Ethics In Russian Psychotherapy And Psychological Counseling: Problem Analysis

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

The problem of violation of ethical aspects is relevant in modern psychotherapy and psychological counseling in Russia. Much research has been carried out in the field of ethical violations by therapists, taking into account the peculiarities of psychotherapy in Russia

An analysis of the ethical principles of the activity of psychologists and psychotherapists is given in the studies of Garber I. E. (2014), Gabbard G., Lester E., (2014), Semenova N. S. (1997), K. G. Surnov, P. D. Tishchenko, E. Yu. Balashova (2007). About "boundaries" and their violations in the therapeutic process write V. K. Kalinenko (2011), W. Wirtz (2014), Kulikov A. I. (2006), Gabbard G., Lester E., (2014). Questions related to the morality and ethics of therapeutic activity are of increasing interest among physicians and psychologists, as well as among therapists who have come to psychotherapy in other ways (Chasseguet-Smirgel, 1988; McDougall, 1988; Heigl-Evers und Heigl, 1989; Kottje -Birnbacher und Birnbacher, 1995; Kottje-Birnbacher und Birnbacher, 1996; Hutterer-Krisch, 1996) [7, p. 370].

In psychotherapy, moral and ethical topics attracted special attention of specialists due to the fact that there are quite numerous cases of sexual abuse in relation to patients and patients that took place in the course of therapy (Becker-Fischer und Fischer, 1995) [7, p. 370].

According to research by A. I. Kulikov. (2006) much more often psychotherapists experience sexual feelings towards patients in psychoanalytically oriented psychotherapy (93.3%), then in gestalt therapy (86.6%) and in personality-oriented therapy (70%) [5, p. 117], which shows the importance of deep study of the problem of ethics in psychotherapy, as well as the relevant role of the problem of "boundaries" in the psychotherapeutic process.

Violation of ethics by specialists by psychologists and psychotherapists is a multifaceted problem, which includes the study of not only specific cases in supervision, but also the study of economic, social, and personal factors influencing violations of ethics. It should be noted that the problem of violation of ethics in psychotherapy should be approached from the point of view of planning rehabilitation measures, both for affected clients and therapists. Organization of the Ethics Committees' work and control over their activities requires adaptation to the conditions of Russian professional communities.

Garber IE in his article "Ethics of psychotherapy and psychological counseling in Russia: problem statement" (2014) considers a number of problems in psychotherapy in Russia that require analysis and solution.

For example:

- lack of an independent organization of the professional community [2];

- the use of non-adapted techniques from other countries by psychologists / psychotherapists to work with Russian clients [2];

- non-constructive discussion of "issues related to the relationship of participants in the psychotherapeutic process" [2];

There are also a number of problems noted by other researchers:

- no sanctions for violation of ethical standards [4];

- the danger of violating "boundaries" in relations with patients in order to obtain personal, sexual, financial, academic or professional benefits [4];

- the formation and use of the patient's dependence on the psychotherapist [4];

Thus, psychotherapy in Russia opens up many unresolved issues concerning not only the rules and standards of interaction with clients, but also problems concerning the functioning of professional communities of psychologists and psychotherapists in Russia, the qualifications of practicing psychologists and questions concerning the legal framework for the activities of specialists providing psychological (psychotherapeutic)) help in Russia.

The professional ethics of psychologists / psychotherapists are regulated by codes of ethics, which contain a number of general provisions:

• professional competence

• respect for the individual

• no damage

• confidentiality [6].

Legal regulation is far from always able to resolve all complex aspects of psychotherapeutic relations arising in the provision of medical care [4].

Each case of violation of ethics by psychologists (psychotherapists) is individual and requires consideration by a special commission not only from the point of view of legal norms, but also taking into account social, personal and even biological factors in the relationship between the client and the therapist.

Russian character and "blurring of borders"

The territorial space of Russia is very large. It is distinguished by its limitlessness, immensity and vastness. A certain infinity is inherent in the character and psyche of the Russian person.

Berdyaev characterizes the Russian man as follows: "bottomless depths and boundless heights" and at the same time baseness, lack of human dignity, slavery, endless love for people, kindness and hatred of mankind, a tendency to violence, humility and arrogance, heightened personality consciousness, boundless freedom of spirit and " unheard of servility, terrible submission ", inertia and" depression in the organic collective ", impersonal collectivism (Berdyaev, 1990, 2007) [3, p. 79]

"Border complex" is characteristic of Russian culture, it took shape and became "a complex of divine worship" (Kalinenko V. K. 2011). This complex determines the rejection of borders, the rejection of everyday life, the average level of culture: for a God-bearing people, the "earthly law" cannot become a limiting framework. Obstacles of this level often lead to the pathology of the transitional space with the corresponding consequences: addictions, Oblomov complexes, "grief-misfortune", "grandmother's syndrome" (deficiency of the third) and "delayed childhood" (lack of separation, fixation on the approach to Oedipus) [3, p..163]

The character of a Russian person is similar to the psyche of a child who is afraid of others, thirsts for entertainment, waits for parents, expensive gifts for the holiday, does not know how to make decisions and does not yet know who he is. Perhaps such a child will invade and violate the "boundaries" of people, because he is in a state of anxiety, fear, confusion, excitement, dependence.

The personality of psychologists (psychotherapists) who violate the "boundaries" in the psychotherapeutic process.

The problem of professional selection of psychologists and psychotherapists is urgent. It includes the lack of developed criteria for the profession of a psychologist and psychotherapist, the lack of structured and tested diagnostic material for identifying professionally unsuitable future specialists.

The personality of psychotherapists who violate the "boundaries" in therapy has many features associated with borderline, and sometimes psychotic disorders. Here are some markers of the psychological portrait of a specialist psychologist (psychotherapist) prone to breaking "boundaries": a personality is characterized by the presence of narcissism, a tendency to establish co-dependent relationships, is characterized by a low level of reflection, rigid "boundaries" of the personality, characterized by incongruence, uncontrollable personality authenticity. Such a "specialist", as a rule, has a limitation in contacts with others, communication is reduced to daily communication with clients.

Gabbard G. identifies four categories of disorders that fall under the psychotherapists who have had sexual relations with their patients:

1. Psychotic disorders, 2. Predatory psychopathy and paraphilia

3. Longing for love or

4. Masochistic surrender (Gabbard, 1994a, 1994b) [1, p. 124].

The indicated personality disorders in psychologists and psychotherapists must be identified at the stage of training future specialists. In Russia, often those who want to become psychologists (psychotherapists) become them, having contraindications to the profession. It is believed that the course of personal therapy, which is included in the program, is able to insure against critical moments in working with clients. However, it is not.

There are personality disorders, the correction of which presupposes long-term psychotherapy, using only a certain method of psychotherapy, for example, psychoanalysis, which, for example, is not included in the training program for client-centered psychotherapists. In this regard, a number of problems arise: the development of contraindications to the profession of a psychologist (psychotherapist), the crisis of the method of psychotherapy, the environmental friendliness of the method of psychotherapy and its effectiveness for a certain group of mental disorders.

Many people want to become psychologists. Future specialists come to universities and enter psychological faculties in order to solve their problems, and not at all with the initial goal of helping future clients. It is important to understand and make a choice for a future psychologist (psychotherapist): either this is help to people, which requires knowledge, certain skills, tension, dedication, or, this is help to oneself, which implies the need for good psychotherapy and in this case it is not at all necessary to enter a university for psychology faculty.

The solution to the problem of the professional unsuitability of a psychologist and psychotherapist has not been practically developed in Russia today.

Psychotherapy in Russia

Many questions arise about whether Western psychotherapy has taken root in Russia, can it be an effective tool for changing the Russian person? The answer to this question is given by a psychiatrist from the Serbian clinic Mikhail Asatiani, one of the first psychoanalytically oriented Russian doctors. Mikhail Asatiani gives his own interpretation of Jung's opinion on the cultural situation in Russia: Jung argued that in Russia for psychoanalysis there are no suitable social conditions conducive to the development of personality, namely, there is an obstacle to the autonomy of the individual (Asatiani, 1999: 62). Freud, for his part, was at first encouraged by the Russians' closeness to the unconscious, which he noted. Later, when Russia became Soviet, Freud's statements became more skeptical: “These Russians are like water that fills any vessel, but does not retain the shape of any of them” (cited by Etkind, 1994, p. 215) [3, p..81-82].

Western psychotherapy requires adaptation to the Russian population and living conditions in Russia, taking into account economic, social, cultural and historical characteristics.

Ethical committees in Russia

Material about ethical committees designed to regulate the rights of psychologists (psychotherapists) and clients is indicated on the Internet resources of the following information:

1. EC activities (goals, objectives) 2. EC Charter 3. Code of Ethics 4. Board 5. Executive Committee 6. Regulations 7. Documents.

The information presented is located on the official websites of the European Confederation of Psychoanalytic Psychotherapy in Russia, the Professional Psychotherapeutic League, the Professional Community of Client-Centered Psychotherapists, the Russian Psychological Society, the Society for Psychoanalytic Psychotherapy, on some personal websites of practicing psychologists (psychotherapists) and on the websites of regional communities.

In general, the Code of Ethics is more directed towards medicine and bioethics. Not enough attention is paid to ethics in psychotherapy and psychology. This is evidenced by the small number of popular articles on the Internet: "Ethical problems of psychiatry, narcology, psychotherapy and sexopathology" (A. Ya. Perekhov), "Ethics in psychiatry"

(L. N. Vinogradova), "Profanation of psychotherapy" (A. Varga).

In this regard, there is an insufficient development and education of the Russian society in the field of ethics violations by psychologists (psychotherapists). It can be assumed that many important problems related to the violation of "boundaries" by psychologists-consultants (psychotherapists) are ignored or paid little attention to professional communities.

What laws are used for the rehabilitation of psychotherapists (rehabilitation, restriction of practice, coordination of rehabilitation) and clients can only be guessed at. Discussion on the forums of the site of psychologists of ethical issues is often carried out by the affected clients themselves, trying to somehow find like-minded people and support.

It becomes important professional selection in this specialty, education, which includes knowledge of moral, legal principles and public, professional and state control over persons providing psychotherapeutic assistance. Professional communities and ethics committees should play an important role in this. However, there is no doubt that for real, effective control, society should have not only rules, but also detailed sanctions for violations of these rules (for example, an official warning, suspension and revocation of a certificate, denial of the right to engage in psychotherapy, and others) [4].

The current ethical committees of the country also need a modern reorganization: a change in the structural units involved in the development and implementation of programs, recommendations for the rehabilitation of not only psychologists (psychotherapists) who violate the ethical aspects of their activities, but also their clients.

Bibliography

1. Gabbard G., Lester Psychoanalytic boundaries and their violation / Per. from English M.: Independent firm "Class", 2014.

2. Garber IE Ethics of psychotherapy and psychological counseling in Russia: problem statement // Theory and practice of psychotherapy. 2014. No. 1 (1).

3. Kalinenko V. K. Boundaries in Analysis: A Jungian Approach. M.: "Kogito-Center", 2011.

4. Karavaeva TA The value of ethical norms and principles in psychotherapy and their consolidation in legal regulation / TA Karavaeva, TS Vyunova, SA Podsadny // Bulletin of psychotherapy. 2008. No. 28 (33).

S.9-17.

5. Kulikov A. I. Study of the sexual feelings of patients and psychotherapists in the process of psychotherapy: Abstract of a dissertation for the degree of candidate of medical sciences. SPb.: 2004.

6. Surnov KG, Tishchenko PD, Balashova E. Yu. Problems of Ethics in Clinical Psychology // INTELROS: Bioethics and Humanitarian Expertise. 2007. №1.

7. Heigl-Evers A., Heigl F., Ott Y., Ruger W. A basic guide to psychotherapy. SPb.: "Eastern European Institute of Psychoanalysis", together with the publishing house "Rech", 1998.