training in self-control techniques are applied. However, psychotherapists treat other methods as well. For example, hypnosis, coding, medications, bio-energetics, neuro-linguistic programming.
Each doctor has his own methods of treating his patients. Therefore, it is important to get to a competent specialist who is really dedicated to his work.
List: what a psychotherapist treats
The psychotherapist deals with not all mental disorders. His competence includes diseases that do not pose a danger to others. Let's take a closer look at them.
What diseases does the psychotherapist deal with:
- Severe depression, in which the patient cannot find an independent way out of the current state;
- Bad habits, from which a person wants, but cannot get rid of (drug, alcohol and tobacco addiction);
- Excessive anxiety and various neuroses and psychoses;
- Various addictions, such as gambling, food, sex, and so on;
- Diseases associated with poor food intake, such as anorexia and bulimia;
- Mental disorders in the form of megalomania or, conversely, low self-esteem;
- Panic attacks, various phobias, and panic states;
- Chronic fatigue and overstrain of the nervous system.
A psychotherapist works with these and many other problems. Such patients do not pose a danger to others. However, these conditions can develop into more serious mental illness.
When to see a psychotherapist
Seeing a psychotherapist on time will help avoid further problems of a more serious nature. Also, a visit to this doctor will allow the patient to improve his standard of living, saving him from painful problems.
Most often, it is adults who have to go to a psychotherapist. Therefore, first we will tell you what symptoms in this group of people indicate the need to visit a psychotherapist.
What symptoms should you contact a psychotherapist with:
- Depressive state. It can be expressed in prolonged apathy, indifference to everything that happens, unwillingness to communicate with anyone.
- Anxiety is also a reason to see a therapist. This also includes panic attacks, with phobias.
- Various addictions that you cannot get rid of on your own. For example, cravings for alcohol, smoking, gambling, and so on.
- Constant tantrums and irritability indicate nervous breakdown... In this case, the consultation of a psychotherapist is also necessary.
- The emergence of various complexes that interfere with a full life.
A psychotherapist is sometimes needed not only for adults. Very often children also need this doctor.
When a child psychotherapist is needed:
- Absenteeism, poor academic performance, and so on;
- Anorexia and bulimia are common among adolescents;
- Various manifestations of inappropriate behavior, such as rudeness, tearfulness and excessive excitability;
- Passivity and lack of interest in communicating with other people.
Such symptoms can speak of both ordinary problems at school, as well as serious depression and even drug addiction. Therefore, visiting a therapist will help you avoid many problems.
Who is a psychotherapist and what does he heal (video)
A psychotherapist is a specialist who can cope with many mental disorders. If necessary, be sure to contact him, and he will help you deal with many troubles.
