Psychological Portraits Of Clients With Oncology. Features Of Psychotherapy

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Video: Psychological Portraits Of Clients With Oncology. Features Of Psychotherapy

Video: Psychological Portraits Of Clients With Oncology. Features Of Psychotherapy
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Psychological Portraits Of Clients With Oncology. Features Of Psychotherapy
Psychological Portraits Of Clients With Oncology. Features Of Psychotherapy
Anonim

As already mentioned in previous articles, if it is possible to single out a psychological factor contributing to the development of oncology, then it will be expressed not in specific problems or feelings, but in a general subconscious message that life in the manifestation in which it is no longer makes sense. At the same time, most people define "meaning" in different ways, and in order for "Caesar's things to go to Caesar" we mark typical behavioral patterns and psychocorrection, respectively. Each research psychologist can single out 11 and 8 types, however, we present such because each of them can be motivated to add various traits of people's characters (we associate these portraits with temperament and constitution, so that it has long and confidently been at the heart of medical psychosomatics) …

So, the most basic problem that becomes a stumbling block in working with cancer patients comes down to the lack of meaning in life. Most often, when we begin to analyze the motivational component of recovery, we say:

Why do you need to be healthy

Answers + / - are standard: to put the children on their feet, I can not leave my parents, there are still unfinished unclosed work projects, to live for the sake of grandchildren, vague "I have not done so much / have not visited / have not tried so much" and so on. We often refer to them as "pseudo resources". Because when it comes to what it means for a client, for example, motherhood (you can substitute any of the options), after abstract happiness and love, we come to the conclusion that this is hard work, constant tension, fear, anxiety, rejection of our own I am "in the name" and so forth. The paradox is obvious, why then should this become the meaning of recovery for the client? And again we come to the conclusion that people cling to generally accepted human values, because "you need to grab onto everything that is offered", "you can't just sit back", "but what about the children"? And then the process of recovery turns into a double struggle, except that we are no longer talking about a bright future, we receive violence against ourselves now, in order to continue to abuse ourselves after recovery … Often people themselves, without realizing it, try to create support and a resource from the source of their pain. Figuratively speaking, they want to live for the sake of what led them to the disease.

At the same time, I want to draw your attention to the fact that children, parents or projects are really very important, but in this case we are talking about the fact that a person is in such a state when all these phrases come from him in a stereotyped manner (so that everything is like people), in fact, he perceives these areas as a struggle, as a duty, self-sacrifice, need and duty, etc. And in this whole story sometimes it is simply impossible to get to the bottom of the client's “I”, he simply does not exist. What brings you true joy? What is your life filled with interesting when there are no children (parents, projects, plans)? What do you dream about (besides health and being left alone)? What is your purpose, purpose, mission, etc. (according to the faith of each)? Do you remember what a thrill, drive, bliss is?

Many patients who have successfully completed treatment and psychotherapy often refer to their illness as a starting point. They note that life was divided into Before and After, they radically revised their values and the disease became a kind of impetus for personal growth, for a new life, new ideas and people, new interests and dreams! This is absolutely true.

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Often when we analyze the metaphorical function of a symptom, through the essence of the disease, through the features of the course, etc. we also come to the conclusion that like a cancerous tumor that shamelessly grows, bending and eating everything in its path, the I of a person suffering from oncology metaphorically screams that it is, it exists … It has its own plans, joys, goals, interests, and it also has the right to be finally heard. However, unlike depressive clients, destructive behavioral attitudes, generic programs and scenarios that literally offer a person: "do not stick out", "be obedient, docile", "be silent, you are smarter", "swallow, leave, forget "," listen to what I am telling you "," you are always not good enough … (not smart enough, beautiful, neat, etc.) ", etc. Unlike the previous description, these people have a clear understanding of what they want from life, but their I is always in second or third place. They will get what they need and want, but sometime later, because first you need to respect everyone, so God forbid offending anyone, so that people do not speak behind their eyes, to please everyone, etc. And some of them are in the process of treatment begins to put himself in the first place, to allow himself at least what is necessary to begin with, to rebuild the intra-family policy, as if to say, "Enough, I have lived all my life for other people's needs, it's time for me to live for myself." However, many are so deeply convinced of their worthlessness or insignificance (there is no analogue of the essence of menshability) that even what they need for treatment is put in second place before the needs of others. You can even hear the phrase "why do I need this, I will most likely die anyway, and let the children have this and that …". And metaphorically, the tumor continues to spread "if you don't need it, I'll take it for myself."

But learning to balance between taking care of yourself and those around you is a very difficult job, since in the psychotype of such a person the pattern of "usefulness and self-sacrifice" is initially embedded. If such a person gives up everything and immediately begins to "love himself", after a while he will only develop a sense of guilt and the meaning of life will become even more vague, because. for what then live, if not for the sake of smiles of loved ones? Putting yourself first is like playing someone else's life, which essentially does not change anything, but only makes you break yourself every day. Moreover, sometimes the problem of oncology is connected precisely with the fact that a person "giving himself away to everyone" (including tumors) also blames himself for "giving not enough", "little", "wrong", "at the wrong time "," could have done more ", etc. Then our task is not only to help a person find something that will breathe life into his reality, which will help to reconsider his attitudes and values and realize where he squeezed the spring, but also is that he learned to be useful not to harm myself.

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Another frequently encountered mechanism is the avoidance / denial mechanism. Conventionally, such patients can be called people without emotions, because they are often at odds with themselves. They are poorly oriented in their feelings (earlier we talked about alexithymia, modern research shows an insufficient connection between alexithymia and psychosomatics, but in this type it occurs). Analyzing earlier symptoms, we come to the conclusion that the body has long been telling the patient that not everything is all right with him. Here, of course, we distinguish clients who guessed about oncology, but were not examined due to fear of hearing a diagnosis, from clients who actually lived like robots with a given program and a complete lack of understanding of what was happening to them. These are also people who are trained not to feel (do not cry, do not shout, do not laugh, do not stick to me - do not hug, do not show your sight, etc.), people for whom others felt (normal soup, not sour; normal water, not hot; stop running, you're tired; this is not love, he is not a match for you, etc.), people who were given the framework of what is white, what is black and therefore everything that is not white and not black causes them fear and rejection. It also begs the metaphor that over time there are so many incentives that a person gets lost, gets tired of figuring out what is his, what is not his, what he needs, what is not, what is good, what is bad, and most importantly how to understand it, to accept and appropriate? And the immune system stops recognizing cancer cells as foreign. If what I have always considered bad has a spectrum to good, then maybe this cell is not so bad either.? Since the body produces them itself, then is it necessary?

First, a person lives with a parent who "asked him algorithms", then with a spouse, if he is lucky, children will start to take care of him over time. At the same time, in my description, the picture is drawn openly infantile and helpless, in fact, in real life, these destructive connections look absolutely natural ("I love my mother so much, we are as one whole" / "you tell everything to my wife, she will explain to me later "/" I only accept what follows the protocol "/" I'm just an introvert and I don't like talking about myself ", etc.). We can be especially confused by former military men (or athletes, people of the regime) who demonstrate strength, confidence, intelligence and practicality, but when they leave or retire, when all these skills give way to feelings and ordinary human interaction, they lose themselves. "Life ends" at the moment when such a person is faced with the need to make emotional and sensory decisions on his own (the same is typical for people of other professions when they deliberately leave their parents, divorce, move, etc.). Then the first time, while there are enough "worked out algorithms" for a comfortable life, a person feels confident. However, the more he lives in a rapidly changing world, the more he encounters various kinds of difficulties, realizing that he does not have universal algorithms, he does not know what to do, how, when, etc. Internal anxiety and hopelessness becomes so much that At first glance, an absolutely insignificant event may become an impetus for the development of oncology, which in fact will be the last straw that overwhelmed the cup of patience (this story stretches for years, so it is difficult to find a connection right away).

More often this psychotype is found in men, and the more difficult is the psychotherapeutic work. They will clearly follow all instructions, accept treatment and even "enjoy life" and "love themselves" by the order of their relatives and the doctor., however, on the one hand, opening up to another person will be hindered by their isolation, on the other hand, a meager sensory experience, a meager experience of recognizing their emotions. Sometimes for such people, a "fatal disease" becomes the very sensual challenge when they, already being adults and independent, suddenly allow themselves to stop and feel the world around them - how the air smells, how the sun warms, how you want to see a friend, etc. becomes such an intense experience that they close, therefore it is desirable to produce "therapeutic feeling" in a metered dose and with the ability to receive feedback.

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Talking about infantilism and egocentrism it is important to distinguish between those patients who are poorly oriented in their feelings, from patients who are used to being in the center of everyone's attention. This personality structure is very well known to oncologists, since these people attract the maximum attention of others. They are sure that everyone should come to them to donate blood, allocate money for treatment abroad, respond to every breath, etc. They sincerely do not understand why everyone does not revolve around their illness when they are so dangerously unhappy. As long as there is a person nearby who supports their belief in their exclusivity, as long as life circumstances develop in such a way that they do not feel the need and do not have to make any efforts to get something elementary, there is no need to worry about their health. But the more they face the need to "grow up psychologically," the more they get the feeling that the world has gone crazy. A small child is hiding behind the external form of an accomplished person (it can be both financial benefits and significant intellectual, scientific potential). And something in his life happened so that he had to become an adult, but he is not ready, does not want, cannot, he is really scared. Then the disease becomes that frontier that will push a person to accept the reality of the world as it is (different and along with pleasures difficult). It is important to remember that overgrown ego (metaphor - as an overgrown neoplasm) speaks precisely about the fact that this person initially no problem with self-love and self-esteem (metaphor - while there were few cancer cells, the immune system coped with them easily), the problem appears when a person ceases to see the value around in anything other than his I (metaphor - there are so many cells that the body fails - it is normal to grow, taking up all the space). But also, as in other cases of true psychosomatics, we cannot orient the patient to abandon his I, “admit his infantilism,” and so on. In this case, it is rather about learning to respect another I, to assess my I adequately, without diminishing its real significance (since they are often people with very strong potential).

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Another pronounced psychotype of cancer patients is the psychotype " achiever"when, in pursuit of life, he forgets to live. And when the situation of the pursuit changes perspective or the goal is achieved, a person discovers that apart from this goal he does not know himself anywhere else, does not see, does not understand. This is sometimes connected with retirement, dismissal, project closure, divorce, or with some kind of physical injury. At the same time, one can speak of a complete chain, when a person lived by a plan: to learn - to find a good job - to get married - to build a house - to buy an apartment for children - ….. and then what ? Living for pleasure is like? Where to run at 6 in the morning? Who to negotiate with, where to break through, etc.? What to do with your grandchildren? Why travel when you have the Internet? Everything to which he ran all his life achieved - here he is the finish … So the problem may also be in the end of a part of a cycle, when a person directed a lot of efforts into one area, and it either ended (closing the project) or did not give the expected result (he disappeared at work all his life, and as a result, no family, no work or all my life I worked for the sake of promotion, and when I was promoted I realized that neither health, nor interest, nor age "does not correspond to the position held").

It is important for such people to learn expand the scope of their achievements and switch on time. If they run into some kind of limiting attitude, go around it. Sometimes life is challenging to find meaning and purpose in a state of deprivation (for example, in case of disability) or postpone business and work and see that there are family, friends, and other areas that are also important to develop.

By and large, as I wrote in other articles, the same disease can have several psychosomatic functions. The type of tumor, localization, course of the disease and other features are all details of a particular order. In our work, we cannot distinguish a clear connection between organs, emotional experiences, etc., even if only because there can be several functions and they can be intertwined. For some, the organ involved is associated with a family history or scenario, for someone with a specific traumatic experience, including childhood, for someone situationally, accidentally, on the basis of a sudden conflict or stress (read the previous article). However, the question of why is often not so important as the question of why. And first of all, it is associated with the loss of connection with our own I, which we, as psychotherapists, strive to restore. It's difficult to talk about how true this is. We judge not by reason, but by result, when we see that some clients get better sooner than others with the same exact diagnosis, volume of interventions and treatment. One way or another, we are faced with the fact that a person with an oncological disease blocks his life - either by the fact that being disappointed cannot find meaning in it, or by the fact that he cannot start living his own life, or by the fact that he does not understand himself himself, does not see his application, or, on the contrary, ceases to see anything around him except his I.

A psychotherapist, while working with such types, needs to try a little to determine where a person's "attitudes" are true, and where they are brought up or imposed by society, since this presents us with different therapeutic tasks.

In working with true psychosomatics, we always need to remember about the therapeutic balance, because often the quality that is developed in a person is unnecessarily not a mistake, but his excessive manifestation of his essence (what is inherent in it by nature). Accordingly, trying to "eliminate" the destructive quality, we will only break the person through the knee. All we need is just to determine the degree of acceptability of certain attitudes and behavior models in order to teach a person not to be excessive in their manifestation or suppression, to understand himself through the prism of his natural characteristics, to accept them and use them as a resource. Then psychotherapy turns not into "surgery with the word", where destructive behavior needs to be removed, but into a kind of harmonization when behavior is needed. save, but adjust it in such a way that it benefits the client … Having learned to do this once, the client gains maximum independence from the therapist, but this is true precisely for working with hypo or hypertrophied qualities inherent in us by nature (constitution, temperament).

We set a slightly different task when a destructive behavioral pattern goes against our constitution and, by and large, is simply learned or imposed. This often happens in families when parents and children belong to different constitutional types (the child may look like parents, or maybe grandmothers / grandfathers, uncles / aunts). Then it turns out that from childhood he was imposed on a model of behavior not characteristic of his temperament and abilities, and all his life he broke himself in order to meet the expectations of the "educator". In this case, the disease itself can be precisely the "awakening of the true Self." We then go from the other side, first we determine which attitudes and values are true, and which are imposed, and then we replace one behavioral pattern with another. And then the psychotherapeutic work really surgically On the one side softens the situation of separation of the patient's self from the self of a significant loved one, on the other side helps on the path of "engrafting" your true self, support on the way of acquaintance with new experiences.

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Sometimes in our work there are people who say “how is it, I have eaten right all my life, been engaged in charity work, led a healthy lifestyle, attended various trainings and courses, developed and thought positively, why is this happening to me, my life completely made me happy and satisfied, and now I am deprived of all this. " There is no universal answer here either. Some patients in psychotherapy open up and make it clear that the "good life" is a run from inner emptiness; others pay tribute to fashion; still others revel in "positivism" so much that those parts of the personality that are responsible for sadness, fear, anger, etc. are simply suppressed, "killed", ignored, etc.; fourth, in the depths of their souls, they have already learned everything that needed to be known in their incarnation and "how much greater self-improvement can be than there is now?"; fifths actively delve into their illness, in order to live it as an experience, overcoming which they can help other people, like, for example, Louise Hay, etc. Everything is individual. The only thing I want to note is the importance of analyzing the situation, because no matter how good or bad his life before, it brought him to the point of reference in which he is now. And in the future, we cannot return to our usual life, because " it is impossible to keep doing the same thing and wait for a different result (c) ". Therefore, not always what we consider positive is our resource and vice versa.

By the way, after my first article on oncology, many spoke negatively about Louise Hay, allegedly her theory was outdated. In fact, Louise, as a person who went through oncology, quite accurately formulated the essence of what a sick person lacks. Her whole philosophy was aimed at self-love, at knowing oneself, at discovering one's potential and at finding one's place in the system of the universe, etc. Yes, even if the offense has nothing to do with oncology, however, over the many years of working with cancer patients, we can clearly define the risk group for relapse, these are exactly the people who fought, were treated, but could not turn life back, find themselves, start living differently, change the global destructive attitudes that prevent us from enjoying life, enjoying it and using it your personal potential for the benefit of yourself and those around you harmoniously.

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