"Exsistentia" translated from Latin means "existence". The existential direction in psychology implies the resolution of conflicts associated with requests regarding freedom of choice, will, loneliness, human death, responsibility for building a scenario of one's own life. In Western and Russian culture of the twentieth century, philosophers and cultural figures turned to the inner experience of a person who realized his total loneliness, mortality and, in parallel, the loss of the meaning of being. But they did not open this page in the history of culture. “Socrates ... posed the problem of life and tried to translate it into the realm of self-knowledge .... He wanted to correct his life with the strength of his spirit, realizing the conflict between the principle of freedom of personality and being. " People thought about the strength of the human spirit already at the dawn of civilization, but the twentieth century exacerbated these issues with a number of wars, genocide, monstrous experiments on people, unprecedented in history.

The existential trend in philosophy and culture began to develop especially intensively in the interval between the world wars. It has not lost its relevance even now, in the 21st century, with the threat of the Third World War. Finding meaning and finding oneself, a sense of one's own strength and responsibility - these are pressing issues that concern clients of all ages: rebel teenagers and retirees, men and women in midlife crisis, students frustrated by their own idealistic ideas about their chosen profession, and many others. The client's existential request is a kind of challenge to the therapist, an invitation to delve into his inner world in order to gain resources. And there is no universal fail-safe technique or standard set of exercises. It is a lively and intense search. This is the principle that I. Yalom proclaimed in the book “Mom and the Meaning of Life”, believing that, ideally, a unique language and an individual method of therapy should be invented for each client, because everyone understands worldview meanings deeply individually.

Existential questions in psychological science

A milestone in psychology was the approach developed by W. Frankl, the creator of logotherapy. His scientific works, including those after the experience of the concentration camp, are widely known, interpreted by the psychologist as an extreme and cruel condition for the creation of new vital meanings (one of them was the presence of relatives and friends, for which it was worth surviving). "Existential analysis will have to help a person become capable of suffering." It’s not just about suffering, but also about accepting this state, when the principle “it hurts, it means it’s bad” is replaced by “it hurts, it means it makes sense”. Let us add that suffering should change a person, contribute to his spiritual growth - this process is the basic meaning. And if a person in a concentration camp does not see him and continues to be horrified at the inhumanity, becomes discouraged, he is actually doomed (it is interesting that A. Solzhenitsyn also argued: those who despaired were the first to die in Soviet camps, and believers were the most resilient - that is, those who found their meaning in the idea of ​​God). “The one who knows the“ why ”can cope with any“ how ”, - considered I. Yal, another representative of the existential trend in psychology. Only meaning gives strength to live. In other words, the concentration should not be on the process of suffering, but on the questions: Why is this happening to me? What does this situation give me? What do I have to survive for? This is the only way to expand consciousness. “Sense is, most likely, something that we project into the things around us, which are neutral in themselves,” V. Frankl considered.

The existential approach in psychology was significantly developed and deepened by Irwin Yal, working with people doomed to death, including cancer patients. In his approach, an indispensable condition is the attitude towards a person's acceptance of his own mortality, especially when death is near. In the book Peering into the Sun. Life without fear of death ”the psychotherapist comes to a paradoxical, but reasonable conclusion: it is the idea of ​​the finiteness of life that prompts a person to be active. Yalom understands existential therapy as productive "interaction and reflection on this interaction" that lead to transformations in human behavior. In his practice, efforts were initially directed at patient acceptance of existential anxiety about loneliness, death, disability, missed years, at comprehending how this is experienced “here and now” by the client and the therapist himself, and this process in most cases led to powerful spiritual transformations, to understanding new aspects of the experienced.

Principles of Existential Therapy

According to this approach, inside a person there is a collision of his attitudes and the realization of the way of being. Faced with the inevitability and reality of his own death, making a vital choice, losing loved ones or experiencing extreme events, a person inevitably breaks out of everyday life and faces all the complexity and depth of life. As you know, there are no atheists in the trenches, and in the same way, in extreme situations, all people are, to one degree or another, philosophers. And then, in order to maintain a more or less balanced state, psychological defenses come into play. But their downside is that, while protecting, they simultaneously block the flows of vital energy, contribute to the creation of illusions that are sometimes vaguely felt as false, but always negatively affect the quality of inner life. “The patient is required to want to do that (in case of a phobia) or, accordingly, to do that (in obsessive-compulsive disorder) that he is so afraid of,” said V. Frankl. The meaning of suffering is in the coming personality changes. Here the principle of a pearl in a shell is triggered: just as the sand that falls into it and hurts a mollusk becomes a pearl, so a person's suffering, experienced in full, with the permission to come true, gives the event meaning, changing the priorities and attitudes of a person, contributing to the appearance of him of new qualities - and hence the fullness of being. Because every event has the potential for spiritual growth. “People devoid of tension tend to create it, and this can take either healthy or unhealthy forms,” Frankl said, noting the intuitive desire of any person to stay in some kind of movement, overcome obstacles and feel their strengths, boundaries, potentials ...

Fear of death therapy

This basic fear is inherent in any biological being - at least at the level of instincts. In existential therapy, everything begins with his acknowledgment and acceptance of the inevitability of the fact of his death.

In this sense, it is effective to draw a line of life and determine your current segment at the moment, a detailed representation of your death with the creation of an obituary or an inscription on the grave (sometimes these inscriptions can be deliberately paradoxical).

Gives its effect group therapy consisting of healthy and sick or in groups of a homogeneous type (for example, cancer patients, as described by I. Yalom).

An important conclusion from the research of I. Yalom, who interviewed dozens of people doomed to death, was the understanding that death is less afraid of those who actively, diversely, in full force lived their lives. People who have allowed themselves little, denied themselves the fulfillment of their large and small desires, fear death more - in fact, the fear of death means regret for the unlived life. Therefore, an important moment of therapy will be the realization that right now gives a person the strength to live, causes him sincere joy - and building his life so that there is always a place for this.

Dealing with a sense of loneliness

Paradoxically, to deal with loneliness, you need to delve into it. As psychologists say, you cannot stop being lonely without the possibility of solitude.

In his work, the therapist will definitely focus on the client's idea of ​​a partnership that excludes manifestations of dependence, manipulation (if this idea is very approximate, they are working on it). As a rule, the client often has a distorted image of partnership or being in a couple, pathologies often appear in the form of an aggressive desire to have a partner, to tell him how to do the right thing, to manipulate, or, conversely, the mechanism of “sacrifice”, codependency, etc. is turned on.

An important role in the work is played by the attitude "here and now" - in the relationship with the therapist, the reasons for loneliness or difficulties in interpersonal interaction always appear. It will be a valuable experience for the client to receive “feedback” from the therapist.

Awakening a sense of responsibility for your decisions

When this problem arises, it will be effective to identify ways to disclaim responsibility (by the method of interview-confrontation, paradoxical statements, etc.). A therapy aimed at awakening responsibility, as, indeed, all existential therapy, excludes the directive style - after all, in this case, there is a great danger of transferring responsibility to the therapist - another trick of the client. Therapy methods should be aimed at strengthening volitional qualities (or awakening them), it is important to take into account personal potential, build goals and desires in order to then translate them into a plane of reality, thinking in what ways this can be done. If there are no desires, there will be work to find oneself, a sense of the client's taste for life.

Loss of meaning in life

Such problems often arise during adolescence - or later, at a turning point. Here it is important to stimulate the client's self-manifestations, to shift the angle of perception from focusing on internal processes outside in order to acquire meaning (sometimes a narrowed perception drives a person into a dead end). This is facilitated by visits to orphanages, hospices, volunteer work, any appeal to someone else's, even more dramatic experience. Often, a person who feels abandoned and lonely, useless to anyone, brightens simply from the eyes with which children, deprived of parental care, meet and see him off, and realizes his own significance, demand, and need on a non-verbal level.

In the process of therapy, it will also be important to think together about different aspects of events, taking into account the principle of V. Frankl: all events are neutral, and only a person paints them in light or dark tones. Flexibility of thinking is an important quality both in therapy and in the subsequent self-help of the patient. If we take as a postulate the belief that there is no only bad or unambiguously good in life, this in itself will have an important therapeutic effect.

And, it is quite possible that the most important thing in existential therapy is what Irwin Yalom spoke about - the manifestation of participation in the client, involvement in his life and the meanings with which it is filled. Attitude therapy is a powerful weapon in the hands of the psychologist. Who knows, maybe this is the last opportunity for the client to be unconditionally accepted and heard.

Literature

• 1. Tregubov, L., Z. Vagin, Yu. R. Aesthetics of suicide. - Perm: Kapik, 1993.
• 2. Frankl, V. Psychotherapy in practice. - Per. with him. SPb .: Rech, 2001.
• 3. Frankl, V. Man in search of meaning: Collection / Per. from English and it. D. A. Leontyeva, M. P. Papusha, E. V. Eydman. - M .: Progress, 1990.
• 4. Yalom, I. Mom and the meaning of life. Electronic resource: Access mode: http://knigosite.org/library/read/54717. Access date: 03/17/2017.
• 5. Yalom, I. Peering into the sun: Life without fear of death. Electronic resource: Access mode: http://knigosite.org/library/read/54717. Access date - 03/17/2017.

Editor: Elizaveta Yurievna Chekardina

Existential psychotherapy is a direction of psychotherapy, which consists in helping people to understand the concepts of death, responsibility, isolation using certain techniques. There are a large number of techniques that the psychotherapist selects individually, depending on the problem and the characteristics of the person. Psychologists who have a basic higher education and have undergone professional retraining in this area are allowed to work within the framework of existential therapy.

Existential psychotherapy: direction description

Existential psychotherapy ("existentia" - emergence, appearance, existence) - psychotherapeutic approaches, in which the emphasis is placed on the free development of the personality, awareness of a person's responsibility for the formation of the inner world and the choice of a life path. The founder of this method is the Danish philosopher Seren Kierkegaard. He believed that the solution to any problem is a difficulty created in an artificial way, which should cover real troubles in importance. Existential psychotherapy emerged in Europe in the second half of the 20th century due to the dissatisfaction of psychologists with deterministic views of man and the development of existential philosophy.

The foundation of existential psychotherapy is made up of 4 basic concepts that underlie human thinking aimed at realizing a negative attitude towards the environment:

• death;
• freedom;
• insulation;
• meaninglessness.

Existential psychotherapy is based on the belief that a person's inner conflict is formed on the basis of his own attitude to the problem that has arisen, that is, what can be a huge disaster for one person, is perceived by others as an insignificant difficulty and passes by him unnoticed. The main feature of this psychotherapeutic method lies in the focus on the life of the individual, and not on the personality, therefore, many psychotherapists of this direction avoid using this term. The main goal of existential psychotherapy is to help you understand your life, better understand your capabilities and their boundaries. There is no provision for restructuring the patient's personality. That is why this direction is associated with philosophy.

Its development was influenced by the following philosophers:

• M. Heidegger;
• M. Buber;
• K. Jaspers;
• P. Tillich;
• J.-P. Sartre;
• V. Rozanov;
• S. Frank;
• N. Berdyaev

Features of this direction

With the development of existential psychotherapy, D. Bujenthal put forward the main postulates of this direction (1963):

1. 1. Man as an integral being surpasses the sum of his constituents, that is, man cannot be explained as a result of a scientific study of his partial functions.
2. 2. Human being unfolds in the context of human relations, that is, it cannot be explained by its partial functions, which do not take into account interpersonal experience.
3. 3. Man is conscious of himself.
4. 4. Man has a choice.
5. 5. Man is intentional, that is, he is turned into the future.

Another feature of existential therapy is the desire to understand a person through his internal universal characteristics. There are 7 such factors:

• freedom, its limitations and responsibility for it;
• human limb or death;
• existential anxiety;
• existential guilt;
• life in time;
• meaning and meaninglessness.

Representatives

One of the representatives of this psychotherapeutic trend is Viktor Frankl (1905-1997). His teaching is called "logotherapy" - a variant of existential analysis, which means a person's striving for meaning. There is a specific and non-specific field of application of this method. The first includes neuroses, and the second includes various other diseases.

According to V. Frankl, a person in any situation strives for meaning. There are three basic concepts in this approach:

• free will (people retain the basic freedom to make decisions);
• the will to meaning (a person does not just have freedom, but he is free in order to achieve certain goals);
• the meaning of life (meaning is an objective reality).

In the teachings of Frankl, there is such a concept as values, which are the result of generalization of typical situations in the history of society. He identifies three groups of values: creativity, experiences and relationships. The values ​​of creativity are realized through labor. Love is one of the values ​​of experience.

The main problem with logotherapy is the problem of responsibility. Having found a meaning, a person is responsible for its implementation. The individual is required to make a decision: whether to implement this meaning in a given situation or not.

American psychologist R. May formulated the reasons for the development and characteristics of this direction. This scientist denied that existential psychotherapy is an independent branch of psychotherapy. J. Bujenthal sought to combine the principles of humanistic and existential psychotherapy and highlighted the main provisions of this direction:

1. 1. Behind any problems of a person lie deeper unconscious existential problems of freedom of choice and responsibility.
2. 2. This approach is to recognize the human in each individual and respect his uniqueness.
3. 3. The leading role is assigned to work with what is relevant at the present time.

Working in an existential direction

Anyone can turn to existential therapy. It is important that the patient is actively involved in the process of exploring his life, be open and honest. This direction helps those in crisis situations when they do not see the meaning of existence, complain of apathy and depression. Such psychotherapy is indicated for people who have experienced changes in their lifestyle, the loss of loved ones. It helps those who suffer from acute or chronic physical illness, mental illness, improving understanding and acceptance of changes due to illness.

The psychotherapist, working in this direction, studies behavior, speech, dreams and biography. Existential psychotherapy is carried out individually and in a group of 9-12 participants.

In most cases, work is carried out in a group, as it has a number of advantages over the individual form. Patients and the therapist can get more information about a person through interpersonal communication, see inappropriate actions and correct them. In existential psychotherapy, group dynamics is important, which is aimed at identifying how the behavior of each member of the group is viewed by other people, makes them feel, creates an opinion about the person and affects their self-image. Training in this direction is carried out on the basis of the availability of basic psychological education.

Specialists do not impose their own thoughts on patients. In the works of a psychotherapist like Irwin Yalom, the importance of implicit "infusions" is mentioned. We are talking about those moments in the session when the consultant shows not only professional, but also human participation in the patient's problems. Thus, the psychotherapy session turns into a friendly meeting.

To establish and maintain good relations with a client, a specialist needs full involvement in a problem situation, wisdom and indifference, the ability to maximally engage in the psychotherapeutic process. There is a question about the psychotherapist's self-disclosure. A specialist can do this in two ways.

First, tell your interlocutors about your own attempts to reconcile with problems and preserve the best human qualities. Irwin Yalom says that he made a mistake by rarely resorting to self-disclosure. As the author notes in his 2000 Theory and Practice of Group Psychotherapy, every time he shared his experiences with patients, the latter benefited from them.

Second, it is not necessary to focus on the content of the session. Psychotherapists can simply use this time to apply thoughts and feelings about what is happening now to improve the professional-patient relationship. Will, acceptance of responsibility, attitude towards the therapist and involvement in life are key points.

Methods and techniques

There are a large number of techniques for applying the concepts of this direction. They are selected by a specialist on the basis of their effectiveness, the client's problem and individual characteristics. If some problems are not solved by the psychotherapist himself, then he is incompetent in solving them and it is necessary to refer the patient to another.

Techniques for dealing with existential concerns are distinguished: death, responsibility and freedom, isolation and meaninglessness. Other techniques are sometimes recommended. Their use can increase the effectiveness of psychotherapy.

Death

The technique of “tolerating endure” is to let patients know that discussing the problems associated with death is highly valued in counseling. This can be done through taking an interest in and encouraging self-disclosure in this area.

The therapist does not need to support the denial of death in clients. It is imperative that these questions remain “in sight”.

The technique of working with defense mechanisms is that the therapist tries to help patients admit that they will not live forever. These psychologists need persistence and timing to help clients deal with and transform their childish and naive views of death.

Dream work is done by telling patients about their dreams. In dreams (especially in nightmares), various themes can unconsciously appear in an unsuppressed form, and the motive of death is often present in them. In this way, the analysis and discussion of dreams is carried out.

The technique of using assistive devices is that the patient is asked to write his own obituary or fill out a questionnaire with questions on the topic of death. The counselor may offer to fantasize about their death, imagining where, how and when they will meet it and how their funeral will take place. The technique of reducing the sensitivity (sensitivity) to death is close to the previous one, according to which the therapist helps to cope with the horror of death by repeatedly forcing this fear to be experienced.

Responsibility and freedom

The technique of defining the types of protection and methods of evading responsibility is that the therapist assists the client in understanding the functions of his behavior in the form of evading responsibility for the choice. Sometimes the counselor, together with the patient, analyzes the responsibility for his own unhappiness and puts him face to face with it. This method consists in the fact that when a person complains about a negative situation that happened in his life, the therapist asks how he created it, and also focuses on the ways in which the interlocutor uses the language of avoidance of responsibility (i.e., often says “I can’t” instead of “I don’t want to”).

The following technique focuses on the relationship between therapist and patient (identification of avoidance of responsibility). It lies in the fact that specialists put clients face to face with their attempts to transfer responsibility for what happens within the framework of psychotherapy and outside of it, onto the counselor. That is, many patients who seek help from a psychologist expect the therapist to do all the necessary work for them, sometimes treating him as a friend. By influencing the counselor's feelings in this way, the client shifts the responsibility onto the counselor.

The technique of confronting the constraints of reality is that the therapist helps to determine the areas of life that the patient can influence, despite the difficulties. The specialist changes the mindset to those restrictions that cannot be changed. It enables the interlocutor to accept the existing injustice.

Isolation and meaninglessness

With the technique of working with isolation, the psychologist helps to understand that every person is born, develops and dies alone. Awareness of this concept affects the change in the quality of life and relationships in society. The psychotherapist invites the interlocutor to isolate himself from the outside world for a while and be isolated. As a result, clients become aware of their loneliness and their hidden possibilities.

The problem redefinition technique is used when patients complain that life has no meaning. What they really mean is that life has meaning, but they cannot find it. The task of the therapist in this case is to explain: there is no objective meaning in life, but a person is responsible for its creation. The technique of defining the types of defenses against anxiety and meaninglessness is that the specialist helps to become more aware of them. It is these concepts that are often associated with the fact that patients do not take their life seriously and create problems that have to be avoided.

Existential psychotherapy ( English existential therapy) - direction to psychotherapy, which aims to bring the patient to a comprehension of his life, awareness of his life values ​​and change his life path on the basis of these values, with the acceptance of full responsibility for his choice. Existential therapy began in the 20th century as an application of ideas existential philosophy To psychology and psychotherapy /

Existential therapy, following philosophical existentialism, argues that human life problems stem from human nature itself: from awareness meaninglessness of existence and the need to look meaning of life; due to availability free will, the need to make a choice and the fear of being responsible for this choice; from the awareness of the indifference of the world, but the need to interact with it; because of the inevitability of death and natural fear in front of her. Renowned contemporary existential therapist Irwin Yalom identifies just four key issues that existential therapy deals with: death,insulation,freedom and inner emptiness. All other psychological and behavioral problems of a person, according to supporters of existential therapy, arise from these key problems, and only the solution, or, more precisely, the acceptance and understanding of these key problems can bring a person real relief and fill his life with meaning.

Human life is viewed in existential therapy as a series of internal conflicts, the resolution of which leads to a rethinking of life values, the search for new paths in life, development human personality... In this light, internal conflicts and the resulting anxiety,depression,apathy, alienation and other conditions are viewed not as problems and mental disorders, but as necessary natural stages for the development of personality. Depression, for example, is seen as a stage in the loss of life values, opening the way for finding new values; anxiety and anxiety are seen as natural signs of the need to make important life choices that will leave a person as soon as the choice is made. In this regard, the task of the existential therapist is to bring a person to the realization of their deepest existential problems, to awaken philosophical reflection on these problems and to inspire a person to make the necessary life choice at this stage if the person hesitates and puts it off, "stuck" in anxiety and depression.

Existential therapy has no generally accepted therapeutic techniques. Existential therapy sessions usually take the form of a mutually respectful dialogue between therapist and patient. At the same time, the therapist in no way imposes any points of view on the patient, but only helps the patient to understand himself deeper, draw his own conclusions, realize his individual characteristics, his needs and values ​​at this stage of life.

Methods and techniques of existential psychotherapy

Recall that I. Yalom defined existential psychotherapy as a psychodynamic approach. It should be noted right away that there are two important differences between existential and analytic psychodynamics. First, existential conflicts and existential anxiety arise from the inevitable confrontation of people with the ultimate given of being: death, freedom, isolation and meaninglessness.

Second, existential dynamics does not imply the adoption of an evolutionary or "archaeological" model, in which the first is synonymous with the deep. When existential psychotherapists and their patients do in-depth research, they do not focus on day-to-day worries but reflect on underlying existential issues. In addition, existential approaches can also be used to address issues related to freedom, responsibility, love, and creativity. [AND. Yalom writes that psychotherapeutic approaches "reflect pathology that can be cured with their help, and are shaped by this pathology."]

In connection with the above, existential psychotherapy is mainly focused on long-term work. However, elements of an existential approach (for example, an emphasis on responsibility and authenticity) can also be included in relatively short-term psychotherapy (for example, associated with work with post-traumatic conditions).

Existential psychotherapy can be carried out both individually and in a group form. Usually a group consists of 9-12 people. The advantages of the group form are that patients and psychotherapists have a greater opportunity to observe distortions arising in interpersonal communication, inappropriate behavior and correct them. Group dynamics in existential therapy aims to identify and demonstrate how the behavior of each member of the group:

1) is considered by others;

2) makes others feel;

3) creates an opinion about him in others;

4) influences their opinion of themselves.

The greatest attention in both individual and group forms of existential psychotherapy is paid to the quality psychotherapist-patient relationship. These relationships are considered not from the point of view of a transfer, but from the point of view of the current situation in patients and the fears that torment the patients at the moment.

Existential therapists describe their relationships with patients using words such as presence, authenticity and devotion. There are two real people involved in one-to-one existential counseling. An existential psychotherapist is not a ghostly "reflector", but a living person who seeks to grasp and feel the patient's being. R. May believes that any psychotherapist is existential who, despite his knowledge and skills, can relate to the patient in the same way as, in the words of L. Binswanger, “one existence relates to another”.

Existential psychotherapists do not impose their own thoughts and feelings on patients or use countertransference. This is due to the fact that patients can resort to various methods of provocative connection of psychotherapists, which allows them not to turn to their own problems. Yalom talks about the importance of implicit "infusions". We are talking about those moments of psychotherapy when the therapist shows not only professional, but also sincere, human participation in patients' problems, thereby sometimes turning a standard session into a friendly meeting. In her case study ("Every day brings a little closer"), Yalom considers such situations both from the standpoint of the psychotherapist and from the standpoint of the patient. So, he was amazed to learn how much importance one of his patients attached to such small personal details as warm looks and compliments about how she looked. He writes that in order to establish and maintain good relations with the patient, the psychotherapist needs not only complete involvement in the situation, but also such qualities as indifference, wisdom and the ability to maximally engage in the psychotherapeutic process. The psychotherapist helps the patient “by being trustworthy and interested; being affectionately present next to this person; believing that their joint efforts will ultimately lead to correction and healing. "

The main goal of the therapist is to establish an authentic relationship in the interests of the patient, therefore the question self-disclosure psychotherapist is one of the main in existential psychotherapy. Existential psychotherapists can reveal themselves in two ways.

First, they can tell their patients about their own attempts to come to terms with extreme existential concerns and preserve their best human qualities. Yalom believes that he made a mistake by too rarely resorting to self-disclosure. As he notes in The Theory and Practice of Group Psychotherapy (Yalom, 2000), whenever he shared a significant portion of his self with patients, they invariably benefited from it.

Second, they can use the process of psychotherapy itself, rather than focus on the content of the session. It is the use of thoughts and feelings about what is happening “here and now” in order to improve the psychotherapist-patient relationship.

During a series of psychotherapeutic sessions, patient A. demonstrated behavior that she herself regarded as natural and spontaneous, while other group members assessed it as infantile. She in every possible way showed activity and readiness to work on herself and help others, described her feelings and emotions in detail and colorfully, willingly supported any topic of group discussion. At the same time, all this was of a semi-playful, semi-serious nature, which made it possible at the same time to provide some material for analysis, and to avoid a deeper immersion in it. The psychotherapist, suggesting that such "games" may be associated with the fear of approaching death, asked why she was trying to be an experienced adult woman, or a little girl. Her response shocked the entire group: “When I was little, it seemed to me that my grandmother was standing between me and something bad in life. Then my grandmother died and my mother took her place. Then, when my mother died, my older sister turned out to be between me and the bad one. And now, when my sister lives far away, I suddenly realized that there is no longer a barrier between me and the bad one, I stand face to face with him, and for my children I myself am such a barrier. ”

In addition, the key processes of therapeutic change, according to Yalom, are will, acceptance of responsibility, attitude towards the therapist and involvement in life. Let's consider them using an example of working with each of the basic alarms.

The effectiveness of psychological counseling is understood as its final results for the client, namely, what really changed in his psychology and behavior under the influence of counseling.

It is assumed that the results of psychological counseling in most cases of its implementation are positive, at least - such as expected by the client and the counselor psychologist. However, expectation and hope is one thing, reality is another thing. Sometimes a clear positive, immediate result of psychological counseling may be absent and even at first glance seem negative. As a result of psychological counseling, something in the psychology and behavior of the client can really change, but not immediately.

In addition, sometimes there are unforeseen, unexpected, negative results of psychological counseling. This often happens when something significant in counseling is not thought out in advance in terms of possible negative consequences, or when psychological counseling is carried out by a professionally unprepared, insufficiently experienced psychologist. However, due to the rarity of negative results in psychological counseling, we will not specifically discuss such cases and will focus our attention only on cases with a positive or neutral outcome of counseling.

The positive result of psychological counseling can be judged by a number of signs.

A positive, optimal solution that satisfies both the counselor and the client of the problem with which the client turned to psychological counseling.

The effectiveness of the result is confirmed by a set of positive results.

Upon completion of the consultation, both parties - the consultant and the client - acknowledge that the problem for which the consultation was carried out has been successfully resolved, and there is convincing objective evidence for this. Neither the counselor psychologist nor the client needs any additional arguments in favor of the fact that the counseling was indeed successful.

The counseling psychologist may believe that the counseling was successful and the client's problem was solved, while the client himself may doubt this, deny or not fully feel the real results of psychological counseling.

Sometimes, on the contrary, the client thinks that as a result of counseling he completely managed to cope with his problem, while the psychologist-counselor doubts this and insists on continuing the consultation, wanting to get additional convincing evidence that the client's problem was really successfully solved.

Positive changes in those aspects of the client's psychology and behavior, the regulation of which was directly directed by psychological counseling. This refers to the main, predictable and possible additional, positive effects obtained from psychological counseling.

The fact is that by influencing some psychological processes and forms of client behavior, counseling can significantly affect others. As a rule, in the event that positive results of the impact of psychological counseling on the personality of the client are found, his behavior, relationships with people and much more in his psychology also change. Improving the client's memory usually has a positive effect on their intelligence, although the opposite effect of intelligence on memory is possible.

Often in the practice of psychological counseling, along with its indisputable positive results, there are problematic and controversial aspects of assessing its results.

Note that, according to its results, psychological counseling can manifest itself in another way: objectively, subjectively, internally and externally.

Objective signs of the effectiveness of psychological counseling are manifested in the fact that it is accompanied by reliable facts testifying to the success of counseling.

Subjective signs of the effectiveness of psychological counseling are manifested in the feelings, sensations, opinions and ideas of the counselor.

Internal signs of the effectiveness of psychological counseling are manifested in changes in the client's psychology. They may be felt (realized) or not felt (not realized) by the client, they may or may not appear in his real behavior, in the actions and actions of the client available to external observation.

External signs of the effectiveness of psychological counseling, on the contrary, always and in a fairly distinct way are manifested in visible, accessible to direct observation and evaluation, forms of his behavior.

EXISTENTIAL THERAPY: DYNAMIC PSYCHOTHERAPY

Existential therapy is a form of dynamic psychotherapy. The term “dynamic” is often used in the field of mental health - which, in fact, refers to nothing more than “psychodynamics” - and without clarifying the meaning of dynamic therapy, a fundamental component of the existential approach will remain incomprehensible. The word "dynamic" is common. and technical significance. In a general sense, the concept of "dynamic" (derived from the Greek dunasthi "to have strength and power") indicates energy or movement: a "dynamic" football player or politician, "dynamo", "dynamite". But the technical meaning of this concept should be different, because, otherwise, what would the therapist's “non-dynamism” mean: slowness? lethargy? lack of mobility? inertia? Of course not: in a special, technical sense, the term refers to the concept of "power." The dynamic model of the psyche is Freud's most significant contribution to the concept of a person - a model according to which conflicting forces are present in an individual, and thoughts, emotions, behavior - both adaptive and psychopathological - are the result of their interaction. It is also important that these forces exist at different levels of awareness, and some of them are completely unconscious.

Thus, the psychodynamics of an individual includes various conscious and unconscious forces, motives and fears acting in him. Dynamic psychotherapy includes forms of psychotherapy based on this dynamic model of the functioning of the psyche.

Existential psychotherapy in my description falls well under the category of dynamic psychotherapy. It is obvious. But then we ask the question: What forces (as well as motives and fears) are in conflict? In other words, what is the content of this internal, conscious and unconscious struggle? The answer to this question distinguishes existential psychotherapy from other dynamic approaches. It is based on a radically different idea of ​​what are the specific forces, motives and fears that interact in an individual.

Determining the nature of deep individual internal conflicts is not an easy task. It is rare for the clinician to observe the initial form of primary conflicts in his suffering patients. The patient presents an incredibly complex picture of symptoms, while the primary problems are deeply buried under the multi-layered crust created by repression, denial, displacement and symbolization. The clinical researcher is forced to be content with a variegated picture, woven from many threads that are not easy to untangle. Establishing primary conflicts requires the use of various sources of information, deep reflection, dreams, nightmares, outbursts of deep experience and insight, psychotic statements and the study of children. Gradually, I will characterize all these approaches, but it makes sense to give a generalized schematic picture right now. A brief overview of three sharply different approaches to prototypical individual inner conflict - Freudian, neo-Freudian, and existential - will serve as a contrasting backdrop to illuminate the existential perspective on psychodynamics.

Freudian psychodynamics

According to Freud, the child is possessed by instinctive forces that are innate and gradually awaken in the course of psychosexual development, just as a fern leaf unfolds. The conflict occurs on several fronts: it is a clash of opposite instincts (ego instincts with libidinal or, according to the second theory, Eros with Thanatos); instincts - with the requirements of the environment, and later - with the requirements of the internalized environment, that is, the Super-Ego: finally, it is the need for the child to reach a compromise between the need for immediate gratification and the principle of reality that requires a delay in gratification. Thus, the instinctual individual confronts a world that does not allow the satisfaction of his aggressive and sexual appetites.

Neo-Freudian (interpersonal) psychodynamics

Neo-Freudians. most notably Harry Stuck Sullivan, Karen Horney and Erich Fromm take a different view of the fundamental individual conflict. For them, the child is not an instinctive and programmed creation ", apart from innate neutral characteristics such as temperament and activity levels, it is completely shaped by cultural and interpersonal factors. The child's basic need is the need for safety, that is, for acceptance and approval from the outside. other people; accordingly, the structure of his character is determined by the quality of interaction with significant adults, on whom his safety depends. He is not governed by instincts, but from birth he is endowed with tremendous energy, curiosity, innocent body freedom, inherent growth potential and the desire for undivided possession of loved adults. These traits are not always consistent with the demands of significant adults nearby: the contradiction between natural growth tendencies and the need for safety and approval constitutes the child's fundamental conflict. he can neither provide safety nor encourage autonomous growth by neurotic struggle, he will develop severe mental conflict. And the trade-off between growth and security will invariably come from growth.

Existential psychodynamics

The existential approach emphasizes a basic conflict of a different kind — not between repressed instinctual urges and not with internalized meaningful adults.

This is a conflict caused by the confrontation of the individual with the given of existence. By "given of existence" I mean certain final factors that are an integral, inevitable component of a person's being in the world.

How does a person discover the content of these given? In a sense, it is not difficult. Deep personal reflection method. The conditions are simple: loneliness, silence, time and freedom from everyday distractions with which each of us fills the world of our experience. When we "put in brackets" the everyday world, that is, we move away from it; when we deeply think about our situation in the world, about our being, boundaries and possibilities; when we touch the soil belonging to all other soils, we inevitably encounter the given of existence, with "deep structures", which I will call everywhere below "ultimate given." The process of reflection is often catalyzed by extreme experiences. It is associated with the so-called "borderline" situations, such as the threat of personal death, the adoption of an important irreversible decision, or the collapse of the basic sense-forming system.

This book discusses the four ultimate realities: death, freedom, isolation, and meaninglessness. Existential dynamic conflict is generated by the individual's confrontation with any of these facts of life.

Death. The most obvious, most easily perceived end-given is death. We exist now, but the day will come when we will cease to exist. Death will come and there is no escape from it. This is a terrifying truth that fills us with "mortal" fear. In the words of Spinoza, "everything that exists strives to continue its existence"; the opposition between the consciousness of the inevitability of death and the desire to continue living is the central existential conflict.

Freedom. Another ultimate reality, much less obvious, is freedom.

Freedom is usually seen as an unambiguously positive development. Does man not thirst for freedom and does he not strive for it throughout the entire written history of mankind? However, freedom as a primary principle breeds horror. In an existential sense, "freedom" is the absence of an external structure. Everyday life harbors the comforting illusion that we are entering a well-organized universe, arranged according to a certain plan (and we are leaving the same). In fact, the individual bears full responsibility for his world - in other words, he himself is its creator. From this point of view, "freedom" means a terrifying thing: we do not rely on any ground, beneath us - nothing, emptiness, abyss. The opening of this void conflicts with our need for soil and structure. It is also a key existential dynamic.

Existential isolation. The third ultimate given is isolation. This is not isolation from people with the loneliness it generates, and not internal isolation (from parts of one's own personality). It is a fundamental isolation - both from other creatures and from the world - hidden behind any sense of isolation. No matter how close we are to someone, there is always the last insurmountable chasm between us; each of us alone comes into the world and alone must leave it. The resulting existential conflict is the conflict between the perceived absolute isolation and the need for contact, for protection, for belonging to a larger whole.

Pointlessness. The fourth ultimate given of existence is meaninglessness. We must die; we ourselves structure our universe; each of us is fundamentally alone in an indifferent world; What then is the point in our existence? Why do we live? How can we live? If nothing is originally intended, then each of us must create his own life plan. But can this own creation be strong enough to withstand our life? This existential dynamic conflict is generated by the dilemma facing a meaning-seeking creature thrown into a meaningless world.

Existential psychodynamics: general characteristics

Thus, the concept of "existential psychodynamics" refers to the named four given - the four final factors, as well as to the conscious and unconscious fears and motives generated by each of them. The dynamic existential approach retains the basic dynamic structure described by Freud, but radically changes the content. Former formula:

ATTRACTION »ALARM» PROTECTIVE MECHANISM *

replaced by the following:

CONSCIOUSNESS OF FINAL DATA »ALARM» PROTECTIVE MECHANISM **

Both formulas express the idea of ​​anxiety as the driving force behind the development of psychopathology; that the task of interacting with anxiety generates mental activity, both conscious and unconscious; that this activity (defense mechanisms) constitutes psychopathology; and finally, that by providing security, it invariably limits the growth and possibilities of experience.

The fundamental difference between the two dynamic approaches is that Freud's formula starts with “impulse,” while the existential formula starts with awareness and fear. As Otto Rank understood, the effectiveness of the psychotherapist increases significantly when he or she sees in a person, first of all, a suffering and fearful being, and not driven by instincts.

These four final factors - death, freedom, isolation and meaninglessness - determine the main content of existential psychodynamics. They play an extremely important role at all levels of the individual mental organization and are most directly related to the work of the clinician. They also serve as an organizing principle. Each of the four sections of this book looks at one of the ultimate realities and explores its philosophical, psychopathological, and therapeutic aspects.

Existential Psychodynamics: A Matter of Depth

Another global difference between existential dynamics from Freudian and neo-Freudian is associated with the concept of "depth". For Freud, research is always excavation. With the precision and patience of an archaeologist, he scraped layer after layer of psychic material until he reached the rock of fundamental conflicts. which are the psychological residue of the earliest events in the life of the individual. The deepest conflict is the earliest conflict. Thus, according to Freud, psychodynamics is conditioned by development, “fundamental”, “primary” should be understood chronologically: both are synonymous with the “first”. Accordingly, for example, the earliest psychological dangers - separation and castration - are considered "fundamental" sources of anxiety.

Existential dynamics are not developmental. In fact, nothing compels us to consider "fundamental" (that is, important, basic) and "first" (that is, chronologically first) as identical concepts. From an existential point of view, inquiring deeply does not mean exploring the past; it means putting aside everyday worries and deeply reflecting on your existential situation. It means thinking about what is outside of time - about the relationship between your consciousness and the space around you, your feet and the ground beneath them. It means thinking not about how we became who we are, but about who we are. The past, or rather, the memory of the past, is important insofar as it is a part of our present existence, which has influenced our current attitude to the ultimate given of life; but - I will talk more about this below - this is not the most promising area of ​​therapeutic research. In existential therapy, the main time is “future-becoming-present”.

This distinction of existential dynamics does not mean that it is impossible to study existential factors from a developmental point of view (Chapter 3 of this book discusses in depth the development of the concept of death in children): but it does mean that when someone asks: “What are the root causes of my horror inherent in deepest layers of my being and acting at the moment? " - the answer is not entirely appropriate from a developmental point of view. The earliest impressions of an individual, as important as they are, do not answer this fundamental question. As a matter of fact, traces of the first events of life give rise to phenomena of biological stagnation, which can cloud the response, which is transpersonal and always located outside the life history of the individual. It is applicable to any person, since it deals with the "situation" of a human being in the world.

The distinction between a dynamic, analytical, developmental model, on the one hand, and an unmediated, ahistorical, existential model, on the other, is not only of theoretical interest: as will be discussed in later chapters, it is very important for therapeutic technique.

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