Profanation Of Psychotherapy

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

Author: Anna Varga Source: snob.ru

I recently ran into Mikhail Reshetnikov and promised to describe my position in more detail. I thought I would write only about confidentiality, but somehow I signed it. Here's what happened.

Recently, I often come across the profanation of the profession. According to my observations, the following ideas are most prevalent.

1. Psychological assistance can be provided by a person who has not received professional training. Option: our homebrew training is no worse, and maybe better (italics mine) internationally accepted.

During the years of Soviet power, psychotherapy developed in the West. The active development of psychotherapy in Russia began after perestroika, at the same time the training of local psychologists and doctors began. This is the generation of those who are today between fifty and sixty years old. Some of the psychotherapists practicing today in Russia have received a full-fledged education according to Western standards. What is included in this education? Knowledge, skills, personal psychotherapy and supervision of their practice with “senior comrades”, ie. from the trainers-supervisors accredited by the professional community. Further professional life, membership in international professional associations, publication of difficult cases in international specialized journals, participation in professional international conferences, finally, obtaining the status of a trainer-supervisor and the emergence of their own students.

Another part of practicing psychotherapists did not receive such a systematic and full-fledged education. Usually their education is a number of master classes and trainings of Western colleagues.

The first obstacle for many is the lack of knowledge of languages. You don’t know a foreign language (English is usually enough), you cannot participate in conferences, you cannot communicate with a supervisor, you cannot finally undergo your own psychotherapy with a psychotherapist recognized in the West. However, somehow these colleagues began to engage in psychotherapy, create their own schools and organizations, practice and teach others. Thus, a certain inherent level of professionalism was reproduced. There is a get-together, where everyone is boiling in their own juice. Let me give you an example from the life of psychoanalysts, because they are the very first and oldest school with the most well-built professional standards.

There is an international psychoanalytic association - IPA. It is an umbrella organization that brings together national associations for psychoanalysis. There is also the European Psychoanalytic Federation (EPF), which is organized in the same way. These associations, in particular, have a training committee that is responsible for developing professional standards and organizing training, and an ethics committee that monitors the observance of ethical standards. To become a member of the IPA or EPF, you must have a relevant education (medical or psychological), undergo your own analysis with a psychoanalyst, whom the association has given the right to be a teaching or training analyst. In parallel with this, it is necessary to attend theoretical and clinical seminars for several years, where the work of analysts and clinical cases are analyzed. An applicant for IPA / EPF membership must obtain permission to conduct, first, one case of his own with weekly supervision. If all is well, then he can get permission to manage the second and then the third case. Supervision cannot last less than a year. If everything goes without delay, you can become a member of a professional association in six years, usually ten. Only after that a person is considered a psychoanalyst, can thus be called, conduct a private practice, hang his diplomas and certificates of membership on the walls in his office. And don't be an impostor. Today in Russia there are about 30, maybe several more, members of the IPA / EPA, they are really psychoanalysts. There are thousands of people who call themselves psychoanalysts. How they were taught, what, is difficult to understand. Thus, they lower the professional standard and of course they know about it. But I don't want to give up the proud title. Then the reasoning begins about the peculiarity of the Russian reality, the client and the psychotherapist and the rationale, thus, of weak professionalism and provincialism.

In my field, in a systems approach, the same story. It's just that everything is not so clear with us, because we are much younger than psychoanalysts, we are only 60 years old. Nevertheless, there is the European Association of Family Psychotherapists EFTA, with its own training committee, with an ethical committee. There are very professionally demanding associations, for example AFTA - American Association for Family Psychotherapy, or AMFTA - American Association for Marital and Family Psychotherapy. My supervisor Hannah Weiner, who was for a time President of the International Family Psychotherapists Association (IFTA), was more proud of her rank-and-file AMFTA membership than her presidency. The debate is about what is the relevant education - only psychologists and doctors, or also teachers and social workers. However, the set of knowledge and skills, the number of hours of practice under supervision and personal psychotherapy - all this is determined by the international professional standard.

In my opinion, many Russian psychotherapists of the first generation of any school and direction have serious problems with personal psychotherapy.

It is easy to get the necessary knowledge and skills, it is more difficult to get personal study, personal psychotherapy. Several conditions must be met here: there can be no relationship with a psychotherapist other than a psychotherapist-client relationship. The teacher cannot also be the psychotherapist of his student. They cannot be friends, it is better that they do not work in the same place. These are all hard-won standards - if these conditions are not met, the effectiveness of psychotherapy is reduced, or in general the ongoing process is not psychotherapy. And in a narrow circle it is difficult to withstand such conditions. And you won't go abroad - there is no language. This is where profanation begins. They say that personal psychotherapy is not required. We are our own psychotherapists. A colleague told Snob that her personal psychotherapy is to socialize with friends. Mom dear. Personal psychotherapy is not needed to get pleasant experiences with friends. The therapist's personal therapy is absolutely essential to ensure that he does not introduce personal issues into the therapeutic process with his clients. So that he sees and understands where his needs, complexes, motives are, and where is professional work that takes place according to professional standards. So that at the end of the day he goes on the path of psychotherapy further than his client, otherwise he is like a lecturer who knows less than his students. A person can read a bunch of professional books, go through a lot of trainings, but if he has not gone through his psychotherapy and has not received hundreds of hours of supervision of his practice, he cannot be an effective psychotherapist. He communicates something like that with suffering people, and may even help them, but he does not engage in psychotherapy. Most often, he simply flatters his vanity and plays at his greatness, taking advantage of the illiteracy of people.

2. Any person can and should be made a client and a consumer of psychotherapy.

This is the exploitation of the social myth that there is a hidden madness in everyone and the psychologist, the X-ray person, sees it. The motive is clear - power and money. Only this is not about the profession. There is no absolute mental health, as well as somatic health. In medicine, there is the correct formulation - practically healthy. Most people are practically mentally healthy. Psychological runny nose”happens to everyone - stressful events, difficult relationships with loved ones, unhappy marriage, failures and disappointments in everyone can cause increased anxiety, decreased activity, depressed mood. There is no such thing as perfect parents and perfect childhood. All this creates local difficulties and suffering, but usually people overcome it. Only that which constantly hinders adaptation, creates serious dysfunction (I want to, but cannot) and is accompanied by the suffering of my own and loved ones, is it worth contacting a psychotherapist and / or a psychiatrist. It is very easy to create a pathologizing discourse - you have complexes, you have problems, you simply do not realize. And since there are quite a few poorly trained psychotherapists, they help (if at all) slowly and sluggishly. So people have been walking for years. As in that joke, when the psychoanalyst dies and tells the last will to his sons: I give the house to you, the eldest son, to you, the middle one, the bank account, and to you, the youngest, my client. Recently I heard a wonderful idea to teach people a course on how to become literate consumers of psychological services: what diplomas to believe, what a certificate of participation in a training or conference means, how to distinguish between parapsychotherapy and real psychotherapy.

3. There is no professional unfitness.

The flip side of blurring the boundaries of mental health is another idea - you can teach psychotherapy to anyone. It is clear that a person in psychosis, a person with a mental disability, cannot learn. In other cases, you should carefully understand. Since correct training presupposes personal psychotherapy of the student, there is always a hope that in the process of such training, the student, especially if he is smart and capable, will heal himself, and at the same time will learn. A lot of people feel an interest in psychology and go to study psychotherapy instead of being treated. It is scary to be treated, there is repressive psychiatry and the inability to accept the idea that there is disorder with me. In our paranoid society, it is believed that having problems means having weaknesses, and having weaknesses means getting a knife in the back because people are malicious. The person understands that he has difficulties, but hopes that after learning psychotherapy, he will cope with them on his own. Like a housewife who goes to study design to decorate her home. The boundary, it seems to me, is determined by motivation. If a person goes to be treated under the guise of studying, it is better not to teach him. Better to persuade him to accept psychotherapeutic help. He will not be able to work in a helping profession - he only wants to himself and for himself. In addition, he is full of social fears and prejudices, which, in my opinion, greatly interferes with the work of a psychotherapist. This is a professional contraindication. "The wise squeaker" is closed only to himself, to others there is no benefit from him, except harm. But for training organizations, this means a loss of money. If a person studied obliquely, he became convinced that as a psychotherapist he was not effective: he binds clients for years, burns out himself, transfers clients to friends, etc., not to mention that he receives subjective information about the result, from a client who often wants to meet the expectations of his therapist - then such a colleague quickly realizes that it will be more enjoyable to teach. It is better to teach everyone, give papers to everyone, and not bear any responsibility for maintaining a professional standard. Such was the story with the so-called educational psychologists. Teachers were reforged into psychologists in 9 months. Educational psychologists were created. Have spawned something that is incapable of either teaching or helping. But the budget was cut.

4. Compliance with all ethical standards is optional.

Here the situation is the same as in our country in general: there are rules, but not for everyone and not always. The views are very primitive. The meaning of these restrictions is not clear to many. Why is it bad that I go to an exhibition, concert, play, birthday, etc. to your client? Why is it bad that, while working on marital relations, I will also accept the mistress (lover) of one of the spouses? Everyone knows that you can't have sex with clients. Many, but not all, follow this rule. The fact that you do not need to engage in psychotherapy with clients at home, you do not need to go on vacation with them and generally be at your feet - not everyone supports. Every whim for your money. Ethical norms help psychotherapists not to fall out of a professional position and not to destroy psychotherapeutic contact with their client. Psychotherapeutic contact is fragile. Mountains of books have been written about this. Ethical standards help the therapist to be effective and do not provide an opportunity to directly, indirectly and remotely harm his client. And harm is very easy to do because the client is emotionally dependent on the therapist. The psychotherapist is an influential figure in the client's life. You can not exploit the emotional dependence of the client, so you can neither engage in sex with him, nor violate him and your boundaries, transferring psychotherapeutic contact to everyday life. Everyday contact cannot be converted back to psychotherapeutic contact. It is impossible to abuse the client's trust, hence the confidentiality rule. Of course, for the development of the profession, it is necessary to discuss cases. However, discussing cases among colleagues who know and accept the rules of confidentiality is different from idle chatter about their clients on the Internet in the popular media. At the same time, even if the psychotherapist is going to publish the analysis of the case in professional publications, he must obtain the consent of his client. Moreover, if it is done in the media. This rule is constantly violated, because many people who believe that they are engaged in psychotherapy also believe that they alone understand what can harm their client and what cannot, he is a seer, a cosmic person, he can. Moreover, when describing his cases in the media, such a person hopes that he will become better known, and more people will turn to him for help.

5. Conclusion.

In the Western world there are laws on psychotherapy, there is a licensing of the profession. Representatives of not all, of course, psychotherapeutic modalities, but a psychoanalyst, a behavioral therapist and some others, in different countries with their own set, can work on insurance. If they screw up, they can lose their license, and, accordingly, many clients and earnings.

In Russia, a consultant psychologist, a practical psychologist as an officially recognized profession, does not exist. There is no formal professional standard either. There are no laws to protect clients from harm that a helping professional can do to them. The reasons are clear: there is no one to lobby for the law on psychotherapy, because officials do not understand how they can cut budget money if this law is adopted and applied. That is why the personal responsibility for their professionalism, for the observance of ethical standards in Russia is very great.