Psychotherapy. Mars in the house of Saturn and intracerebral injections of homeopathic psilocybin
I usually begin each of my articles with this Warning: This article was written not by a qualified psychiatrist, but by a patient with severe pathology.
Reminder: ADHD, especially in such a strongly pronounced form, aggravates many cognitive distortions. In patients like me, the Dunning-Kruger effect is prominent. The carelessness that passes all the boundaries compromises the facts and sources of information, and reduced intelligence, with complete disregard for significant details, calls into question the conclusions and generalizations.
But now I will not. Many psychologists can burn. But I will start:
Psychiatry can be very conditionally divided into large and small.
With a big one, it's generally understandable. Large - these are acute conditions that require emergency medical care. All sorts of affective disorders, personality disorders, manic states, schizophrenia, psychosis ... The delirium delirium is the same, very popular and beloved in Russia, especially in mid-January.
And its final tasks are clear. Remove acute symptoms.
With the so-called “minor psychiatry” everything is much more complicated.
First , minor psychiatry should work with the same F-section of ICD-10, but with patients whose pathology is sufficiently pronounced to throw their emotional sphere either on the floor or on the ceiling, but not sufficient for acute conditions.
Secondly, maintenance of the whole hangout of the district mental hospital between races on leave to a large psychiatry.
Thirdly , elimination or partial correction of congenital and arisen maladaptations, elimination of pathological disorders of the emotional sphere.
What else? People seem to go to psychotherapists not only for this. The mental health industry itself, depending on the school and direction, will offer you a dimensionless range of answers, what is the ultimate goal of the efforts of a psychologist / psychiatrist / psychotherapist.
But in general: a psychologist or a psychiatrist?
1. Psychiatrist-psychotherapist vs psychologist-psychotherapist
In an ideal world, only a psychiatrist-psychotherapist. Why?
Because, firstly, it is right.
A neuroscientist examines the brain. The neurosurgeon operates it.
Secondly, if your problem requires preparative treatment, the psychotherapist can immediately write a prescription. A psychologist can send ... to a psychiatrist. Clinical depression as an example. Generalized anxiety disorder is also much more cheerful and more fun is eliminated together with anti-anxiety drugs. Some pathologies cannot be compensated at all without preparative modulation (the same ADHD).
Thirdly, a huge part of people come to a psychologist not to be treated. Here we begin the million first variation on the theme “understand yourself better”. If the patient is so baked that he did not stop reading Paulo Coelho, but tore his ass off the chair and went to a psychologist, then we can interpret this burning sensation as a condition requiring treatment?
In practice (everywhere in the world, but in Russia there is just an extravaganza, I will explain why below) the vast majority of psychotherapists (that psychologists are psychiatrists) are so incompetent, stupid and ignorant in their own discipline that they take aback.
I confess, I myself have long learned to distinguish garbage style articles. Expression, peremptory and rollover foundations. In a word, all that you see in this article.
But I'm bombing
Весь последний год я провел на pubmed-е, отыскивая корректный даташит на свой мозг в попытках его починить (частичный успех), но недавно произошла катастрофа. У близкого мне человека внезапно снесло крышу. По взрослому. Я давно научился курить свое тревожное расстройство. И вовсе не собирался его лечить. Но этим летом оно капитально лишило меня сна. Первый психиатр, к которому мы обратились, оказался экстрасенсом. Поверьте, это было только начало. Чем дальше я заходил в лес в поисках психиатра, который бы мог помочь, тем дивнее были персонажи. Когда генерализованное тревожное расстройство, слившись с гипоманией, оказывается перед настоящей экзистенциальной угрозой, требующей качественных решений в условиях тотальной неопределенности, то после трех суток без сна, закидываешься шестью таблетками феназепама и идешь читать pubmed и учебник по психиатрии еще двое суток. На четвертые сутки появляются стойкие галлюцинации в периферическом зрении. На пятые уже оживает все вокруг. На шестые сутки уже не возможно сфокусировать взгляд на буквах. Галлюцинации по характеру напоминают не LSD (ожившие текстуры), а тяжелый мескалиновый приход. Тогда пара таблеток Хлорпротиксена дарят 16 часов небытия и абсолютной черноты. И новый цикл.
In Moscow and St. Petersburg, competent psychiatrists and psychotherapists can still be found with a dozen. Therefore, if in your city you have found a skill practicing psychologist who is engaged in business, and not esoteric - Bingo! Wait until the perfect world comes, not for us. For an example, the scientific method in its modern understanding is formulated by mankind for almost a hundred years. And there is still no thirty evidence-based medicine. And only now, with bloody vomiting, does the medical community expel all homeopathy and acupuncture from themselves. Among the psychotherapists "homeopaths" - the vast majority. Minority can not pull out the majority. In addition, there is an ethical moment. When one of the sensible psychotherapists says: “Guys, how is it possible to do psychoanalysis in the twenty-first century ?!” Then the answer flies: “You assert yourself at the expense of others, with * kin son ?!”
The revolution in neuroscience, particularly in psychology and psychiatry, is happening right now and not in Russia. A flurry of articles on neuroscience published in English is almost unnoticed by the Russian medical community. Only a few professionals are involved in this process and burden themselves with work on a regular and systematic basis to monitor and read this wide stream of publications, to update their knowledge, to abandon inefficient methods.
Ideally, the psychotherapist, of course, should know the structure of the human brain. How does the interaction between the structures of the “reptilian brain” and the structures of the limbic system occur, how does the formation of this or that emotion take place, where the dopamine pathways begin ... Disruptions or changes in what structures that give cognitive distortions and how they influence the formation of behavioral outputs But here it is completely in trouble. It seems intuitively clear that programmers who volunteered to write drivers for hardware should understand how this hardware works (I myself hate comparing the brain and the computer). But then we will have a dozen experts all over the country.
I have long been subscribed to hdablin articles. This article will be pretty sharp, apparently. But to argue with hdablin I will not take it. He is very, very not bad. But he still retrained from a psycho to a psychologist. Therefore, I can not afford the sharpness that I can afford.
2. Psychoanalysis, Gestalt, NLP ... (hundreds of them) - who is the welder, and who has found the mask
In the West (in all countries in different ways), some of the problems of “minor psychiatry” are insured events and are paid for by insurance companies. Insurance companies are very resisted and did not want to pay for long, expensive and unproductive conversations about children's experiences. There was a request from insurers: there are scientific criteria, there is a scientific method, the principles of evidence-based medicine are formed. We want to know what treatment you have there, and what kind of life for ... talk. As soon as the results of research and meta-studies began to be published, they screamed, screamed, oor and indignation at frost by the collar ...
Perhaps, we will first understand what is a healthy mind and what is pathology. Without this, we cannot distinguish treatment from a seance.
And why do you need a psychotherapist if you are healthy.
3. What can, what can not ... psychotherapy. And in which case to you to the psychotherapist, and in what on pornhub
First, I will say on the subject: “There are no healthy ones. There are under-examined. ”There are, of course, healthy ones. They are not so few. Moreover, healthy abnormals make me especially envious, because normal ones (what is considered normal? - I will explain later) cause melancholy, boredom and a slight attack of nausea.
Virtually the entire F list is not discrete. Well no. It is almost always a spectrum. Because syphilis can manifest itself in different ways, depending on your immunity, but you are either infected or not.
But take for example a Bipolar. Here the picture is completely different. Here on one caught by psychiatrists, ten not caught runs. Their symptoms never or for the time being result in acute conditions. They themselves and their families perceive the "swing" of their moods as part of their character, until they catch aliens.
But in truth, not everyone is as lucky as me. I may have an evil pathology, but only one. F90 - sign on, get it and exit! (GAD does not count) Some not only “borderline” on the line of darkness and light, but also a ticket for a roller coaster of bipolar affective manage to win at birth. And as long as they do not climb out the window, relatives just sigh: “Character is difficult. All my life from childhood ... ”
Meanwhile, almost every item in the F list describes a very specific and specific set of bugs, resulting in typical cognitive distortions and / or behavioral exits. And you see, it would be cool if every such lucky person heard from his relatives not a slander about the character, but received a voucher for the good Aibolit, which will help work out the problematic. But the people are dark. And the Aibolites are even darker.
And if you are still healthy. Do you need a psychotherapist?
hdablincited the definition of psychotherapy according to the American Psychological Association: “this is a deliberate and informed use of clinical [psychological] methods and interpersonal relationships, aimed at achieving changes in behavior, thinking, emotional response, and other personal characteristics in the direction that participants consider desirable”
I will formulate more shortly : The only thing you want from psychotherapy is to become an effective version of yourself.
Psychotherapy is definitely not about happiness. Few have you ever seen happy non-adaptive idiots? And then, a little happiness is sold at Burger King and is taken orally. Large is sold on the darknet and administered intravenously.
Be an effective version of yourself. It would seem that the goal is extremely clear. But there is a problem. Many people want to be an effective version of Ilon Mask or Justin Bieber.
That is, in general, total misunderstanding of one’s own nature and features of one’s own psyche is quite common among people.
And in the presence of almost any pathology of the F-section, the cognitive apparatus is distorted.
Here I, for example, always on a sensual level, seem to myself terribly clever. I feel this way my limbic system works. Intellectually, I understand that the mind in my head is simply nowhere to take. I have never studied hard enough and systematically. Sometimes, when hypomania subsides, higher divisions flex the limbic system. Then I feel disgusting. But it does not last long.
If one is guided by the formula: “happiness is reality minus expectations”, then I would have to go out the window a long time ago. In general, the death rate from suicides among hyperactive would have to be almost one hundred percent. For our ambitions are endless, and the results are puff. But no. There are fantastically few suicides in our group. Although repeated suicide attempts are common. But we understand that the human body is so fragile that it is possible to not cope with this task only in one case. Moreover, such attempts are peculiar to the most intellectual of us. Most ADHD patients do not experience any cognitive dissonance, because so much, b *** are stupid, that they believe Mavrodi ... the limbic system and the thousandth time they go to the circle.
It should be understood that each of us is a realized one of a million unique variations on a rigidly defined topic.
For example, you can look at an MRI and say: this person is an eternal dissident. He is always dissatisfied with the system. Though in Russia, even in America. Or, looking at another scan, say: that conservative, and this liberal. And in the latest research on the viscera guessing with performance over 80%. Damn, reliable weather forecast. That is, software (again disgusting programmer analogies) is written by the influence of the external environment. But the architecture of the machine is able to perceive the part for which it is optimized. It takes serious skill and work to make the machine cheat correct cognitive constructions, and not the best get on.
In this case, the therapist will not find out for you what you are in your ideal configuration. The bad will not understand what it is about, he is an idiot and still reads Jung. A good too busy, so it will help cure neuroses and kick out. That is, psychotherapy itself will only be successful if you yourself conduct continuous work in a given direction. Talk will not change you. Chatter in general, only the air shakes and never changes anything. Another question is that a good psychotherapist is extremely specific to the method and task. But we must understand that on the couch after talking about children's fears, you will not be better and you will not become better. You do not have a com-port on your head to which you can connect from the outside and configure everything. Only from the inside. Only yourself, all yourself. And no one can formulate for you what is the best version of you. Although, if you plucked a feather from a heatbird's ass, and a good competent psychotherapist is in front of you, and you still could not answer the question of what kind of person you are, then you are not in a hurry to complain about neurosis. Spend precious hours on extremely specific and detailed identikit of yourself in the future. With full reliance on reality. Unscrewing the benefits of your psyche to the maximum and twisting your weaknesses to a minimum.
4. Who is the end welder?
Let's better tell you how I choose a good psychotherapist.
I am guided by publications. And then I climb into all the profiles and see if he is suitable for me, or the patient for whom I am looking for, according to the worldview.
But the primary selection? I see that in his profile, among the techniques with which he operates, there is only KPT. Only CBT and nothing else. No psychoanalysis, gestalt, and especially NLP.
Why? - you ask.
Many psychologists point through a comma many techniques. And including Cognitive Behavioral Therapy. What a bad thing that he can also in Gestalt?
It’s bad that you either understand how our psyche works (and this knowledge is not without gaps, with very medium detail, but on the whole it has already emerged from the contours of coffee grounds), or not. If you understand, why are all these ineffective, and in the case of psychoanalysis simply harmful practices of the times of the shamans? Does not converge.
Some, however, may indicate several practices that are essentially branches of the same behaviorism. This is the norm.
And immediately the answer to the unasked question. Or maybe it is that the psychotherapist is really skilled at CBT, but so that stupid patients do not think that he doesn’t know anything else, he declared everything in a bouquet?
Maybe of course. But watch your hands!
The more a person learns something, the more he applies strength and attention to a business, the better it turns out. The better it turns out, the more generous the reward system. (Sometimes it is possible without “better work”, but now it is not about that) The more generous the reward system, the more this interest begins to dominate, among all others. So turn by turn, interest grows into a dominant. The stronger the dominant, the more it determines the internal ethics and morality of a person.
The person who put a lot of energy into mastering the craft and immersion in science will be jealous of this tool and most likely will not want to dirty it. (Most often)
Especially for some companions:Erickson hypnosis is not even the level of acupuncture, which with reservations can be considered a health practice - it is terry astrology. The stories about how to control the universe using Ericksonian hypnosis, without attracting the attention of orderlies, are as convincing as the story of resorbed oncology after visiting a psychic.
Yes, and to classical hypnosis, I am very skeptical. I'm not so sure here. But I do not see the mechanism. Subconscious - it clicks the crocodile mouth. You don't hypnotize him. There is a trance. There is a consciousness. Sometimes consciousness in a trance. Something I doubt that hypnotherapy is much more effective than acupuncture. But if you have something to object to, please object to references to studies.
5. Why is it sad to be a normal person?
We are biological self-learning machines. All of us were born without prior arrangement, none of us were asked for permission. At birth, each of us was given the meaning of life. Standard as Bigmak in McDonalds. And the meaning of life for us, chimps, orangutans ... is the same. To dominate, mate, raise offspring ... Most sign in the statement and go with what they received. But some of them were lost at the time of growing up, some were broken ...
And by the way ... and so damn silly scribbling. If interested, continue from this point next time.