Technique of creative self-expression. Creative self-expression therapy. List of used literature

Creative expression therapy psychotherapeutic and psychoprophylactic method, focused on helping people suffering from the painful experience of their inferiority. This technique was developed by a Russian scientist M.E.Burno(Professor of the Department of Psychotherapy, Medical Psychology and Sexology of the Russian Medical Academy of Postgraduate Education).

Creative self-expression therapy can be mastered and used in their practice not only by professional psychotherapists, but also by psychologists, coaches, etc. In recent years, this method has been increasingly used as an element of various trainings, a soft means of revealing the creative potential of a person, its reflection in the works created by the patient.

Initially, the method was focused primarily on helping the sick suffering from indecision, vulnerability, shyness, anxiety, fears, obsessions, painful doubts, suspiciousness, supervalues, hypochondria, etc. Often, these manifestations lead to various chronic diseases, as well as to combat their symptoms through the use of alcohol, potent drugs. It is clear that this dead end road which only exacerbates the problem.

Dignity creative self-expression therapy lies in the extraordinary softness approach. For example, unlike some Western similar methods, Burno's therapy is based on the fact that a person's character cannot be changed, you can only reconcile a person with himself, direct him to the path of self-knowledge so that he sees his advantages and can use them.

One of the main concepts method is an emotional stressful effect, which is understood not as " harmful stress", and spiritual uplift, inspiration which have a tonic and healing effect on all aspects of human life, including health.

essence method lies in the available teaching patients fundamentals clinical psychiatry, characterology, psychotherapy, natural science in the process of various creativity patients. As a result, a person turns from a suffering person into a creative one, comprehends his own characteristics, recognizes himself through artistic self-expression, opens his own path and accepts it. An important role in this process is played by the study experience talented, brilliant creators, for many of whom art was a means of self-healing.

Similar methods of treatment have been known and practiced since ancient times - treatment with music, theatrical performances in ancient times, etc. Already in the 19th century, medical research showed that patients with mental pathologies recover much faster if they have an interesting, favorite activity to which they can devote their time.

Creative self-expression therapy sees its ideal in achieving a healing and creative lifestyle, a constant feeling of creative inspiration. Such a result can be achieved after several years of practice, but episodic procedures have a very beneficial effect.

Methodology includes individual conversations with a psychotherapist, doing homework, participating in a creative self-expression group in a cozy psychotherapeutic living room (warm home environment, tea drinking, pleasant relaxing music), playing roles in a psychotherapeutic theater (as a special group of creative self-expression by performing art).

The main stages of treatment

  • Self-knowledge and knowledge of others. First of all, we are talking about the study of human characters and types of mental disorders.
  • Knowledge of oneself and others in creative self-expression. Includes therapy:
    • creation of creative works;
    • creative communication with nature;
    • creative communication with literature, art, science;
    • creative collecting;
    • penetratingly creative immersion into the past;
    • keeping a diary and notebooks;
    • home correspondence with a doctor;
    • creative travel;
    • creative search for spirituality in everyday life.

It should be noted that the method of creative self-expression therapy requires a great deal of experience and dedication. Here, each case of treatment is individual and often the right decision can be obtained only intuitively.

In the practice of creative self-expression therapy, two forms work - individual meetings and work with open groups in the outpatient clinic. Individual the form enables the doctor to enter the world of the patient, learn about his intimate experiences, clarify with him the question of his well-being and mood. group the form enables the patient to visually see himself, his character, his spiritual values, his creativity in comparison with all this in his group mates. The patient can be convinced of the sincerity of interest and respect for him on the part of his comrades, understand and accept other images of experience and behavior, which in itself is therapeutically valuable.

One of the most common types of creativity in creative self-expression therapy is drawing. The patient can only master the basics of this artistic method, but this is quite enough - after all, the goal is not to create a work of art, but to self-knowledge. Drawing available almost always, which allows the patient to independently quickly relieve emotional tension - this is akin to the effect of keeping a diary. Create drawings in group work is a unique opportunity in a short time (literally in a few minutes) to get to know the characters of the participants and their characteristics more clearly.

Among contraindications to therapy it should be noted: deep psychotic depression with suicidal motives; defensive low-progressive schizophrenic cases, in which patients persistently report that they are becoming more and more " fragile", vulnerable, the treatment awakens joyful hopes - and it only hurts more from all this" blows of life"; delusional and overvalued mood of patients with a tendency to delusional interpretation of the doctrine of the typology of characters to the detriment of the patient and the people around him.

positiveaction of therapy creative self-expression is based on the fact that a person acquires his own individual core, which saves him from emotional tension, fears, and uncertainty in the future. In the creative process, a person finds and discovers himself - acquires new values and brings into his confused and amorphous soul certainty, answers his own questions - who am I, what am I worth, what can I do, what is my vocation, etc. A creative person is more emotional protected, since he can perceive life's hardships, grief and other negativity as creative material, on the basis of which a work of art is created.

All these facts, observations and regularities served to create one of the original directions in modern psychotherapy, called "Creative Self-Expression Therapy" (CTS). Its founder is a well-known domestic psychiatrist and psychotherapist Mark Evgenievich Burno, who published many interesting works on the detailed development of this method.

M.E. Burno defines his method as a clinical, non-psychoanalytic, psychotherapeutic way of treating people with painful experiences of their inferiority, suffering from anxiety and depressive disorders. The method is based on the following two main ideas.

  • 1. A person suffering from some kind of psychopathological disorder, in the process of creativity, can better learn and understand the features of his character. And by recognizing his strengths and weaknesses, the patient can mitigate his negative state, because our shortcomings are an extension of our virtues.
  • 2. Any creativity releases a large amount of positive energy, so any creativity is healing. It is as a result of this that positive changes occur in the psyche.

Mood disorders of a similar nature

are not uncommon in healthy people, especially those who are referred to as the so-called accentuated personalities. For all such patients, TTS helps them feel healing creative inspiration, learn how to overcome difficulties in moral self-expression, without resorting to drugs, alcohol or drugs to alleviate mental tension.

Creativity in the TTC is understood broadly - as the implementation of any socially useful deed in accordance with its unique spiritual characteristics. Therefore, creativity cannot be reactionary, immoral, it is always creation, bearing in itself the positive individuality of the author.

Since the main tool of any creativity is a manifestation of a living spiritual individuality, both a sick and a healthy person recognize their uniqueness in creativity, become themselves and free themselves from the painful uncertainty that is always present in mood disorders.

The main and specific mechanism of creative self-expression therapy (which combines on a single basis the treatment of patients through their communication with music, painting, architecture, through the creation of their own works of art, etc.) is a healing revival of spiritual individuality, bringing patients to the opportunity to experience creative experience - inspiration.

Specific methods of therapy with creativity according to M.E. Stormy include:

  • 1) therapy with the creation of creative works (stories, drawings, photographs, etc.) in order to discover in all this one's own personality trait and compare one's creativity with the characteristics of the creativity of one's group mates;
  • 2) therapy with creative communication with nature (with the search for oneself in nature through consonance and dissonance with certain plants, insects, landscapes, etc.);
  • 3) therapy with creative communication with literature, art, science (search for consonance in various works of culture);
  • 4) therapy by creative collecting (collecting objects, consonant and dissonant - to clarify their characteristics and thus);
  • 5) therapy by penetrating and creative immersion in the past (communication with childhood objects dear to the soul, with portraits of ancestors, studying the history of one’s people, the history of mankind - in order to more clearly know oneself in harmony with all this, one’s “roots”, one’s non-randomness in the world) ;
  • 6) therapy by keeping a diary and notebooks (various creative notes reveal, emphasize the features of their author);
  • 7) home correspondence therapy with a psychotherapist (as an opportunity to show a personality trait in live correspondence);
  • 8) creative travel therapy - searching for yourself in the knowledge of the new, unfamiliar on the journey;
  • 9) therapy with a creative search for spirituality in everyday life - to see the unusual in the ordinary, the opportunity to see and feel the world around you only by knowing the ordinary in your own way, personally).

All these types of creative activity contribute to the enrichment and development of the personality of both the patient and the healthy person. The main thing is that patients observe and be guided by three fundamental provisions for themselves:

  • 1 - know the characters of people;
  • 2 - find among them your character and its inherent inclinations and aspirations;
  • 3 - choose for yourself, according to your character, the path in life, occupation and hobbies.

Creative self-expression therapy, applied in the field of psychological impact on a person for both therapeutic and non-medical purposes, invariably reveals the ability to help a person to know and study himself through creative activity, consciously and purposefully clarify his individuality and significance. It helps to find one's place in society, to find oneself in creativity, contributes to the active search for means to overcome crisis states and rise to a new stage in one's development.

Method of creative self-expression ( FOOTNOTE: How the method was tested on the basis of the well-known psychological methods of M. E. Burno. See: Burno M.E. Therapy with creative self-expression. – M., 1989.–S. 304) includes a number of techniques united by a common methodology and construction technology. The meaning of this method is to bring each teenager into contact with his own creativity, to give him the opportunity to feel an existential involvement in the world, to help him find a foothold in his uniqueness. To be able to find reserves in one's own individuality is the most valuable skill that a person needs in predicting and further shaping his life destiny (M. E. Burno).

The method is based on the idea that subjective creativity and positive experience will help to convince a person of his significance and find the meaning of life.

The method of self-expression through literary creativity, as well as through other types of creativity, is carried out in the form of practical exercises. Classes of this type are structured in a certain way, like any lesson, in accordance with the learning objectives. Receptions are selected by the teacher arbitrarily. There are no particular difficulties in conducting classes of this type, so we will limit ourselves to describing the method with instructions and an approximate lesson plan.

Instruction:

“You need to create a picture of words, filled with sensations (taste, smell, touch, sounds, visual images). The story must be very sincere, even if it is under the guise of another person. If the author describes some experiences that are not characteristic of him, then it is necessary to express his attitude to what is happening in the story.

Each student can choose their own topic for the story, or all students write a story on one topic. It is advisable to offer several options. We consider it expedient to work with the following topics:

1. Describe a childhood event, trip or experience.

2. Try to make a direct description of nature. To do this, go to the bosom of nature and write down everything that you feel, see, remember, think about.

ABOUT CREATIVE EXPRESSION THERAPY

Creative Expression Therapy (TTS) a psychotherapeutic (psychoprophylactic) method that can seriously help, first of all, people with a painful experience of their inferiority. This method can be mastered, as life has shown, not only by psychotherapists, but also by psychotherapists with non-medical education master in their own way, that is, with their own characteristics. However, this is possible only when the psychotherapist, firstly, is able to sincerely sympathize with people who are experiencing their inferiority; secondly, it has a keen interest in spiritual culture and, thirdly, it seeks to help a person express himself in a healing and creative way in accordance with his nature.

This section outlines the very beginnings, the elements of the method even, more precisely, its flavor, which must be captured for the subsequent more in-depth study of the TTC in other works, for example, indicated in the text, as well as in special lectures, seminars and in a psychotherapeutic workshop.

Creative Expression Therapy (TTS)

I will tell here about how people with a variety of mental difficulties described in the work "Emotional Stress Psychotherapy" can help themselves. These difficulties are mood disorders with indecision, vulnerability, shyness, anxiety, fears, obsessions, painful doubts, suspiciousness, supervalues, hypochondria, etc.

The special psychotherapeutic techniques described here will seriously help in cases where these disorders-difficulties are imbued with an experience of their inferiority, their weakness by a suffering person, that is, he is defensive as opposed to aggressive. At the same time, there is still often no obvious pathology, which means that there is also no need to be treated by a doctor. But this necessity may arise if internal disease-producing causes or harmful circumstances of life continue their work and if mental self-help does not prevent the formation of a pathological disorder, illness.

Often tense people soften themselves with smoking, wine, arbitrarily take sedatives or stimulants without permission. All this, muffling tension, “setting fire” to lethargy, does a lot of harm to the body.

Here we will talk about safe-powerful psychotherapeutic techniques for dealing with mood disorders, which can be resorted to without going to a doctor. This is self-help with cultural, spiritual values, creative self-expression.

The techniques of traditional elementary self-hypnosis (which many people have already mastered with psychoprophylactic benefit) have long come into life, beyond the walls of medical institutions, from the special psychotherapeutic direction "Methods of psychotherapeutic training (mental self-regulation)" and the techniques that will be described here came out of psychotherapeutic direction "Therapy with spiritual culture". The essence of the psychotherapeutic mechanism underlying this direction is creative inspiration, healingly enlightening the soul, softening tension with a sense of one's spiritual characteristics, riches, and understanding the meaning of one's life. Psychotherapeutic impact of this kind V.E. Rozhnov (1985) calls it “emotionally stressful” in a broad sense, in the sense of “elevating” a person with beneficial emotional excitement.

In the expression "emotionally stressful psychotherapeutic impact" the word "stress" can confuse. He is not to be feared. It is only in everyday conversations that a one-sided idea has been established that stress is a harmful blow to a person. The author of the classical doctrine of stress, Hans Selye, in his book “Stress without Distress” (M., 1979) complains about this one-sidedness: “In everyday speech, when they say that a person “experiences stress”, they usually mean excessive stress, or distress , just as the expression "he has a temperature" means that he has an elevated temperature, that is, a fever. Ordinary heat production is an essential property of life.” Also, emotional stress a protective and adaptive rise in vitality caused by emotional influences can be sharp, “noisy” and outwardly quiet in its healing and harmfulness.

Selye advises every person to acquire a stable spiritual uplift, the enjoyable stress of life. He himself lived in this state for a long time. So often spiritualized artists, artists, scientists, gardeners in love with plants live.

Emotionally stressful psychotherapeutic influence is biologically based on the beneficial healing work of emotional stress. In different people, in different ways, depending on the mental and physical make-up and the nature of the disorders, this healing excitement-tension of vital forces is formed, and, therefore, in different, sometimes unexpectedly found, subtly poetic ways, one has to evoke it.

The term “stress” introduces a biological “subtext” into the understanding of psychotherapeutic work, emphasizes the impact of emotional stress on the entire body: Selye’s biological axis (hypothalamus pituitary adrenal cortex) works with the release of “medicines of the body”, the internal “elixir of life” into the blood. Without special psychotherapeutic intervention, this happens to a person who is healed of an illness by falling in love; with a patient doomed to death, who does not die until, in a state of emotionally stressful enthusiasm, he completes his book; with a soldier bravely defending his Motherland in the damp and cold swamps without any colds of peaceful life.

Even before the emergence of the classical doctrine of stress (the 50s of our century), the domestic therapist A. I. Yarotsky wrote, in fact, about the same thing in the book “Idealism as a physiological factor” (Yuriev, 1908). He understood here by “idealism” not philosophical direction, but embraced by ideals, spiritual elation, powerfully increasing the body's resistance to physical diseases.

For a long time, healers have used various healing techniques that uplift the soul and, therefore, the tone of life (for example, treatment with music, theatrical performances in ancient times).

In 1887, in Kazan, at a meeting of the Society of Physicians, obstetrician-gynecologist I.M. Lvov with a speech: "Emotional unrest as a cause of illness and as a therapeutic agent." He said that a person ill with a serious internal illness should be captured by some interesting, fun things, activities, it would be nice for him to have a “pretty house”, where he would be surrounded by the caring warmth of his relatives, and then he would soon recover.

A lot has been said about therapy with creative excitement both in fiction and in the letters of writers. Thus, Chekhov wrote to Suvorin (August 18, 1893) that he gave Chertkov "Ward No. 6" "because before spring and spring (...) he was in such a mood that (...) it didn't matter." And further: “If he began to ask for all my works, then I would give, and if he invited me to the gallows, then I would go. Such an impersonal and weak-willed state sometimes keeps me for whole months. This partly explains the whole structure of my life. Chekhov saved himself from mood disorders primarily by creativity, creating, highlighting his individuality in stories, novels, plays and pushing aside, thus eliminating the "impersonal and weak-willed state." Complaining to Suvorin about the many uninvited guests in Melikhovo (December 8, 1893), Chekhov was worried: “But I have to write, write and rush to the mail, because for me not to write means living on credit and moping.”

Therapy by creative self-expression (with awareness of one's social benefit, with the emergence of a stable light worldview on this basis) there is a special complex method developed by me from the field of “Therapy with Spiritual Culture”. The essence of the method is in the therapeutic accessible teaching of the ABCs of clinical psychiatry, characterology, psychotherapy, natural science to patients in the process of various creativity of patients.

The method is intended for the treatment of patients with a variety of mental disorders, imbued with a painful experience of their inferiority.

Understanding one’s spiritual, characterological features in communication with creativity, more or less consonant with it in terms of the temperament of the soul, the experiences of famous creators, comrades in the treatment group, in communication with one’s own creative works, in creative communication with nature, with a penetrating and creative immersion in the past, a suffering person, comprehending these characteristics (characterological, chronically depressive, neurotic, etc.), tries to find his own way, the meaning of inspired healing self-expression, under the guidance of a psychotherapist and using the experience of talented, brilliant creators (always suffering and spontaneously, each in their own way, treated by creativity).

When a person does something creatively, that is, in its own way and in the name of Good (for creativity is creation as opposed to destruction), then its spiritual-spiritual feature-individuality is revived, the painful anxiety-depressive porridge-uncertainty in the soul recedes, and all this is invariably accompanied by a bright upsurge (creative inspiration), in which both Love (in the broadest sense, including a gentle, benevolent attitude towards people with the search for good, kindness around) and Meaning (why am I? where am I going? where? in the name of what do I live?) live together. The biological basis of such a rise is emotional stress in the understanding of Selye (protective-adaptive splash into the blood of one's own beneficial, poetically, philosophically "intoxicating" drugs).

Psychotherapeutic help of this kind can be temporary, episodic, but ideal creative self-expression therapy cultivate a healing and creative lifestyle in yourself and imbue it, that is, experience constantly(usually possible after several years of therapy) more or less creative inspiration.

The components of the TTC individual conversations with a psychotherapist, homework, creative self-expression groups in a cozy psychotherapeutic living room (with tea, music, candles, slides, etc.), psychotherapeutic theater (as a special group of creative self-expression by performing arts) Thanks to all this, patients within 2-5 years they learn to express themselves creatively (including in their professional work), in accordance with their own characteristics, for the immediate good of people, being filled with the riches of spiritual culture, highlighting more and more deeply, emphasizing for themselves their socially useful features - abilities, with light in the soul affirming itself in the "strength of one's weakness."

I stage of treatment:
1) self-knowledge("know thyself" "nosce te ipsum", lat.) study of one's own painful disorders, one's own character; 2) knowledge of other human characters("to each his own" "suum cuique", lat.) classes on the typology of characters; the study of mental disorders.

II stage of treatment:
continuing to know oneself and others in creative self-expression("gains strength in motion" vires que acquiriteundo, lat.), with the awareness of one's social benefit, with the emergence on this basis of a stable light worldview with the help of specific techniques. These specific techniques are: 1) creative writing therapy; 2) creative communication with nature; 3) creative communication with literature, art, science; 4) creative collecting; 5) penetrating and creative immersion in the past; 6) keeping a diary and notebooks; 7) home correspondence with a doctor; 8) creative travels; 9) creative search for spirituality in everyday life.

I briefly described here the essence, the content of the TTC, so that it would be easier for any person to use some elements, “crumbs” of this complex method for self-help.

So, what is the essence of any (including healing) creativity? In exactly his, individual, and therefore always a new, fresh look at things, in an original attitude towards them.

The artistic attitude to life, in contrast to the scientific one, reveals not only the peculiarity of thinking-judgment, but also its personal, individual experience about some events, relationships with people, with nature. In this sense, not only a poem or a watercolor landscape, but every creative photograph or slide is a self-portrait of the author. Prishvin wrote: “The landscape is the totality of animals, plants, stones and all other components of nature, attributed to the personality of a person” (Prishvin M. Forget-me-nots. M .: Khudozhestvennaya literature, 1969, p. 84).

That is, to express oneself creatively is to express one's attitude, for example, to nature, to building a house, to express oneself in the work of a teacher and a veterinarian, a carpenter and a businessman; in a letter to a friend, in an essay, in a conversation with a person, in a notebook, in reading a Chekhov story. Creativity clarifies, delineates, builds and affirms the personality of the author. A person with mood disorders, as already noted, in the process of creativity finds himself, his certainty, getting out of mental disorder, painful confusion, anxiety-uncertainty.

As the author of the concept of probabilistic forecasting, I.M. Feigenberg emotional tension, anxiety are caused not so much by the danger situation itself, but by "the uncertainty of the further development of events", in which a person who is ready for a variety of actions "does not yet know what kind of actions will be needed". The creative state of the soul introduces a certain certainty into the confused, amorphous soul (including, if not primarily, the certainty of the forecast), which is practically expressed at least in the realization of who I am, what I stand for, what I can do, what I must do in life, and in what situation, what, most likely, I will feel and how I will act.

The man who creates involuntarily and constantly looking for for his creativity, for refraction in his originality, the material is everywhere around him and in his experiences too, even in grief. And therefore he is more securely protected than a suffering man, but uncreative.

The psychotherapist uses the means of his soul to release the healing forces of nature in a sick person. This is a very complex matter, requiring special education, experience, known innate abilities. The doctor professionally knows exactly how (for example, by creative self-expression) to help a person, depending on the characteristics of his character, clinical picture.

In a cozy treatment group with tea, music, candles, the patient learns about his painful disorders and how it is possible to alleviate them, learns about different human characters, communicating with other patients of the group, peering into other painful disorders and characterological structures, into others, so say, "lifestyles", studying them together with a psychotherapist. The patient in the process of serious (for all its external festivity) work learns to understand, to feel in this chamber laboratory of life, who is strong and weak, what is the “strength of weakness” and even painful symptoms, what are true values ​​for him, how to deal with whom themselves for the mutual benefit, how to spare the vulnerability of people, how to consider the good in people, how even bad desires, having transformed, to direct to good.

Knowing people in live communication and through the objects of their creativity (slides, stories, etc.), you get to know yourself deeper with your abilities, features, shortcomings, in order to better apply yourself for public benefit, to be imbued with a bright worldview. Thus, the essence of the TTS is to help you deeply understand yourself, find your main spiritual work, in which you will express yourself healingly and rise for the benefit of the people around, finding the meaning of life.

The healing revival of the creative abilities, the forces of a person, I think, is the most vital and sometimes the only serious medical intervention that helps the suffering, although for an ignorant person it seems to be not medicine at all. Influences of this kind are so complex that they are often produced by an experienced psychotherapist (in any case, at first) intuitively, but true intuition is, in contrast to instinct, a condensed experience in one’s business, only at first not realized at every moment in its details.

The psychotherapist who heals in this spirit is necessarily a "scientific artist." Cold and hot suggestions, auto-suggestions, explanations, instructions in many cases cannot help the patient understand and feel how and what to do to mitigate painful tension. In the process of therapy with creative self-expression, the doctor is forced to encourage creativity in patients, people with mental difficulties, including their own creative individuality, their own creative experience. This explains, perhaps unusual for other medical works, but vital here, the scientific artistry of presentation, the depiction of the psychotherapist's therapeutic experience, including in his psychotherapeutic stories and plays.

Psychotherapeutic techniques similar to those of TTS are scattered in the psychotherapeutic world under the names: “aesthetic therapy”, “art therapy” (art therapy, mainly fine art), “occupation therapy”, “creativity therapy”, “music therapy”, “bibliotherapy” (book therapy) , "landscape therapy", etc. Many psychotherapists are engaged in therapy with spiritual culture, creativity, but only a few here work in the spirit of our domestic traditional medicine, that is, in sufficient detail, penetratingly starting from the clinical picture of mental suffering, the personal identity of patients, in order to therapeutically contribute self-protective natural forces of the patient, embedded in the very picture of the disease.

A realistic psychotherapist helps himself and his patients to be imbued with the conviction that each person (healthy or sick) is limited and at the same time strong in his own characteristics, which is different for everyone, if only a good, moral principle prevails.

We should never forgive anyone for immorality, cynicism, outright boorishness, but we should be restrained and indulgent, kindly attentive to human weaknesses, youthful inexperience, undeveloped tastes. It is important to understand that in both big and small things, especially in our time when the world is saturated with deadly weapons, the highest value is the moral value. It should be the starting point.

It is spiritually joyful to know, to feel that a person who does not agree with you, who is not like you, is right in his own way, and this truth of his can serve people well.

So, creative self-expression therapy is seriously in line with the characteristics of the clinical picture and the character of the suffering person. However, I will not enter here into the characterological features, the difficulties of people. This is done above, in a special section. Here we will set off, in an attempt to help ourselves with “crumbs” of creative self-expression therapy, from those spiritual difficulties, disorders that have already been described, and from a more or less clear philosophical idea of ​​defensive people about the strength of their weakness.

Without going into characterological details, I will note two polar characterological structures authoritarian(authoritarian-aggressive) and defensive(passive-defensive), characteristic of the so-called "weak" people (with the experience of their inferiority). This "weakness" has its own strength.

It is important to talk about this in more detail, since creative self-expression therapy, in its medically qualified form (for sick people) and in simplified home, preventive forms (for healthy people with mental difficulties), as noted above, especially helps deficient (“weak” people). ). The “weak”, in order to be successfully treated or resort to the psycho-prophylactic self-help described here, in the order of healing self-knowledge, it is necessary to understand their “weakness”.

Deep human love for children, parents, close people, for one's work and other forms of true, spiritual love have a common inalienable property - the ability to sacrifice oneself for the sake of this love.

This property has its prototype in the life of animals. And in the animal kingdom, as you know, a mother often does not spare her life, protecting, saving her children. But animals of a melancholic temperament (“a weak type of higher nervous activity” in Pavlovian physiological terminology) are distinguished by especially tender, affectionate, sacrificial care for each other.

For example, melancholy cats and dogs attach themselves to their owners more strongly and warmer than animals of other temperaments. The fearful one is affectionate, affectionate, and in this insecurity there is its own attempt at protection.

The main behavioral reaction of melancholic ("weak") animals in danger is a passive-defensive reaction, that is, the desire to move away from an unpleasant situation with their tail between their legs, while "strong" animals behave predominantly aggressively in danger - they attack by baring their teeth.

In “weak” animals, reflexes are usually poorly developed that help them survive. It is enough for a “strong” animal (choleric, sanguine, even phlegmatic) to see once from the side how a predator or a person caught, killed an animal of the same species, so that another time, seeing the enemy, escape or attack (the so-called “reflex of the audience” ). This "spectator reflex" is sluggishly developed in melancholics, and they die, sometimes die out as whole species.

This is how Steller's sea cows died in the 18th century. These large marine mammals, up to six meters long, peacefully grazed in huge herds under water near the coast, feeding on sea grass, without going to land, without going far from the coast. It was possible to swim up to them on a boat when they were grazing in a shallow place, stick a hook tied to a rope between the ribs in the back, and pull the animal ashore. At the same time, as eyewitnesses noted, the sea cows were extremely attached to each other. For example, a male followed a captured female to the shore as she was pulled by a rope; he tried with tender helplessness to free her, although he was beaten from the boat in the process; sometimes on the second and third day he sat over her dead body.

Sea-cows and many other melancholic animals have disappeared from their imperfection. But in the process of evolution, the rudiment "hidden" in the passive-defensive response, the prototype of selfless affection, love for one's neighbor, also passed to man. Particularly deep conscientiousness and the associated spiritual, moral and reflective depth, which sounds in everyday life, in scientific or artistic creativity, are distinguished by people of a melancholic temperament (for example, Darwin, Pavlov, Chekhov). Therefore, a passive-defensive “weakness” persists in the world: behind this mask of innate physical clumsiness and impracticality lie the inclinations of qualities that are closely related to it, highly respected by people, which develop and flourish in public life heightened morality, conscientiousness, delicacy, and sometimes the ability to subtle analysis, extraordinary spiritual creativity.

“Weak” Hamlet is weak in practical (in the broadest sense) life, incapable, for example, of decisive revenge by murder (usual for his contemporaries and compatriots), because this is not his lot. His innate abilities lie elsewhere - in a witty, clear, philosophical and moral explanation to people of the complex mysteries of life and death. A deep, moral-analytical, responsible attitude to all living things, to the mysteriously delightful natural cycle of life and death prevents him from simply and immediately killing the killer of his father. By the way, it is very important for a “weak” person to see, to understand the shadow of Hamlet in himself, precisely in order to be more resolute, nobly “practical” in danger, protecting good from evil: the innocent from injustice, the Motherland from the enemy.

This complex clinical psychotherapeutic method has been developed by me for more than thirty years and is described in detail in 4 books (Burno M., 1990, 1999, 2000).

There is already an extensive literature on creativity therapy in the world. However, careful works outlining the practice of this serious treatment in accordance with the characteristics of the clinic, personal soil, could not be found. Basically, these are psychoanalytically, psychodynamically, generally psychologically (in a broad sense), but non-clinically oriented messages, books about self-disclosure therapy in creativity (Naumburg M., 1966; Franzke E., 1977; Gibson G, 1978; Zwerling I., 1979 ; Kratochvil S., 1981; Biniek E., 1982; Burkovsky G. and Khaikin P., 1982; Günter M., 1989). It is generally accepted that it is possible to speak about therapy with creativity, art only in the language of psychoanalysis. Thus, the relatively recent remark of the Cologne professor P. Rich that “non-psychoanalytically oriented art therapy makes little sense” is characteristic (Rech P., 1991, p. 158). W. Kretschmer (1958, 1963, 1982) builds his “synthetic psychotherapy” on the clinical principles of his father (E. Kretschmer) and V. Stern’s ideas about personal consciousness, including culture as a therapeutic tool in psychotherapy (“Treatment with positive experiences and creativity” ). V. Kretschmer, however, is fundamentally limited here to general theoretical expressive provisions, without offering the doctor and psychologist any practical developments-recommendations.

Therapy by creative self-expression (with awareness of one's social benefit, with the emergence of a stable light worldview on this basis) grew up in the field of the concept of emotional stress (“elevating”, addressed to the spirituality of a person) psychotherapy by V. Rozhnov (1985). This method is very effective for the treatment of patients with defensive disorders. "Defensiveness" (from défēnsio - defense, protection (lat.)) is understood in clinical psychiatry as the opposite of "aggressiveness", authoritarianism. The essence of defensiveness is the experience of one's inferiority, the conflict of feelings of inferiority (the feeling of inferiority is revealed by timidity, self-doubt, shyness, anxious suspiciousness, etc.) with vulnerable pride. Defensiveness is characteristic of psychasthenics, asthenics, many cycloids, schizoids, patients with neurosis-like schizophrenia, defensiveness sounds in many depressive disorders.

The main healing "mechanism" of creativity

In anxious tension, in general, with almost any serious mood disorder, a person experiences a painful feeling of uncertainty, instability, amorphousness of his "I" - up to painful depersonalization disorders. This loss of oneself is, I think, the main, deep knot of painful, pathological spiritual tension (in comparison with the personal experience-purification permeated by one's own "I"). Creativity as the fulfillment of any moral deed in one's own way, in accordance with one's spiritual individuality, helps to return to oneself, to feel oneself more clearly, more distinctly, to soften one's soul, to brighten up, to see one's path more clearly, to find the meaning of life. A meaningful meeting with oneself in creativity, the crystallization of individuality is revealed by spiritual uplift (creative inspiration), and in this sense, Creativity and Love (in the broadest sense - at least as sincere goodwill towards people) are always together. But a creative person is directed towards people, serving them also by the fact that with his lively individuality he is interested, “infects” them, and encourages them to their own creativity. After all, only spiritual individuality makes art art, inspiration inspiration, and only it is eternal. This is true both in the spiritual-idealistic and in the spiritual-materialistic (clinical) understanding.



The essence of the method

However, it is often not easy to revive, “warm up” healing creative movements in a suffering soul. This is greatly facilitated, in our experience, by a feasible clinical study of one’s chronic depression, one’s spiritual individuality (state of mind), the study of other personal options (characters) and how exactly this or that mental warehouse (character), this or that depression in a variety of creativity. In order to consciously and confidently walk along his, on a special socially useful road, feeling like yourself, with a creative healing light in your soul, you need to at least study the elements of characterological radicals - synthonic, autistic, psychasthenic, etc., knowing and feeling that there are no "good" and "bad" radical characters, just as there are no "good" and "bad" nationalities. It is important to feel-study in oneself and in others - both weaknesses and strengths, values ​​(constitutionally closely related to these weaknesses) - in order to realize that for each his own(if only it his was moral). A truly deep understanding of oneself and others, one's purpose in life is possible, as I am convinced, only in the process of various creative self-expression.



Patients in individual meetings with a psychotherapist, in group sessions (in an open creative expression group- 8-12 people, 2 times a month for 2 hours) in the liberating, soul-softening atmosphere of the “psychotherapeutic living room” necessary for defensive people (tea, slides, music, candles) (ill. one) and homework - they learn, study their own spiritual characteristics, the characteristics of each other, the characteristics of famous artists, writers, philosophers (based on the doctrine of characters, on memories of famous people). They learn to express themselves creatively in every possible way, studying the characteristics of their creative personality among the world's spiritual culture.

Here are specific methods of creativity therapy, intertwined in our work, reinforcing each other: therapy 1) the creation of creative works; 2) creative communication with nature; 3) creative communication with literature, art, science; 4) creative collecting; 5) penetrating and creative immersion in the past; 6) keeping a diary and notebooks; 7) home (at home address) correspondence with a doctor; 8) creative travels; 9) creative search for spirituality in everyday life.

Gradually, over the course of 2-5 years of such outpatient work, patients acquire a more or less persistent inspirational and creative style, a bright meaning of life, in which they are freed from their hopeless mental tension-amorphism.

It is also possible to have a short-term, concentrated treatment by this method in an outpatient clinic or in a hospital with daily exercises in a group - for at least two weeks. Then the groups become closed. In such cases, we count on at least an increase-illumination of the quality of spiritual life in the future.

With a full, long-term course of treatment, compensation or remission is usually hardly reversible - in the sense that there is no longer a complete return to the previous difficult days, it is now easier for the patient to resist his disorders. However, if he stops creative pursuits and loses his creative form (style), deterioration often occurs.

In Therapy with creative self-expression, as well as in humanistic psychology-psychotherapy, a person grows personally, enriches himself, self-actualizes, acquires the meaning of life, but, unlike the types of personality (character) and the clinical picture of the approaches of Maslow, Rogers, Fromm, Frankl, who carry the conviction in the originality of the Spirit, the spiritual - here the psychotherapist helps to grow spiritually, to find oneself as an autistic or syntonic, or psychasthenic person, etc. warehouse, to find a creative style characteristic of their warehouse, the meaning of life. This is based on the theoretical position of E. Kretschmer (Kretschmer E., 1934) about psychotherapeutic searches, together with the patient, of his characteristic style of behavior, life field - in accordance with his constitutional foundations. Of course, I am aware that such a materialistic commitment to the constitution, the clinical picture looks more mundane, less spiritual in the psychological-autistic understanding than humanistic, existential, psychoanalytic, religious and other spiritual-idealistic approaches, but this clinicism, this The natural-science approach to the human soul is the essence of my psychotherapeutic method, which seriously helps the Russians and continues (as I am convinced) the domestic clinical psychotherapeutic tradition. The clinical nature of the method fills it with a subtle, complex clinic, especially the study of the personal soil, without which this method is impossible. Patients, acquiring elements of clinical knowledge, become, to a certain extent, clinicians-psychotherapists for themselves.

Therapy with creative self-expression, spiritually-materialistically starting not from the eternal Spirit, but from the eternal Nature (features of the constitution, clinical picture) allows the patient to feel himself unique by himself (synthonic, autistic, etc.) in spiritual culture, in life (including through its spiritual consonance with famous artists, writers, philosophers). Thus, emphasizing in its own way the freedom of the individual, the pricelessness of everything moral, human, it can lead the patient to my philosophical-idealistic, religious personal way.

Some practical examples-tips

1. Ask the patient to read aloud in a group a memory story, for example, about childhood in the village. At the same time, let him show the slides he has already made of those herbs and flowers that grew in that village in childhood. Let him show his, albeit inept, but sincere drawings, memories of rural landscapes from memory, a drawing of the house in which he lived. Here he turns on a tape of the birds singing he heard there, the crowing, the bleating of the sheep, and so on. Patients, together with the psychotherapist, try to be imbued with all this, but not in order to evaluate literary or artistic and photographic skills (this is not a literary circle, not an art studio!), but in order to kindly feel in the creative self-expression of a friend his spiritual, characterological feature, compare with your feature, tell and show in response his on this topic and suggest to each other the possible ways of creative (and therefore healing) self-expression peculiar to each.

2. On the screen in comparison - slides: the ancient Greek Kore and the ancient Egyptian Nefertiti. Patients try to “try on” their vision of the world to the syntonic vision of the world of the ancient Greek artist and the autistic vision of the ancient Egyptian. Where is more consonance with the artist? Not - what do you like more, but - where is more of me, my character, my attitude? Look, talk about how these two worldviews continue in the paintings of famous artists of all times, in poetry, prose, music, cinematography, in the work of group mates. What is the strength and weakness of each of these attitudes? In what, in what matters do various synthonic and autistic people usually find themselves happily in life? How do psychasthenic people differ from them in all this? Etc.

3. If at first it is difficult for a “newcomer” to express himself creatively, you can ask him to bring to the group several postcards depicting paintings by artists that are consonant with him or with images of his favorite animals, plants. Or we ask you to read a poem by your favorite poet aloud in the group, turn on a piece of music that you like (that is, as if about him, as if he himself wrote, if he could).

4. The psychotherapist participates in the group with his own creativity, revealing his personality (character) to patients. For example, he shows on a slide how he himself involuntarily philosophically “clings” to thunderclouds with a camera, expressing his experience symbolically and autistically. Or, if he is syntonic, he shows with his slide of nature how he naturally dissolves with his whole being in the surrounding reality, without opposing himself to the fullness of life. Or, talking about creative communication with nature, the psychotherapist shows how he himself feels and understands his peculiarity, communicating with a flower consonant with it (“my flower”). How exactly this communication with a flower (including photographing it, drawing it, describing it in a notebook) emphasizes to the psychotherapist his own peculiarity.

5. You should not "load" these insecure patients with a frightening "encyclopedic" abundance of information. Minimum information, maximum creativity.

6. In the process of creative self-expression, patients should be helped to learn to respect their defensiveness. It is not only a weakness (excessive anxiety, impracticality, clumsiness, etc.), but also a wonderful strength, which manifests itself primarily in anxious and moral reflections and experiences that are vital in our era. This "power of weakness", which, by the way, is filled with Dürer's Melancholy, dejected with doubts, is important to use usefully in life. One should help the patient to become as socially useful himself as possible - without breaking himself, without trying to turn himself by artificial training into his "daring", "impudent" opposite (which is what many defensive sufferers strive for at first).

So, for example, in the group of creative self-expression, with common, cordial efforts, we show the modern Hamlet that behind his everyday impracticality, indecision, there is an invaluable moral scrupulousness, the ability to comprehend reality philosophically and witty and tell many people about themselves and the wondrous dialectics of life - just as they themselves they couldn't see it, figure it out. Having realized that bravely aggressive, practical deeds are not his destiny, that, perhaps, Darwin, Tolstoy, Chekhov would also suffer from defensive experiences in the appropriate environment, let the defensive patient learn to respect this Darwinian, Tolstoyian, Chekhovian thing. Confirming his true worth, he will sooner learn to do the necessary practical work more resolutely. But only the necessary practical.

I tell in groups how a long time ago my school friend V., gifted in mathematics, but timid, absent-minded, physically fragile, awkward, literally tortured himself in physical education classes with complex exercises, despising to tears his “weakness”, impracticality. Already a student, he continued to “break” himself by climbing and soon died in the abyss. Apparently, thanks to Therapy with creative self-expression, V. could feel and realize that his bodily fragility, awkwardness can even be respected as an integral part of the mental and bodily constitution, without which his mathematical gift would not exist. This is what distinguishes clinical psychotherapy, which individualizes each case, from psychologically oriented psychotherapy, which could require the opinion of the group to transform Hamlet into a self-confident, unreasoning brave man (even if artificial), forcing him to shout loudly: “I! I!! I!!!".

Creative self-expression therapy is contraindicated in many cases of psychotic depression. Here, the experience of dreary hopelessness, separation from people can even deepen - in a bright environment of inspired creativity.

Conclusion

Thus, Creative Expression Therapy as a method of clinical psychotherapy is not just a treatment with joyful, creative experiences. This is an attempt to help the defensive patient to feel a conscious sense of spiritual, socially useful originality with the help of special spiritually creative activities. Specifically, in life, this is expressed, for example, in the fact that on an excursion in an ancient city a person no longer sees just white gray walls, bulbs of churches, but feels, realizes in them and in himself the characterological features of ancestors - severe softness, syntonic, cheerful sweeping in the spirit of "Moscow baroque", shy closeness to wildlife (onion). In the greenery near the temple, he now distinguishes goat-beards, forest geraniums, yarrow, and with inspiration knows his attitude to a specific flower, to a specific architectural image (“how close it is, how much all this emphasizes me myself, my own path in life”). This everyday creative self-expression is somewhat reminiscent of "being" (as opposed to "possession") in the spirit that Fromm thinks of it. Unlike Fromm, I understand the essence of being, creative being spiritually and materialistically: a person does not “choose” to absolute (in essence, divine) freedom from his “I”, but free-moral, socially active lives his own “I”, concretely-realistically studying it.

1. 1. 2. Therapy (prevention) by creative self-expression

In these recommendations, the author of the psychotherapeutic (psychoprophylactic) method indicated in the title briefly describes the practical essence of the matter in relation to the circumstances in which a doctor and psychologist work with patients and healthy people.

The present method is especially effective in the treatment of patients with various deficient non-acute psychotic disorders and as a prophylaxis of nervous pathology in healthy people who experience mood disorders of a deficient nature within the normal range. The term "defensiveness" is close to such concepts as asthenicity, psychasthenicity, asthenicity, psychasthenicity, inhibition, melancholicity. It is clear that depressiveness usually carries a certain defensiveness. Defensiveness (the experience of one’s inferiority) is found as a leading disorder in many patients with low-progressive neurosis-like schizophrenia, in psychasthenic and asthenic psychopaths, in defensive schizoids, cycloids, epileptoids, defensive hysterical psychopaths, in patients with alcoholism and drug addicts of a defensive (inhibitory) warehouse. Defensive mood disorders are not uncommon in healthy people, especially in accentuated individuals. For all these people, a real reception helps to soften mentally, to imbue with more or less persistent healing and creative inspiration, to learn to overcome difficulties in moral self-expression without resorting (for easing spiritual tension and “raising the spirit”) to psychotropic drugs, alcohol, drugs.

Creative Expression Therapy (TTS) goes in detail from the clinical picture, from the features of the natural mental and bodily self-defense lurking in it, as well as clinical hypnotherapy, clinical rational conversations, clinical methods of mental self-regulation and other clinically refracted methods that make up the arsenal of a psychotherapist-clinician. Creativity (in a broad sense) is understood as the performance of any socially useful deed in accordance with its unique spiritual characteristics. Therefore (as opposed to simply “self-expression”) creativity cannot be reactionary, immoral, it is always a creation that carries the individuality of the author. By their dissimilarity to each other, by their moral characteristics, people unite into collectives, in which, ideally, each spiritually in his own way (and not mechanically, not machine-made) implements a socially useful task that unites the collective. Since the main instrument of any creativity is a living spiritual individuality, a sick and healthy person studies mental disorders, characters in TTS, cognizes their individuality in creativity, becomes, as it were, more themselves and, thus gaining inspiration, are freed from the painful uncertainty that is always present in mood disorders. , in any mental tension, depression. In the process of treatment (prevention), a person finds or refines his own creative, socially useful and at the same time healing and inspirational path in his profession, in communication with people, in his family, at his leisure. This is, in the most concise presentation, the clinical and psychotherapeutic, scientific essence of Therapy with creative self-expression as a complex clinical and psychotherapeutic effect.

The goals of the method Clearly, it’s not about teaching those we help to create works of art, science, or giving them some kind of “distracting” “hobby” from spiritual difficulties. Goals are as follows.

Therapeutic purposes

1. To help defensive patients get out of painful mood disorders, significantly alleviate their pathological experience of their inferiority, various psychopathic and neurosis-like manifestations: obsessive, asthenic-hypochondriac, senestopatho-hypochondriac, depersonalization, etc. Thus, to prevent the destructive “self-help” possible here by drinking and drug addiction.

2. At the same time, in the process of therapy, to liberate, to activate the hidden reserves of social, moral activity, often “hidden” in these unconfident patients without such special treatment. To help them creatively, more useful for society and healthier for oneself to “fit in”, “include” in life precisely with their own, including chronic pathological, features.

Preventive goals

1. To help healthy people with defensive difficulties get rid of the tension that interferes with life and work, fraught with addiction to alcohol and drugs.

2. By special classes, to help a healthy person with characterological difficulties find his creative, most socially useful, and therefore inspirational and healing life path.

Method objectives(as tactical, realizing the strategy of goals)

Medical tasks

1. To help patients in the process of individual conversations, medical-educational, psychological-typological influences in a group, if possible, to learn, to study their painfully persistent, "difficult" characterological features, chronic pathological disorders - first of all, in order to find out how it is possible to apply their most socially useful, which is the peculiar vitality of this chronic pathology.

2. To help in the process of personal psychotherapeutic contact with a doctor, psychologist, in the process of Therapy with creative self-expression, in accordance with one’s own characteristics, to realize one’s place among people and for people, having thought through and felt one’s own serious non-randomness in the country, in humanity.

3. Not just encourage patients to be creative (write, draw, photograph, etc.), but unobtrusively, in a cozy creative environment, lead them to this, “infect” them, arouse the interest of group members in each other’s creativity, pushing them to self-expression and own (doctor, psychologist, paramedic, nurse) creativity.

4. To help patients, thanks to their individuality, now already strengthened by creativity, steadfastly and productively enter into life teams - work, study, household, etc.

Preventive tasks

1. In the process of psychological and character studies, to help healthy people with mental difficulties study the elements of the typology of characters, their own characterological radicals, abilities, in order to consciously try to become personally more socially active and, therefore, healingly spiritualized.

2. To "immerse" healthy people with defensive experiences in the work of a group of creative self-expression, so that in the kaleidoscope of special classes they are spiritually enriched, find themselves, realize and feel in creativity their personal, useful for society features, their serious place among people and nature.

The practical essence of this method is the same in treatment and prevention and consists in the following. Patients and healthy (with mental difficulties) - in individual conversations with a doctor, a psychologist, in group classes (a group of creative self-expression) in a liberating, softening atmosphere of a "psychotherapeutic living room" (tea, slides, music, dim light) and in homework they learn in every possible way express yourself creatively. Any creative activity at leisure, even seemingly completely useless, but clarifying, strengthening the personality, can contribute to the strengthening of professional creativity, since a person in any moral self-expression becomes generally more of a personality. Such a person becomes more secure in relation to mood disorders (with which, for example, an alcoholic is associated with a relapse).

I stage- self-knowledge (study of one’s character, one’s painful disorders) + knowledge of other characters (study of the elements of the doctrine of characters: “to each his own”, learn to respect this “own” of the other, in any case, treat this “one’s own” of the other kindly, if it is certainly not immoral); duration from 1-3 months (in the case of unhurried outpatient work for 2-5 years) to several days (with reduced work - a hospital, sanatorium, rest home).

II stage- continuing to know oneself and others in creative self-expression (with awareness of one's social usefulness, with the formation of an optimistic attitude to life) - with the help of specific methods of therapy with creativity; duration from several years (with unhurried outpatient work - a dispensary, clinic, sobriety club) to 2 weeks (in the case of a short course of treatment (prevention)).

Forms of therapy (prevention) by creative self-expression:

1) individual conversations (from 3 times a week to 1 time in 2 months);

2) mail correspondence (from several letters per month to several per year);

3) groups (open or closed) of creative self-expression (8-12 people each) in the “psychotherapeutic living room” with reading aloud their stories, discussing each other’s slides (how the author’s characteristic features are manifested in all this and how socially useful it is possible to apply them ) etc.; group meetings from once a day to twice a month (according to working conditions) - in parallel with individual conversations.

Along with all this, if necessary, hypnotic sessions, training psychotherapy, drugs (mainly sedatives, tranquilizers) are used.

Of course, a labor-intensive course of treatment over several years is quite long. But the long-term experience of Therapy with creative self-expression in patients with defensively low-progressive schizophrenia, defensive psychopaths and alcoholism patients with a defensive warehouse confirms that only with such a long, unhurried treatment is it possible in most cases to achieve high and middle degree of therapeutic efficacy.

high the degree of therapeutic effectiveness here is found in fairly stable compensations and remissions, containing psychotherapeutically educated creative, inspired uplift and the ability to resist, thanks to this, internal and external difficulties, an almost unfailing ability to soften, enlighten oneself during the hours, days of deterioration by certain creativity, noticeable the rise of the social curve of life with a clear, conscious sense of one's useful involvement in the life of society and the conviction that, basically, these changes are due precisely to this long-term Therapy of creative self-expression. There is also a desire to help “sufferers” like themselves with creativity in the way that they helped themselves.

Medium the degree of effectiveness is expressed in a more or less stable improvement, in which the patient is able to significantly alleviate his disorders by developed ways of creative self-expression against the background of a noticeable (generally) rise in the social curve of life. Experiencing from time to time a bright feeling of his social usefulness, the patient is convinced that all these beneficial changes in the state are due to a new, creative style of his life.

Malaya the degree of effectiveness is an unstable improvement, during which the patient gets the impression that the painful is able to recede precisely in the process of creative self-expression, the hope is strengthened that everything will be better. Feeling clearly now at least "crumbs" of his social usefulness, the patient is drawn to creativity.

The effectiveness of Creative Expression Therapy is primarily evaluated clinically. Attempts to "measure" the effectiveness of our psychological methods here (especially in cases of schizophrenia and psychopathy) are unreliable. So, for example, with a clear and long-term improvement, established clinically, socially, the MMPI profile often remains the same.

In cases of chronic alcoholism, the effectiveness of treatment is assessed by the generally accepted method or (with long-term outpatient management of patients in an anti-alcohol club) by the total number of “sober” able-bodied months, days a year.

As an aid to evaluating the effectiveness of Creative Expression Therapy, this questionnaire is provided in which patients are asked to underline what they believe to be true.

1. In the process of our treatment, thanks to him, you have specific creative activities, with which you can:

Reliably get out of painful mood disorders

Significantly alleviate your frustrations

Improve your condition a little.

2. You experience a definite improvement in general:

In the last 3 months

In the last six months

During the last year

Last years (2, 3, 4, 5, 6, 7, 8, 9, 10)

3. You attribute this improvement to our individual and group meetings:

Fully

Mainly

only partly

4. Your improvement is mainly due to favorable life circumstances that do not depend on treatment:

5. Are you convinced that your condition has generally improved due to treatment, although the circumstances of your life have become more difficult:

6. Due to the fact that in the course of this treatment your condition has seriously improved, you want to help people with experiences, disorders similar to yours in this way (or are already trying to do this):

7. Concrete, official facts show that, thanks to our treatment, you are increasingly bringing social benefits:

8. You experience, thanks to our treatment (or - regardless of it, in your opinion), a creative upsurge, a desire to work spiritually:

Almost permanent

By the times

Only occasionally

9. Thanks to our treatment, it has become much easier for you to cope with your spiritual and life difficulties:

10. You are sure that you have become more socially useful to yourself, although this is not expressed in official data (position, salary, etc.):

11. In the process of treatment, the hope arose and strengthened that you would get better and better:

12. Thanks to the treatment, a distinct impression arose that mental difficulties were receding, weakening in creativity:

The data of this questionnaire should be interpreted clinically with caution (especially in cases of schizophrenia), comparing them with the actual state of the patient, his objective success in life, information from relatives, etc.

Therapy with creative self-expression, with all the kaleidoscopic multicolor of its means (studying characters, writing stories, poems, painting, communication, for example, with dioecious and stinging nettles, with antiquities, books, toys of your childhood, the starry sky, penetrating slow reading, for example, Nekrasov , collecting coins, searching for beauty even in an earthworm, and an endless variety of other similar activities) - must remain in all its details clinical, i.e. constantly conform to the clinic, personal soil, so as not to turn into psychological attempts at a violent "reconstruction" of the personality or into entertaining pranks that can even hurt. In groups of creative self-expression, patients with schizophrenia are treated together with psychopaths, often becoming friends with each other, thanks to the defensiveness that unites them. However, this defensiveness is clinically different and the treatment remains clinically differentiated (according to the nosological affiliation), even in the group. So, if a psychasthenic in the process of treatment needs detailed scientific and medical information and all kinds of sensual revival, then the asthenic must be given more psychotherapeutic care that affirms him in life, healingly elevating the soul of artistic emotion. The defensive cycloid should be humorously encouraged, relying on his tendency to believe in the authority of the doctor, to lead him through creativity, first of all, to his characteristic living practical activity (professional and social). The defensive schizoid should try to help him apply his autism in symbolic-philosophical art, philosophy, physics, mathematics, etc., for the public good, thus gently leading him away from a possible painful immersion in mysticism. Let the defensive epileptoid use in the name of good, for example, in the fight against hooligans, his dysphoric tension, authoritarianism, and the defensive-hysterical patient will find a useful use of his beautiful demonstrativeness, anancaste - his scrupulousness. We will not be able to significantly help a patient with schizophrenia without a special kind of emotional contact (Burno M.E., 1985). We are trying to spiritually revive patients with alcoholism, encourage them to be creative - also in accordance with their premorbid personality, in accordance with what is left of the personality in the process of alcoholic coarsening, decline. At the same time, we constantly strengthen the teetotal attitude in them - including by “artistic and psychotherapeutic” methods (writing stories, poems, drawing - on the bitter topics of the former drunken life, analyzing the play of anti-alcohol content, in which, perhaps, the patients themselves play roles, and etc. ). In accordance with personal characteristics, we work prophylactically and with healthy people in “risk groups”, in sobriety clubs.

Each patient and healthy person with mental difficulties will eventually, with the help of a psychotherapist, his assistants and his comrades in the group, feel, realize his own characteristics, for example, in his own stories, slides on the screen, etc. - in order to learn your strong, your way in life.

Creative self-expression therapy involves personal contact with a doctor, psychologist, paramedic, nurse. This means a keen interest in the personality of a patient or a healthy person, an interest in his work and everyday affairs, as if not related to mood disorders, symptoms, the ability to sincerely sympathize, experience, i.e. everything that excludes the feeling of a “guinea pig” that often arises in a person who finds himself in a therapeutic or prophylactic formal environment. At the same time, for the success of the business, there should not be in the full, vital sense of friendly (or, even more so, lovers) relations, there should be (without any falsehood!) That thin, invisible distance on which psychotherapeutic (psychoprophylactic) art is kept, those. that beneficent "artificiality" that distinguishes art (including psychotherapeutic art) from life itself.

This personal contact has its own characteristics in accordance with the clinic or healthy characterological properties.

Similar posts