Foreign literature review. Foreign literature - complete review

Was the legendary blind singer from Asia Minor the author of these epic tales or just a celebrated performer? There are different points of view on this matter. The poems were probably composed by many folk singers over several generations. Homer may have combined the disparate songs into a single cycle, doing the work of an editor. It is possible that individual fragments are the fruit of his

individual creativity. The “Homeric question” has been debated for over two hundred years, but none of the scientists denies that Homer owes exceptional credit for the dissemination of the ancient epic.

« Iliad"The poem is named because the second name of Troy was Ilion, located on the coast of Asia Minor. For a long time it was believed that the city was just a poetic fiction. However, Heinrich Schliemann's excavations showed that the siege of the city of Troy by the Greeks could well be a historical fact. Today, some of the finds of the German archaeologist can be seen in the exhibition of the State Museum of Fine Arts named after A.S. Pushkin. The twenty-four songs of the Iliad recount the events that occurred during the forty-nine days of the last, tenth, year of the war.

In the poem "Iliad" there are two grandiose stages: the besieged Troy and the camp of the besieging Greeks. The epic tale embodies the struggle of equals, while the heroes are positioned symmetrically. The eldest son of the Trojan king Priam, Hector, is not inferior in courage to Achilles, from whom he is destined to die. He is equally skilled in all military techniques. Note that the battle narrative includes a whole series of fights. In single combat with Achilles' friend Patroclus, Hector dealt him a fatal blow and took away from him the armor that belonged to Achilles. Achilles must avenge the death of his friend. Hephaestus forges him a shield, which depicts land and seas, cities and villages, vineyards and pastures, everyday life and festivals. The image on the shield is symbolic, because it includes everything that the valiant Greek knight protects.

Events " Odyssey"are dated to the tenth year after the end of the Trojan War. All the victors returned to their cities, others, like Agamemnon, had already died. Only Odysseus cannot return to his island of Ithaca. This is prevented by Poseidon, who was angry with Odysseus for blinding his son the Cyclops Polyphemus.

Odysseus must return to Ithaca at all costs, where his parents, wife Penelope and son Telemachus are waiting for him. The Greeks were patriots; isolation from their homeland for Odysseus was tantamount to death.

On the way to the hero's home, trials await (episodes in the cave of Polyphemus, sailing past the island of Sirens and the monsters Scylla and Charybdis) and temptations - the love of the nymph Calypso and princess Nausicaa. Odysseus, thanks to his cunning and courage, emerges victorious in all dramatic conflicts.

The second plot motif of the Odyssey is associated with the image of the faithful Penelope, who waits for her husband for twenty years, by subterfuge rejecting the advances of those who want to share her bed and the royal throne.

The third storyline is dedicated to their son Telemacus, who goes in search of his father.

At the end of the poem, all the characters are united. The unrecognized Odysseus, together with Telemachus, expels uninvited guests - the suitors of his wife, who joyfully greets him.

Classical period Greek art and literature dates back to the 5th century. and coincides with the highest flowering of slave-owning democracy. Having won the Greco-Persian Wars (500-449), the city-states, united in an alliance led by Athens, defended their independence from Persian rule. This contributed to the development of trade and crafts, as well as the rise of morale and patriotism.

The largest theater was located in Megapol, it accommodated 44 thousand people.

The participation of the choir in the tragedy allows us to identify the genesis of the tragedy. The word "tragedy" itself means goat's song and also points to the origin of the dramatic genre. The tragedy arose from the choral performance of dithyrambs in honor of the god Dionysus, who was also called Bacchus. In the fall, the Greeks, having harvested grapes, made new wine and tasted it (diluted with water!), organized games in honor of the patron saint of winemaking. The satyrs and bacchantes who accompanied Dionysus dressed themselves in goat skins and stained their faces with grape marc. The one who was entrusted with the role of Dionysus took the lead, entering into dialogue with the choir. The procession was accompanied by riotous dancing and singing. Dialogue could obviously take place between individual actors, in any case, a dramatic performance - a tragedy - was born from the dialogue.

In tragedy, the hero entered into a duel with superpersonal forces. He invariably found himself defeated, but in the duel with fate his dignity and strength of resistance to the will of the gods were revealed.

Aeschylus (525-456)- the father of ancient Greek tragedy. An aristocrat and warrior, he took part in the battles with the Persians at Marathon and Salamis. He was the author of about 90 works, of which 7 have come down to us. In the tragedy “Oresteia”, which consisted of three parts “Agamemnon”, “Choephora”, “Eumenides”, he spoke about the sinister crimes of the Atrides family, about the murder of the leader of the Achaean army of his wife Clytemnestra, the cruel reprisal of children against their mother and the revenge of the gods on Orestes for his crime. The main conflict of the tragedy is not family, but historical.

In tragedy "Prometheus Bound" For the first time in world culture, Aeschylus recreated the image of a tyrant fighter, bringing people the light of truth. Aeschylus interprets everything that human civilization had achieved by that time as the gift of Prometheus. In the central monologue, the tragic hero speaks about himself and about people:

Sophocles (496-406) wrote 120 works, 7 tragedies have reached us. The son of a wealthy gunsmith from the Athens suburb of Colon, He received an excellent education, took an active part in the political life of Athens, and was a friend of Pericles. He won 24 victories in playwriting competitions. The most famous dramatic works of Sophocles are associated with the Theban cycle of myths. In tragedy "Oedipus the King" the hero, unknowingly, became the killer of his father and the husband of his mother. The gods send a terrible pestilence to the city of Thebes, because a regicide lives here. Oedipus, who became the ruler of Thebes, promises to punish the criminal, but soon becomes convinced of his own guilt. The action of the tragedy develops retrospectively: from the present to the past. People close to Oedipus, when suspicion of his own guilt crept in, convince him that he could not have committed the crime. But the more evidence they provide that it is impossible for him to commit crimes, the stronger his confidence: he himself is guilty. The tragedy of Oedipus consists of an unconsciously committed crime and a consciously accepted punishment. Oedipus was sighted, but did not know what he was doing. Punishing himself, he gouges out his eyes and leaves Thebes, then settles in Colon. The land that gives shelter to a repentant sinner is under the protection of the gods. This is the main idea of ​​the tragedy “Oedipus at Colonus”.

In tragedy "Antigone" a conflict arises between the heirs of Oedipus. Two sons of Oedipus, Eteocles and Polyneices, died in the fratricidal war. The new ruler of Thebes, Creon, prohibits, on pain of death, the burial of Polyneices, who went to war against his hometown. Creon issues this law with the best intentions, wanting to stop chaos and anarchy. Oedipus' daughter Antigone, risking her life, disobeyed the ruler and buried her brother's body. Sophocles in the tragedy “Antigone” not only glorifies the heroine’s courage and loyalty to duty, but also confronts the eternal moral laws that humanity has developed throughout history with the willfulness of rulers who violate the world order.

Due to the large number of studies, we will focus only on the main areas of psychotherapy in children, comparing them with areas of psychotherapy in adults.

At the end of the 19th - beginning of the 20th centuries. The greatest importance in psychotherapy for adults is given to methods of hypnosuggestive influence (Bernheim N., 1910; Moll A., 1909). In children, suggestion is mainly used, when the doctor, in a directive form that does not tolerate objections and doubts, prescribes one or another course of action that promotes recovery, and in the same form gives pedagogical recommendations to the parents of a sick child (Toma F., 1911). In the 1950s, there was renewed interest in hypnotherapy for children. Its harmlessness and effectiveness are emphasized not only for emotional, but also for some organic disorders (Veldeshi F.A., 1964, 1965).

The art of persuasion, which underlies rational psychotherapy in adults, involves proving, through logical conclusions, the error of the patient’s judgments and prescribing the appropriate course of action (Dubois, 1912). The same applies to children's practice and to work with parents, usually in the form of medical and pedagogical influence (Finn-Scott M., 1930). Subsequently, rational psychotherapy underwent a number of changes, mainly due to the inclusion of elements of discussion, i.e., the development of two-way contact between the doctor and the patient.

The founder of the school of individual psychology, A. Adler (1928, 1930), made a significant contribution to the development of rational psychotherapy for neuroses and characterological disorders in children. In his opinion, behavioral motivation based on feelings of inferiority is the center of a neurotic personality. The neurotic character aims at limitless compensation for a reduced sense of personality, primarily in terms of gender identity, which is expressed, especially in boys, by protest reactions, negative behavior and stubbornness. At the same time, the child, with his weakness and dependence, tries to direct the care of others to himself. Both lines of behavior guarantee compensation for a reduced sense of personality and allow one to get rid of the demands of life. This is the fictitious, predetermining goal of the neurotic, his life position. Neurosis is thus regarded not only as a disease, but also as a kind of “trick”, a “dominant fiction”. Despite all the value of these conclusions, one cannot help but see in them a one-sided refraction of the problem of neuroses.

In the system of psychotherapy, A. Adler pays special attention to the correction of effeminacy in the character of children, which, like the feeling of physical inferiority, is considered the starting point for painful personality development. Rebuilding the relationship (position) of children with neuroses in a relatively short period of time compared to psychoanalysis, A. Adler appeals to consciousness, self-esteem, clearly explains the causal relationship between characterological and neurotic manifestations, uses goal and perspective as the basis for changing the individualistic position, Children's interest in “masculine” professions is widely attracted as a means of developing appropriate character traits. Focused discussions with parents to change their relationships and organizing joint discussions between parents and teachers are worthy of attention.

The psychoanalytic teaching of S. Freud played a historical role in the diagnosis and psychotherapy of neuroses. Considering mental processes to be unconscious, and conscious processes only as individual manifestations of mental life, he attributed to sexual desires a predetermining role as the cause of nervous and mental illnesses. In his opinion, the pathogenesis of neuroses lies in the repression from consciousness into the sphere of the unconscious of affectively colored sexual experiences of the first years of childhood, represented by the “Oedipus complex” and the internal conflict between instinctive and social demands.

Subsequently, S. Freud more than once clarifies that “a person becomes ill due to the conflict between the demands of instinctive life and the resistance that arises within a person against this” /6/.

Behind the external manifestations of the disease, S. Freud finds unconscious driving forces and, in connection with this, regards the symptoms of neurosis as an unconscious expression of what was previously the goal. Therefore, he admits that in the interpretation of the data obtained there is no need to look for the evidence that a clinical psychiatrist is looking for, since the facts should be considered as symbols of previously experienced, primarily in terms of sexual development and the “Oedipus complex.” Explaining symptoms as an indirect expression of unconscious and incompatible needs, S. Freud considers the task of psychoanalysis to be the discovery in the “meaningless” ideas and “groundless” actions of the present of the past situation in which these ideas were justified and the actions served the purpose. To do this, the analyst does not seek to introduce anything new, but only takes away and eliminates what obscures the main meaning of the disease. He is a dispassionate observer, deliberately distant from the patient, a kind of screen for expressing his feelings in the form of free associations. In the process of long-term treatment and often daily meetings, the patient involuntarily transfers onto the analyst his infantile-neurotic patterns of family relationships, that is, friendly, hostile or ambivalent feelings that he previously showed towards his parents or other persons who played an important role in his life. The meaning of transference is that it manifests an attitude towards the person with whom the analyst is subconsciously identified. As a result of projections of relationships of the “child-parent” type, transfer neurosis arises, in which the initial pathogenetic conflicts of past family relationships are duplicated, but with a lesser degree of intensity. Since the analyst, in contrast to these feelings, remains emotionally uninvolved and an impassive observer, the patient’s affective tension increases, hostility towards the analyst and resistance to continuing treatment appear. These feelings are examined objectively with the patient, and it is explained to him how his feelings in the present grow from previous experiences. Thus, in the process of psychoanalysis, the patient transfers images of his family to the analyst, whose main function is to provide conditions for the development of transference neurosis and its subsequent interpretation with a proper assessment of resistance. At the same time, the analyst tries to penetrate the patient's defense mechanisms in order to make him aware of his own anxiety and hidden conflicts, because only then can they be dealt with rationally. This is a slow process, as too rapid awareness may be unnecessarily traumatic for the patient and result in increased rather than decreased anxiety.

In psychoanalysis there is no guidance for the patient, his education, or active change in relationships. It is believed that psychosynthesis in a patient, if the necessary conditions are created for this in the form of “decomposition” of symptoms and the elimination of resistance, occurs without the intervention of the analyst, automatically and inevitably. If awareness of the repressed is the goal of psychoanalysis, then its peak is the resolution of the “Oedipus complex,” which means the highest integration of the personality, the predominance of “I” over “it.” Healing through awareness or liberation of repressed drives is the essence of the mechanism of catharsis (purification).

The main concepts in psychoanalysis as a therapeutic method are free associations, transference and resistance. A distinction must be made between the theoretical concepts of psychoanalysis, that is, the interpretation of the data obtained, and the practical techniques of examination and treatment. If the interpretation of data and the starting points of psychoanalysis are considered by many researchers to be tendentious and often do not meet the criteria of clinical reality, then diagnostic methods, as well as a thoughtful, unhurried, serious approach to the experiences of a neurotic and taking into account his relationship with the doctor, left a deep mark in the future development of foreign psychotherapy.

Psychoanalysis is most vulnerable when it goes beyond the boundaries of psychiatry, and this often gives rise to fair criticism. If we turn only to the clinic of neuroses, it turns out that indeed unconscious pathological motivation can largely predetermine the behavior of patients with neurosis, at least in terms of the creation of involuntary defensive attitudes. It will also be true that a patient with neurosis, unlike a healthy person, often lives in his own subjective, irrational-affective world, which for him is often more significant than the real world. However, these variations in psychoanalysis turn into dogma, which prevents the doctor from changing his view of the patient in the process of treating him.

In our observations, phenomena resembling transference do not occur so often, apparently due to a different psychotherapy strategy than in psychoanalysis. For the most part, they occur in single-parent or conflict families, when the doctor involuntarily fills the unsatisfied need for communication with one or another family member. More frequent transference in adolescence and adolescence, primarily in hysterical neurosis, is explained by the need to achieve recognition from family and peers in relations with a doctor.

Is orthodox psychoanalysis a directive method of psychotherapy? This question might cause bewilderment, but, in our opinion, the classical forms of hypnosuggestive therapy, rational psychotherapy and psychoanalysis have something in common, no matter how opposite they may be in appearance. This commonality consists in the visible, as in suggestive and rational psychotherapy, and invisible, as in psychoanalysis, the prescription of a certain, pre-formed way of thinking to the patient. Such a prescription is often of a directive nature and represents, to one degree or another, a cast of the doctor’s thinking. In addition to the “obligation” to think and act in a certain way (in psychoanalysis this is achieved once and for all by a given interpretation of the data obtained), relationships with all three tactics of psychotherapy are built according to the type of one-way “doctor-patient” connection. What psychoanalysis has in common with rational psychotherapy is the suggestive effect of awareness, for which the patient is directly or subtly prepared and which is expected as something capable of “opening his eyes” and changing his personality. But if in rational psychotherapy there is an active restructuring of relationships under the guidance of a doctor, then in psychoanalysis the patient must do this himself under the supervision of a doctor.

S. Freud, being a keen observer, noticed many features of child development that were unknown or ignored before him. These include child sexuality. But its interpretation in the form of the “Oedipus complex” as the only source of neurosis requires explanation. Indeed, children aged 4-6 years may experience something resembling sexual attraction, but it is not specifically directed towards a parent of the opposite sex, but can manifest itself in the form of specific sensations during affection from adults and games with peers. It should be added that sexual development in children suffering from neuroses is somewhat inhibited. There are many reasons for this, including “sexless” upbringing on the part of parents and repressive measures against any manifestations of sexual interest that are natural for children. Masturbation in preschool children is also rarely observed in our cases (6%). Inhibition of sexual development is one of the expressions of mild disturbances in the development of the body diagram in children with neuroses, when they feel their body worse than their healthy peers and coordinate their actions. There are reasons for this, and among them are excessive intellectual stimulation, restrictions on physical activity, general, nervous and somatic weakness.

As is known, the structure of the “Oedipus complex” includes the libidinal attachment of children aged 5 years to a parent of the opposite sex, the resulting competition or hostility towards the parent of the same sex and, as a consequence, the repression of incestuous experiences into dreams, feelings of guilt and anxiety.

In 1978, we conducted an extensive study (961 patients 3-16 years old without neuropsychiatric disorders) to study the age and gender characteristics of children’s identification with their parents. It turned out that the peak of identification, as identifying oneself with a parent of the same sex, in boys and girls is observed precisely at the age of 5-6 years. By this age, the necessary emotional and cognitive prerequisites for identification are created in the form of the development of the ability to empathize and take a role, and the need for gender-appropriate behavior in communication with peers, the standard of which is the parent of the same sex, develops. Identification with him is associated with emotionally warm relationships, especially among girls. The foregoing allows us to conclude that children at the studied age, imagining themselves in the place of a parent of the same sex and identifying themselves with him, also experience the need to imitate his attitude towards a parent of the other sex, i.e. boys, just like the father , want to be “married” to their mother, and girls want to be “married” to their father. Consequently, the parent of the same sex is not an object of hostility, but an object of imitation and authority. We see that S. Freud expanded the sphere of the sexual, essentially replacing with it the emotional and cognitive sphere of personality development, while they all act in unity and mark a certain maturity of genetic and socially determined personal development by 5-6 years.

S. Freud did not specifically engage in psychoanalysis of children. Classical psychoanalysis in children in the 20-30s is represented by the studies of N. Huq-Helmuth, M. Klein and A. Freud. If M. Klein conducts analysis without intervention and guidance, then N. Huq-Helmuth and A. Freud carry out, if necessary, active management of the patient, changing his relationships and re-education.

N. Huq-Helmuth sees the task of education “in the ability to find the proper measure in encouraging the development of some drives and in inhibiting others” /7/. Emphasizing respect for the natural course of child development and the pathogenic significance of an insoluble internal conflict, she is the first to practice medical and pedagogical consultations on educational issues, the purpose of which is to alleviate the tense relationship between parent and child. The technique of psychoanalysis itself remains unchanged, even down to the use of a couch during the session.

A. Freud derives all childhood conflicts from the process of “maturation”. She eliminates manifestations of neurotic inhibition through emotional contact with children and interpretation of their behavior in play, for which they are encouraged to give an account of everything. The analyst's authority is recognized as superior to that of the parents and he is expected to guide the child. The latter is feasible when the child has a clear awareness of his “defect” and a desire to get rid of it. Children's drawings are also used for analysis (Freud A., 1971).

M. Klein in the 30s associated the origin of neuroses with depressive reactions when interacting with the mother in the first year of life, masturbatory fantasies and fear. The latter is derived from masturbatory fantasies, fear of castration and the Oedipus complex. The development in the process of analyzing children of a transference neurosis similar to adults is implied, but the method of free associations is replaced by the spontaneous activity of children in play with toys that reproduce the real world. The game itself is interpreted psychoanalytically, and the sexual symbolism of one or another game action is literally explained to the child. M. Klein’s method of symbolic interpretation of play activity is further referred to as play therapy.

A. Freud and M. Klein in the 20-30s, G. Pearson (1949) and I. Kessler (1966) for a better understanding of the child’s conflicts, observe the game in order to give an interpretation after it. In contrast, D. Levy (1939) uses observation of the game as a precondition for its planning and participation in it. For all these researchers, play is interpreted and organized in a certain way, so this direction of play therapy is called directive.

The subsequent development of psychoanalysis follows the path of reducing its duration (already with M. Klein the duration of the analysis was not several years, but 8-10 months with 4-5 visits per week) and providing directed psychoanalytic guidance to the education process. In 1939, at the IX Congress of Psychoanalysts of French Language Countries, the concept of family neurosis was formulated. The child's neurosis is considered as a product and revealing factor of family anomalies. The need to analyze children together with their parents, especially the mother, is noted. Thus, psychoanalysis began to go beyond just individual work with the child, when parents were considered only as reflections on the screen of his associations (Duche I., 1967). Currently, psychoanalysis is no longer considered the ultimate truth, but by limiting its expansiveness and preserving its own field, it is considered useful in a number of cases. One of the most prominent representatives of modern psychoanalysis, E. Erikson (1968), agreeing with the classical provisions of psychoanalysis about achieving greater mobility of the “it”, tolerance of the “super-ego” and the ability of the “I” to synthesize, adds that the analysis of the “I” should take place in connection with historical changes that dominated the period of childhood and adolescence, and social adaptation in adulthood.

Psychoanalytic and non-psychoanalytic methods of treating neuroses, using a number of general principles, are combined under the name psychodynamic therapy. It is aimed at eliminating the causes of neurosis rather than its symptoms. In the psychodynamic approach, the main determinants of neurotic behavior are intrapsychic processes and subconscious motives, and the main concepts are anxiety and defense. The problem, as we have already seen, is not that they exist, but how the mechanisms of their origin are interpreted. Such well-known foreign psychiatrists of a non-psychoanalytic direction as K. Norney (1950) and N. Sullivan (1953) see in anxiety the general dynamic basis of neuroses and derive it from the experience of early interpersonal relationships. It is believed that psychoneurotic personality disorders arise from attempts to cope with specific internal psychological problems, which the individual cannot overcome without tension or damage to psychological mechanisms. Symptoms of these disorders consist either of direct sensations and expressions of anxiety, or of automatic attempts to control it through defense mechanisms such as conversion, dissociation, repression, the formation of phobias or obsessive thoughts and actions. Neurosis, according to K. Norneu, occurs when the potential for development collapses or is blocked by “internal pressure.”

Awareness of the significance of emotions, drives and other irrational components of the psyche in the origin of neurosis is the goal of psychodynamic therapy in all its variants. Therefore, it is defined primarily as an insight (intuitive) type of therapy. But if psychoanalysis is aimed mainly at reconstructing the patient’s past, then in the non-psychoanalytic psychodynamic approach more attention is paid to current dynamic processes. According to K. Norney, the goal of treatment is to help a patient with neurosis realize his real “I” and develop the possibilities of his mental growth.

In psychobiology (Mauer A., ​​1934), personality is considered as a holistic entity in the context of its historical formation, and mental disorders are studied as dynamic maladaptive reactions of an individual to tension - stress and conflict. In a casual conversation, the main attention is paid not to finding subconscious motives and mechanisms of neurotic behavior, but to actual situations and circumstances. Transference is not given any significance, and the psychiatrist strives not for the patient to relive his early experiences, but for him to understand their today's meaning. Discussion with a psychotherapist is intended to help the patient trace the origin of his disorders. Such biographical analysis also includes an examination of somatic factors and a panorama of the patient's psychosexual development. Only those facts that are understandable to the patient or that occupied a prominent place in his life experiences are discussed. After the various experiences, situations and symptoms have been analyzed and discussed, the patient is asked to reformulate them into a dynamic autobiography with motivations so that he can, if possible, understand their meaning and evolution.

The views of A. Mauer were not so widespread in the era of the dominance of psychoanalysis, but as an expression of the branch of psychodynamic therapy that is most distant from psychoanalysis, they played their role, and, in our opinion, affected the development of a systematic approach in foreign psychotherapy. (Masserman I., 1969).

The psychotherapeutic approach, based on the patient's experience and placing him at the center of interaction with the doctor, is developed in the form of relationship psychotherapy or “client-centered” psychotherapy by S. Rogers (1965). It views the unconscious and the conscious as a unity in terms of experience and perception. Neurotic disorders are explained as a consequence of unfulfilled vital needs, psychogenic blockage (“blockage”) of experience and loss of its congruence with the “I”. S. Rogers is not as concerned with the patient's past as the psychoanalyst, and does not involve transference and interpretation as active factors in psychotherapy. The focus is not so much on the connection between anxiety and defense, but on the neurotic's reduced self-image and sense of self-esteem. The relationship between a doctor and a patient (client, according to S. Rogers) is built on the principle of egalitarianism, that is, at the “person-to-person” level, and not “doctor-patient”, as in the psychoanalytic approach. What matters more is not what the doctor says, but what he is: the personality of the therapist is his main tool (Rogers S., 1965). The psychotherapist does not lead, but accompanies, participating in the patient’s direct experience, creating conditions for him to feel a sense of security; he does not think for the patient, but thinks and evaluates together with him; does not give advice and instructions, but empathically imagining himself in the patient’s place, unobtrusively contributes, through a special manner of conversation, to the development of a tendency towards actualizing the potential of his body. The lack of interference in natural development explains the use of the opposite concept of “catalysis” - facilitating, accelerating the process of self-actualization. All this does not exclude the general direction of the positive evolution of the patient, for whom conditions are created for a calm, purposeful monologue - the patient speaks and reasons as if with himself, the doctor only inserts words that indicate his interest and keeps the conversation in line with essential issues. Thus, the patient is encouraged to correctly formulate his problems and often finds a way out of the situation himself, constructing the right motive. Your own, sufficiently convincing and specific motive becomes the best incentive for activities leading to mental balance. In the process of psychotherapy, the following changes in the patient’s personality are observed: “1) the patient evolves to a state of more complete internal agreement (harmony), he is more open to his experience and less protected; 2) its perception is more realistic, more differentiated and more objective; 3) he becomes more and more capable of solving his problems; 4) his mental functioning improves and develops in an optimal sense; 5) vulnerability decreases due to increased agreement between “I” and experience; 6) positive consideration of oneself increases, and the subject increasingly perceives himself as the center of evaluation” /8/. As a result mainly of a decrease in anxiety and an increase in internal agreement, the patient can identify, experience and accept by his own means the psychogenic aspects of his disease state. As he develops the ability to respect himself, he becomes increasingly able to respect and appreciate other people.

The psychotherapeutic approach of S. Rogers has found some distribution in the practice of foreign pedagogical work, when students and teachers change roles in a game and the group acts in these conditions for some time. It should be noted that the theoretical premises of psychotherapy by S. Rogers are more developed than the practical part. A number of provisions of this psychotherapeutic approach can be found in the Socratic oral dialogic teaching method, designed for the “inner voice” of the student. The art of conversation, according to Socrates, requires starting from what the interlocutor already knows, and not suppressing him with erudition and incomprehensible truths. Socrates believed that listeners could, with his help, discover a lot of beautiful and reasonable things in themselves, however, if this was already inherent in them (Nersenyants V.S., 1977).

Relationship psychotherapy by S. Rogers has been developed in the direction of non-directive play therapy, when the psychotherapist does not interfere with the spontaneous play of children and does not interpret it, as in the directive direction discussed above, but creates an atmosphere of warmth, safety and unconditional acceptance of the patient’s feelings and thoughts with the game itself (Alien E., 1942; Axline V., 1947; Moustakas S., 1970). In this form, play therapy is considered primarily for children with long-term neurotic disorders, emotionally tense, suppressing their feelings (Alien F., 1942). Play therapy should help the child see and understand himself, his strengths and weaknesses, difficulties and successes. This is facilitated by the principles formulated by V. Axline (1947) on which the behavior of the psychotherapist is based: 1) acceptance of the child, achieved by a friendly, warm, non-suppressive manner of communication; the doctor does not show impatience, dissatisfaction or disagreement, refrains from praise and approval, which limit the freedom of the child ; 2) establishing permissibility in play, security in relationships, which allows the child to express his feelings and experiences; 3) giving him the opportunity to independently choose his line of behavior; the doctor is most often outside the game and can only sometimes direct it at the child’s request; 4) refusal to force therapy, leading to loss of contact; 5) reflection of feelings - the doctor refuses to interpret the child’s statements and actions, using his own symbols in the game. A psychotherapist is a mirror in which a child sees himself.

With this construction of therapeutic situations, children have the opportunity to act out and thereby react to their tensions, frustrations, aggressiveness and fears. By playing out these feelings, they transfer them outward, open them. By facing them face to face, children learn to control their feelings and behavior in general. According to V. Axline, as a result of play therapy, children gain the opportunity to move forward, become more independent and mature. Providing the child with maximum independence in the game, V. Axline identifies only three types of restrictions: the constant duration of the session, the ban on damaging the game material and on using the doctor as an object of aggression. S. Moustakas (1970), who worked actively with children in the 50s, considers the most important aspect of the therapeutic relationship to be the establishment of such restrictions that connect psychotherapy with reality and remind the child of his responsibility to himself and the psychotherapist. The development of positive relationships in play becomes possible only when the adult responds to the child’s feelings and sincerely believes in him. The child then moves toward expressing clear positive or negative attitudes that enable him to feel worthy and develop his real abilities. Because a child's emotional problems and symptoms are a reflection of his relationships, as they change, the problems and symptoms disappear. In his work with parents, S. Moustakas leaves all decisions to them. The received material is commented on carefully, within the framework of the parent’s feelings and thoughts. The purpose of family consultation is to help the mother and father live with the child “face to face”, but without a plan on how to study and analyze his condition. Training and active restructuring of relationships are not used, and such tactics cannot always lead to tangible psychotherapeutic results. According to our observations, non-directive play therapy can be useful as an initial, but not the main stage of the psychotherapeutic process in children.

A notable contribution to the therapeutic use of play was made by E. Erikson (1964), who considers spontaneous play a way to resolve life’s difficulties by creating model situations and mastering reality through experimentation and planning. Therefore, play seems like the most natural self-healing measure that childhood is capable of.

In the 30-40s, the development of social psychology and the ideas of J. Moreno accelerated the development of group psychotherapy. S. Slavson - the founder of group psychotherapy for children - allows you to express internal conflicts and aggressive tendencies in the group. Group catharsis opens the way to more friendly relationships and relieves anxiety, guilt and fear. For teenagers, discussion of their problems is additionally used. The doctor's tactics are situational and vary depending on group dynamics. Exceptional attention is paid to the selection of psychotherapy participants. Groups, depending on the purpose, are divided into closed (simultaneous start and end of treatment) and open (gradual replacement of participants). As a result of group psychotherapy, the ability to accept oneself and others develops, life interests expand, endurance to failures and life difficulties increases, personality maturity and “group morality” are formed (Slavson S., 1943).

N. Ginott (1961) applies group psychotherapy to characterologically inhibited children. Pointing out that it is almost impossible to avoid fear in a group, N. Ginott, like S. Slavson, reproduces situations that cause fear in the process of spontaneous and guided games and helps its playful and verbal expression. Currently, group psychotherapy has become widespread in regular schools as part of a program to help children with emotional disorders (Anderson N., Marrone R., 1977). Positive results of group psychotherapy, according to various authors, are observed in only 1/3 of cases (Abramowitz S., 1976), which is due, in our opinion, to the insufficiently critical use of indications for group psychotherapy, the use of unproductive group psychoanalytic techniques without the development of the group process speakers.

The psychotherapeutic concept of psychodrama by J. Moreno, created in the 40s, is based on the socio-psychological patterns of communication, which best meets the requirements of real life. The basis of the therapeutic effect of psychodrama is catharsis - that mental “purification” and relief that Aristotle wrote about, explaining the mechanism of action of ancient tragedy on the viewer. The source of catharsis, according to J. Moreno, is spontaneity, by which he understands the ability to adequately respond to suddenly arising circumstances. This ability is weakened in a neurotic person. He also has an imbalance between the world of reality and the world of imagination. Psychodrama, combining reality and imagination, bridges this gap. The goal of psychodrama is to create conditions under which the performance of a role will be perceived by group members as a natural expression of the self, which will relieve many of their overstrains. The main character of the psychodrama - the protagonist - portrays himself in various problematic situations. The supporting characters he appoints from among those present reflect and change the nature of his interactions. If necessary, the game director plays a similar role. According to J. Moreno, the use of an auxiliary “I” in role-playing action distinguishes psychodrama from group psychotherapy.

A psychodramatic session includes three stages: psychological warm-up, action and subsequent discussion. Warm-up is an interview and analysis of upcoming game situations, which should be relevant and interesting for the participants in the game, but not overly traumatic. The tensions that arise in psychodrama are reduced with the help of fictitious situations, changing roles and repeating the play theme. The ability to “enter” the desired role is considered in psychodrama as a means of relieving excess mental stress. At the same time, the influence of the audience - the group and those present at the session - is essential in the system of teaching adapted behavior. As a result of psychodrama, emotional response, awareness and resolution of problems occur among its participants with a simultaneous improvement in their mental state (Moreno J., 1946).

In its expanded form, classical psychodrama is used mainly among adolescents (Lebovici S., 1961). There are numerous attempts to simplify psychodrama. G. Lehmann (1968) proposes an improvisational group game of fairy tales to reduce neurotic pubertal inhibition. I. Corman (1973) and R. Gardner (1975) use dramatization in individual work with children. The psychodrama method has become widespread in socialist countries. In the GDR, in addition to G. Lehmann, it is practiced by S. Krauss, V. Scholz, M. Knopfel (1977), S. Palmer and R. Rank (1978); in Czechoslovakia M. Bouchal, D. Dufkova, M. Robes, Z. Sekaninova (1973), etc. These authors refract rhythm, pantomime, and outdoor games in a psychodramatic way.

Of the various options for psychodrama that combine it with group psychotherapy, it is worth noting the so-called kinetic psychotherapy by R. Schachter for children with neurotic and behavioral disorders who have difficulty verbally expressing their feelings. In outdoor games, children learn to more adequately express anger and other emotions. The mechanisms of psychodrama are interpreted in terms of play therapy, classical psychodrama by J. Moreno and behavioristic (behavioral) therapy (Schacter R., 1974). A number of other combinations of group psychotherapy with dramatization, rhythm and expressive, “bodily” expression by children of their feelings have been proposed, which reflects the concept of “psychomotor education” characteristic of French psychiatry (Dellaert R. et al., 1969). The psychoanalytic direction of psychodrama is most actively represented in the works of French psychiatrists. The group plays a variety of roles, including family ones. Psychotherapists (usually a man and a woman) intervene in the game only to clarify certain points and verbalize the actions of its participants. The psychoanalytic interpretation of the game consists of responding to failed stages of sexual development, transferring images of mother and father to psychotherapists, opening the “Oedipal family structure” and analyzing individual and group resistance in the treatment process (Monod M., Bosse J., 1965; Cosnier I. et al ., 1971; Testemale G., 1971).

The principle of desensitization, which forms the basis of behavior therapy, can be found in the great French educator Rousseau: “... all children are afraid of masks. I will start by showing Emil a mask with pleasant facial features, then someone will put it on his face in front of his eyes: I will start laughing, everyone will laugh, and the child along with others. Little by little I will accustom him to masks with less pleasant features and, finally, to disgusting figures. If I have maintained the gradation well, then not only will he not be afraid of the last mask, but he will laugh at it as at the first. After that, I’m not afraid that they’ll scare him with masks” /9/.

Behavioral therapy grew out of laboratory experiments on animals, and was greatly influenced by the experiments of I. P. Pavlov and V. Skinnera. Behavior therapists believe that all behavior, both normal and abnormal, is a product of what a person has learned or not learned. Therefore, neurotic disorders are considered as habits that exist in the present, and their development is not given importance. N. Eysenck (1959) states that there is no neurosis that hides a symptom, but there is simply a symptom, and if you get rid of it, you can destroy the neurosis. To the behavior therapist, all problems are pedagogical in nature. The patient learns new emotional and cognitive behavioral alternatives that must be rehearsed and experienced inside and outside the therapeutic situation. Learning eliminates the need for insight and catharsis. The couch method (in classical psychoanalysis) is replaced by the pulpit and classroom methods, and the relationship between therapist and patient resembles that between teacher and student. The behavior therapist views himself as an instrument of direct influence, intervention and control, as well as a social enhancer for the patient (Hollander M., 1975). In behavioral therapy, reward techniques are widely used, punishment is used less frequently, and the results of therapy are carefully monitored (Wolpe J., 1958; Eysenck H., 1959).

There are three main modifications of behavior therapy. With systematic desensitization - reciprocal inhibitory therapy (Wolpe J., 1958) - a list of objects of fear is compiled in advance, starting with the weakest. The patient is asked to imagine a situation that initially causes mild fear for a few minutes, and then is instructed in relaxation techniques. This process is repeated until there is complete absence of anxiety in the imaginary situation of expressed fear. In another variant, relaxation precedes the presentation of a fear stimulus, which, moreover, may be most intense at the beginning, but since the presentation of fear occurs against the background of general relaxation, its weakening (desensitization) occurs. In children, relaxation is not always possible, but the very principle of gradual and indirect presentation of fear stimuli has found a wide response, including in the treatment of school phobias, often associated with the fear of separation from the mother (Duvano I., 1962; Garvey W., Hegrenes I., 1966). A radical behavioral technique called “immersion” is described, where children are placed in an environment that causes anxiety and where they remain long enough to cope with it (Lamontague V., 1975).

Another modification of behavioral therapy aims to directly reinforce desired behavior through the use of dosed procedures of reinforcement, and less commonly, punishment. The principle of such operant conditioning was anticipated by M. Jones (1924), who showed that fear responses can be extinguished as a result of the presentation of feared objects simultaneously with another, pleasant stimulus, such as candy. Reward methods are widely used in children's practice, including in the treatment of selective mutism and in teaching mothers how to gradually eliminate fears in children (Hagman R., 1932). Another method is used in the treatment of enuresis, when in response to urination the electrical circuit is closed and awakened by the sound of an alarm clock or a weak electric shock (Eysenck H., 1959).

The next modification of behavior therapy involves the use of models, especially in preschool children. According to this method, treatment, for example, of dog phobias consists of 8 short-term periods in which fearful children watch with the help of a movie how other children approach dogs without fear and pet them (Bandura A., 1969).

To date, behavioral therapy has undergone a number of changes. There is less maximalism in it, more attention is paid to interpersonal diagnostics, psychological training of self-confidence, as well as group and family forms of therapy. Many of the techniques of behavioral therapy have become firmly established in the arsenal of modern psychotherapy, and the doctor’s ability to “cope” with fixed symptoms is no less important than their pathogenetic analysis.

The development of social psychology and social psychiatry in the 50s and 60s also influenced the development of family psychotherapy, in which emotional problems in children are studied from the point of view of the functioning of the family as a whole. The foundations of a holistic approach to the family as a unit of study and an object of treatment were formulated by N. Ackerman (1958) and I. Howells (1968), who showed that psychiatric problems of the family are not exclusively the area of ​​psychoanalysis, and even if individual assistance is provided to each of its members, then this will not yet create family psychotherapy. The latter is understood as a method of introducing the psychotherapist into the family system in order to promote the maturation of the family process. For the success of family psychotherapy, the correct choice of the primary patient is important, that is, the person who has the greatest pathogenic influence in the family. Through joint and separate interviews, the nature of family disorders is established, which is reflected in a dynamic “family diagnosis”. The point of view of N. Ackerman and I. Howells about the simultaneous treatment of parents and children by one doctor is supported by many modern researchers (Bell J., 1957; Carroll E., 1960; Buckle D., Lebovici S., 1966; Graham Ph., 1976; Minuchin S., 1974).

There are various approaches to family psychotherapy, including psychoanalysis (Grotjahn M., 1960: Ville-Bourgoin E., 1962; Berge A., 1965), behavioral therapy (Liberman R., 1970), a combination of psychoanalysis and behavioral therapy (Skynner A., 1976), group psychotherapy of various directions (Bell J., 1957; Skynner A., ​​1976), joint psychotherapy of the child and mother (Male P. et al., 1969), psychotherapy aimed at parent-child interaction (Bromwich R., 1976). Family psychotherapy can be carried out by one or two doctors working with spouses (Martin P., Bird H., 1953), and even by three specialists, if one of them is engaged in psychotherapy of children (Sandler I., 1966). Methods of indirect observation of the interaction of family members, tape and television recording of interviews are widely used. Various drawing tests are used for the purpose of psychological diagnosis of family relationships (Van Krevelen D. A., 1975). Mental health centers have become widespread to provide preventive psychological and psychiatric assistance to families who are in a crisis period of their development (Caplan G., 1964).

Modern foreign psychotherapy is characterized by the mutual penetration and complementation of various psychotherapeutic approaches, which is reflected in the difficulties of differentiated assessment of their effectiveness. This gives grounds for such a well-known psychotherapist as J. Frank (1977) to state that the choice of psychotherapy method should be subordinated to the personal style of the psychotherapist. It would be ideal if the latter, knowing all the methods of psychotherapy, could choose the most suitable one for a particular patient. Another feature of the development of foreign psychotherapy is the wider use than before of methods of education and changing relationships. In this regard, W. Spiel (1976) distinguishes between the concepts of “psychotherapy” and “education”. If psychotherapy in the narrow sense of the word consists of returning to the patient the “internal balance of the mental apparatus,” then the process of education is aimed at “ennobling” and creating the prerequisites for the purposeful development of the individual.

Comparing the achievements of foreign and domestic psychotherapy for neuroses in children, it should be noted the priority of domestic research in a number of areas of psychotherapy, primarily in hypnotherapy and group (collective) psychotherapy. The principles of medical and pedagogical work with families were also formulated earlier. In general, the medical and pedagogical aspect predominates in domestic research, while in foreign research more attention is paid to psychotherapeutic methods themselves. Much of what was achieved in Russian psychotherapy was lost in the mid-30s, when a one-sided physiological approach to the problem of neuroses and their treatment delayed the development of the psychological aspect of the problem. The situation began to improve in the 70s. The introduction of the nomenclature position of a child psychotherapist and training in this specialty will accelerate the development of child psychotherapy and the implementation of effective measures for the psychoprophylaxis of neuroses in children and adults.

Our experience of psychotherapy has been formed since the early 60s. Some of the psychotherapy methods we have independently developed have analogues in foreign experience. This applies to family psychotherapy, the use of games and groups as a therapeutic tool, and behavioral therapy techniques. The essence of our approach is not in the application of certain individual techniques, but in using them as a single psychotherapeutic complex based on the principles of domestic pathogenetic psychotherapy by V. N. Myasishchev and his school. At the same time, psychotherapy for children is not a copy of psychotherapy for adults, but an independent, clinically defined method of treating neuroses.

Psychotherapy as the main method of treating neuroses can be defined as the process of directed psychological (mental) influence of a doctor on a patient in order to restore impaired mental functions, strengthen them and develop them. In this sense, it consistently acts as a unified process of therapeutic and pedagogical measures, which does not allow the replacement of the therapeutic aspect by the pedagogical one, which is fraught with the danger of using educational measures where the elimination of painful manifestations is required.

Psychotherapy is not only the process of the doctor’s influence on the patient, but also the process of interaction between them, the dynamic, two-way nature of which is obvious in personality-oriented psychotherapy. This process includes socio-psychological mechanisms of communication, and primarily the mechanisms of interpersonal contact.

If we combine the noted aspects of psychotherapy, it will look like a personality-oriented process of interaction between a doctor and a patient, aimed at restoring and strengthening the mental unity of the patient’s personality and achieving an acceptable level of socio-psychological adaptation. Here it is important to maintain a balance between individual personal and social requirements, that is, between the requirements of the patient and the requirements of reality. At the beginning of psychotherapy, the doctor mostly proceeds from the requirements and hopes of the patient as a person, helping him to find himself, explore his capabilities and establish himself in them. As psychotherapy continues, the doctor focuses more on socially significant requirements, correcting relationships, rebuilding life position and character traits, and cultivating positive, socially acceptable personal qualities.

Psychotherapy is conventionally divided into family, individual and group, which constitutes a single pathogenetic complex, the sequence of which is determined by the clinical and personal characteristics of patients. For neurotic reactions, a short course of treatment consisting of elements of suggestive, explanatory and play psychotherapy, as well as some recommendations for parents, may be quite sufficient. Psychotherapy of patients with a chronic course of neurosis and unfavorable personality changes, as a rule, requires long-term, many months of treatment and the use of the entire complex of psychotherapeutic influences, starting with family psychotherapy. Correction of unfavorably established family relationships is a necessary condition for pathogenetically based psychotherapy. This is of particular importance in preschool age, when the family has the greatest influence on the formation of children’s personality. Parents' awareness of the causes of the child's painful condition, improvement of their mental state and restructuring of family relationships lead to the elimination of the most common source of mental trauma in children associated with conflicts in the family and improper upbringing.

Removing painful manifestations, strengthening the psyche and nervous system as a whole, restructuring the patient’s relationship with himself and others and changing his unfavorably formed character traits occur in the process of individual and group psychotherapy.

As a result of the restructuring of the relationship between parents and children, the normalization of their interpersonal relationships and the cessation of the conflict are observed. Improving the family environment creates the prerequisites for restoring the patient’s broken relationships in the social and psychological spheres of communication.

In general, the effect of psychotherapy, including its individual techniques, is derived both from the personality of the psychotherapist, his human qualities, life and professional experience, and from the personality of the patient, primarily his desire for a cure, faith in the doctor and method of treatment, and the clinical severity of the condition , characterological changes and personal capabilities.

A personality-oriented psychotherapeutic approach can be presented as interaction at the level of “personality (doctor)-personality (patient)”, and not “doctor-patient” or personality (doctor)-patient.” The most significant factor in such a system will be the doctor’s attitude towards the personality of the patient who has asked for help, and highlighting, first of all, his human qualities, and then those aspects of the personality that are affected by the disease process. The effectiveness of psychotherapy and its prognosis largely depend on what this personality is in its moral and ethical basis, how much it is changed or abnormal from the generally accepted, human point of view.

The person-oriented psychotherapeutic approach is also a situationally dynamic approach, varying depending on the specific psychotherapeutic situation. Feeling this situation and managing it in the interests of the patient’s recovery is an integral part of professional psychotherapeutic experience.

The personality of the psychotherapist, his knowledge and experience are one of the most significant factors in the success of psychotherapy. Each psychotherapist has his own range of therapeutic capabilities, which largely depends on his personal and typological characteristics. Psychotherapists with an introverted personality structure often prefer analytical, explanatory methods of psychotherapy and may be prejudiced towards its game, group and behavioral modifications, while other psychotherapists pay more attention to them.

The age of the psychotherapist is also an important parameter. Beginning doctors strive first of all to master hypnosuggestion, which rather confirms their professional ability to treat. As they age, many creative psychotherapists expand their treatment range, using a variety of psychotherapy techniques that reflect their increased life and professional experience. Each seeking psychotherapist has his own critical stage of professional development, when he thinks about his therapeutic potential and finds new approaches in psychotherapeutic communication with the patient. In this case, the psychotherapist whose age is equal to or greater than the age of the child’s parents is in the best situation. This manifested itself to a noticeable extent in our practice of family psychotherapy, when not only increased experience, but also the suggestive effect of age allowed us to achieve better results in correcting family relationships.

Of exceptional importance in psychotherapy are the art of persuasion, speaking in a clear and understandable language for the patient, self-confidence in critically reflecting on experience, as well as flexible tactics of psychotherapeutic interaction, combined with the psychotherapist’s ability to defuse and stabilize the patient’s emotional reactions. The tone of the doctor, his cheerful, optimistic attitude, opposing the pessimism and skepticism of the patient, sincerity and spontaneity in treatment, encouraging the patient’s activity in treatment are also essential in psychotherapy.

Within certain limits, the doctor does not interfere with the expression of the patient’s aggressive fantasies and thoughts; he accepts him as he is, providing an opportunity for emotional response to internal tensions in order to direct them in a more acceptable direction and develop self-control abilities.

In most cases, the doctor acts as an object of imitation and authority for the patient. You need to skillfully use this, without making the patient dependent on yourself and without undermining the authority of the parents. The psychotherapist must be warm, kind and sympathetic in order to understand the patient's weaknesses, but strong enough to be able to tolerate and eliminate them.

Being with the patient in a situation of interpersonal contact, completely trusting him and believing in his human qualities, the doctor helps to strengthen the patient’s confidence in himself, in his capabilities and abilities. Thus, the doctor increases his sense of personal value, balancing it with the requirements of the surrounding reality.

The psychotherapist proceeds from the concept of the fundamental reversibility of neurotic disorders and strives, other things being equal, to apply those methods of psychotherapy that resonate more with the patient. The optimal option is to achieve psychotherapeutic resonance when the techniques used correspond to the patient’s preliminary expectations regarding the method of his treatment. Then the psychotherapeutic effect finds the most active positive emotional response in him. In turn, the doctor’s timely and even somewhat anticipatory emotional response to the patient’s needs and requests, to his way of responding in the process of psychotherapy, is a model of human responsiveness and contributes to the formation of similar emotional responses in patients. Imbued with the patient’s feelings and thoughts, the psychotherapist often experiences the treatment situation to a greater extent than the patient himself, while simultaneously managing the treatment process and relationships in it.

The need to remember the individual uniqueness of each patient, his dynamics in the process of psychotherapy creates mental stress for the doctor, not to mention a significant waste of his nervous energy. Therefore, he can retain in his professional memory the experience of working with only a limited number of patients. It is difficult to give specific figures here due to their variability depending on the individual characteristics of psychotherapists. In our opinion, it is possible to effectively treat no more than 10-12 patients simultaneously in the process of individual psychotherapy, the same number in group and hypnosuggestive psychotherapy, i.e., in the end, no more than 30-40 patients. A significantly larger number of them may occur with follow-up observation and supportive treatment.

Psychotherapy is complicated by such manifestations of the doctor’s personality as insincerity, playfulness, aplomb, distrust, bias, anxiety and conflict, which can seriously undermine psychotherapeutic communication with the patient. Insincerity is perceived by the patient as a “mask”, reminds of the traumatic experience of relationships and causes distrust in the words and actions of the doctor. In preschoolers, this is accompanied by anxiety if the doctor deliberately treats them like children. This attitude is automatically associated with the cunning and treacherous images of fairy tales and increases, rather than reduces, anxiety in the doctor's office. In adolescents, psychotherapeutic contact is complicated by the doctor’s excessive familiarity, imposition of opinions, and lack of discussion of issues of concern. A well-produced doctor’s voice without deliberate amplification or muffledness, and especially without shades of irritation and threat, moderately expressive facial expressions, plastic movements and the entire manner of behavior have an impact on the patient through the inductive mechanism of imitation, reviving his facial expressions, increasing tone and developing the ability to express himself.

As a result, a number of principles of psychotherapy can be formulated as follows:

1) conduct an appointment without a medical gown and be just a person for the child;

2) leave the table, approach the child and directly contact him;

3) play together and be a partner for him;

4) proceed from the feelings and desires of the child to a greater extent than from one’s own ideas and professional aplomb, burdened by medical experience, elevated to the degree of authoritarian assertion of power over the patient;

5) do not rush into re-educating a child, not knowing what he is like and what he is capable of;

6) do not forget that, in addition to the doctor, there are also parents who are ready to both place the child completely in the care of the doctor and jealously perceive his successes in the contact and development of the child;

7) believe in yourself and your ability to heal before convincing the child to believe in yourself and the possibility of healing.

Foreign literature of the 20th century, exploring the human phenomenon, combines various artistic styles and philosophical solutions. American writer D. D. Salinger(b. 1919) in the story “ Catcher in the rye(1951) explores the phenomenon of young man's alienation. Holden Caulfield, faced with reality, experiences emotional drama. The hero is shocked by the insincerity of people and plunged into a state of internal chaos. He sees salvation in the immaculate world of childhood and dreams of saving children from falling into the world of vulgar everyday life of adults.

Thematically, Salinger's work correlates with the novel Heinrich Bell(1917—1985) " Through the eyes of a clown"(1963). Lonely and having lost faith in the possibility of human mutual understanding, Hans Schnier decides to stage a clownish protest. At the end of the novel, he, despairing of the possibility of finding understanding from those around him, sits on the steps of the Bonn station, puts his hat in front of him and sings funny couplets. Rebellion against the world is perceived as the tragic clownery of a person who has not found himself in the world of selfish bourgeois morality.

A different semantic tone characterizes the story E. Hemingway « The Old Man and the Sea"(1952). At the center of the story-parable is the figure of the old fisherman Santiago. The author emphasizes that this is not an ordinary old man, this is a man who lives according to the laws of a special ethical code that contrasts heroism with moods of despair and despondency: “Man was not created to suffer defeat.” The author’s humanistic formula sounds like a concentrated expression of optimism: “A person can be destroyed, but he cannot be defeated.” It would seem that the story ends with the defeat of the hero: the sharks ate the fish he caught, but in terms of philosophical generalization, the ending demonstrates the idea of ​​​​man's invincibility, his ability to overcome any difficulties.

This topic is important in post-war literature, when sentiments of pessimism intensified and many writers representing existentialist direction, emphasized the futility of human efforts to overcome the dictates of world tragedy. Hemingway proves the thesis: life is a struggle, thereby asserting the limitless possibilities of the individual.

A special place in foreign literature of the 20th century is occupied by image of a book and numerous motives associated with it. Time leaves chronicles, legends, books, creations of the human spirit to people. Time erases chronicles, legends, books... A dramatic search leads to the comprehension of the truth, systems of evidence become obsolete, once pressing problems give way to new ones, and they soon become a thing of the past. Understanding and acceptance of existence is replaced by mystical horror of it.

However, there is something that allows a person to establish himself in the stability of spiritual values, to resurrect entire eras and the diversity of individual life manifestations. This is a book. A book, embodied memory, reveals the history of thoughts and feelings, eliminates the boundary between past and future, turns a person to absolute truths, and directs him to immortality. Overcoming the fear of death is an impulse to creativity. Identity and continuity are the main forms of embodiment of culture and man, striving to understand the mystery of existence and man through an idea, image, word.

Truth can be discovered logically, or it can also be accidentally perceived through spiritual intuition. The book combines logic and intuition, it complicates reality, endows it with a phantasmagoric character, from the point of view of ordinary consciousness.

In the short story, a classic of Japanese literature Akutagawa Ryunosuke(1892-1927) " Thicket“Various options for deciphering the mysterious incident are presented. A murder has occurred in the mountains, witnesses and suspects testify, hypotheses are put forward, and the killer confesses to his crime. The plot is formally completed and, it would seem, it’s time to put an end to the work, but the author completes the short story with two chapters: “What the woman said in confession in the Kiyomizu temple,” in which she confesses to the murder of her husband, and “What the spirit of the murdered man said through the mouth of the soothsayer,” where the reader learns that a man took his own life. It is unknown who is telling the truth.

Where is the clue? The logic of cause-and-effect relationships turns out to be ineffective for interpreting the parable; the code of meaning is moved beyond the private literary text and is addressed to cultural memory, according to X. L. Borges, the “garden of forking paths,” where each marks its own direction in commenting on the mystery, gives its own version Life, the key to understanding Death.

Central theme of the novel Gabriel Garcia Marquez(b. 1928) " One Hundred Years of Solitude"(1966) - the absence of boundaries between life and death. The mythological idea of ​​the permeability of existence into non-existence becomes the general law of existence.

Marquez plays on the classic plot of human loneliness, giving it the symbolic meaning of universal alienation: a hundred years of solitude. The Universe - Macondo - house - room - a chain of allegories, symbolic meanings commenting on the motive of boundless nostalgia of culture for a harmonious, ordered cosmos, stoically indifferent to death. Marquez's heroes can pass away and remain in oblivion until they are needed.

Marquez's plot is strictly determined by the history of the family, thematically close to the “ancestral” sagas of Galsworthy and Zola. The difference between the Colombian writer and his predecessors lies not in the saturation of the work with folklore elements, but, first of all, in the special organization of artistic time. It can develop in the past and future, creating a sense of continuity, constantly intrudes into ongoing history, and predicts destinies.

The phenomenon of eliminating the boundaries between the world of the living and the dead is associated with the theme of memory, first identified in the novel by “various gloomy prophecies about future offspring.”

The manuscript, which must be translated from Latin, is a chain of events that have already occurred and at the same time, prophecy is a form of predicting the future, it comes from the past, which will live as long as the movement of life is realized. The human race is exhausted by reading the text. The final hurricane materializes the “end of the book” metaphor and is transferred to the human world, equating the last word of the book with the last breath of a person.

One Hundred Years of Solitude ends with a hurricane scene, thematically related to the fire at the end of the novel. U. Eco “The Name of the Rose”. A fire in the library, the world of signs and mental experience, in a romantic interpretation can mean a tragedy of memory. Another interpretation is also possible. Borges in one of the program works " Babylonian Library” describes the universal repository of books “that have been written, are being written, or will be written. Here are signs suitable for creating works of art, books awaiting their interpreters...”

The author is far from a hoax, he substantiates his own hypothesis - all the books have been written a long time ago, and new texts are nothing more than the results of repeated repetition of conflicts, motives, artistic formulas, words. And it is impossible to bypass the library, limitless and comprehensive, open to the most diverse associations. Borges argues that culture can be reproduced in any volume, since any text gives rise to a huge number of models that can be reproduced indefinitely. However, the writer is far from optimistic in his belief in the eternity of literature.

For Marquez, like Borges, the categories of gender and memory are something more than individual history. Writers correlate it with the cycles of existence - birth, growth, death, but point out differences in the dynamics and prospects of development: culture is not subject to decay, it functions due to the constant increment of meanings, old meanings do not die, but are enlarged and can be comprehended exclusively as the embodiment of transpersonal quantities In Margaret Mitchell, a representative of a different cultural tradition, in the novel Gone with the Wind, the reflections of the main character Scarlett O’Hara are based on the leitmotif - “this is very difficult to understand... I’ll think about all this tomorrow.” Her private emotion is unable to comprehend an event that can only be interpreted in the context of generic thinking, the maximum embodiment of which is presented in Marquez’s novel.

The burnt library of U. Eco, the Macondo of G. G. Marquez, erased from the face of the earth, can be read as a universal model of the universe: there were many people, worlds, feelings, they died, leaving a memory of themselves in words and books.

Humanity leaves a memory of itself. The heir to the romantic tradition, M. Bulgakov, argued: “Manuscripts do not burn.” The end of the 20th century gives a different commentary on this problem: in order to survive, cultural experience must acquire a transtemporal, transpersonal character. If this does not happen, the “manuscripts” will begin to burn. In the parable "Coleridge's Dream" Borges proves the following idea: there is a plot that is in search of its final embodiment - it is dreamed by the Mongol emperor in the 13th century, Coleridge and Stevenson in the 19th century... And it will dream until it finds its completion; in the cyclical, infinite flow of life-culture there can be no ending. A person is reflected in his descendants, a book is reflected in books. An endless chain of repetitions. This concept bears a clear influence of postmodernist aesthetics.

Presentation on the topic "Foreign literature of the 19th century. Review" on literature in powerpoint format. This presentation for schoolchildren contains 56 slides with a general description of Western European literature of the 19th century. Author of the presentation: teacher of Russian language and literature, Kolpakova M.Yu.

Fragments from the presentation

Literary movements and currents

• Late Romanticism- a direction in literature, which is characterized by the depiction of an exceptional hero in exceptional, fantastic circumstances. The writer’s subjective assessment of the events being reproduced is important.
• Critical realism- a direction in literature, which is characterized by a truthful depiction of reality, knowledge of the laws of development of social phenomena and “truthfulness in the reproduction of typical characters in typical circumstances” (F. Engels).
• Symbolism- a direction in literature, which is characterized by the desire to put a symbol in the place of a specific image, which was opposed to naturalistic down-to-earthness and photographicity.

General characteristics of Western European realism of the 19th century.

• Critical realism (M. Gorky's term) is a new stage in the development of realism, emerging in Western Europe in the 30-40s. XIX century after romanticism. It was romanticism that was the boundary that separated this period of development of realistic art from the previous ones. Realism was already given by the Renaissance, when the best of the masters of literature - Shakespeare, Cervantes - showed the rich and complex world of man.
• An important stage was the realism of the Enlightenment, which reflected the ideal of the revolutionary bourgeoisie - the ideal of freedom and universal equality, the pathos of struggle. The positive hero here actively resisted circumstances and thereby asserted new principles, new morality. In educational realism, which immediately preceded the realism of the 19th century, the environment that shapes man is often depicted through conditional, implausible positions and details.

Criticism of contradictions

• In the 19th century in the light of the most important historical experience - the replacement of feudal relations with bourgeois ones - a new type of realism was created. The contradictions of the new social system became the subject of his criticism: realist writers were able to reveal the source of these contradictions.
• The understanding of the interconnection of life phenomena was also facilitated by the successes of natural science in the first decades of the century. Literature borrowed from the natural sciences the principles of observation, comprehension and generalization of the facts of surrounding life. It is no coincidence that Balzac’s novel “Père Goriot” is dedicated to the famous naturalist Saint-Hilaire, his contemporary, who discovered the diversity of species of the animal world.

A true depiction of reality

The most important feature of realism of the 19th century is a reliable life situation, which consists of truthfully recreated features of everyday life, human characters and relationships between people. In turn, these relationships and characters are always determined by objective reasons - phenomena of social order. For educators, the fate of a hero, for example Robinson Crusoe or Faust, is carried out in accordance with the author's ideal. Writer of the 19th century. reflects the dominance of the social laws of bourgeois society over the fate of an individual, acting like an irresistible element. Thus, in the development of realism, the subject of research becomes, first of all, those social relations that determine the position and actions of people.

Typical characters. Image-type

Therefore, the images in the realistic work of the 19th century. collective, typical. They carry within themselves, first of all, a generalization of the most characteristic features of a certain class or estate. However, the variety of typical images created by the literature of realism is achieved by the fact that the realist artist gives the depicted personality and individual characteristics, through which the social appearance of this person becomes more expressive, catchy, and memorable. Thanks to this, the image-type acquires a broad meaning, sometimes even going beyond the framework of the reality that gave birth to it, the meaning of a life phenomenon (in Russian literature such are, for example, the types of Gogol, in Western literature - Balzac). Engels considered the depiction of “typical characters in typical circumstances” to be the main distinguishing feature of realism.

The role of the portrait in a realistic work

One of the most important means of conveying a typical character is a portrait. It is in the portrait that the features that express the essence of the type are most often sharpened. In the facial expression, the outline of the figure, in the gait, manners, and costume, both the social position of a person and the moral qualities characteristic of people of his class are visually embodied: the carelessness and selfishness of the aristocrat, the prudence and heartlessness of the bourgeois. The best examples of realistic portraiture among Western European writers were given by Balzac and Dickens.

Psychologism is the most important feature of critical realism

Sometimes a portrait reflects not only social affiliation, not only “type”, but also the state of mind, the psychology of the hero. The further development of psychologism is another of the achievements of realism of the 19th century. “Typical circumstances” are the objective circumstances of life, derived in the work, that determine a person’s behavior, form his contradictory internal makeup, and cause mental struggle in him. The work of Stendhal, a remarkable contemporary of Balzac, is distinguished by its subtle rendering of a complex inner world.

The image of the "little man"

One of the methods of sharp criticism of society in a realistic work is a sharply negative, sometimes satirical presentation of representatives of the ruling class and at the same time a sympathetic portrayal of “little people,” the humble, the poor, who are most often victims of the social order. The latter, in their human merits, are immeasurably higher than the “masters of life.” And it is in them that the best human qualities are collected, in which the author sees the guarantee of a fair world order: hard work, kindness, nobility. However, these heroes do not represent an active force capable of resisting social evil: without engaging in the fight against it, they only suffer from it or seek to protect themselves from its vices.

CONCLUSIONS:

• Realists of the 19th century picked up the denial of the inhuman world, first proclaimed by romanticism, but supported it with a specific analysis of reality.
• From romanticism they also adopted exceptional attention to spiritual life, to human feelings, and here they also achieved a special power of image, revealing all the relationships between people - in the family, in society.
• Having assimilated the achievements of previous stages in the development of art, critical realism became a new artistic method, with its own special principles for reflecting reality.
• In each country, it was affected by the unique historical conditions and national literary traditions. But this does not prevent us from establishing the general features of the method, the development of which culminates in the works of N. Gogol, L. Tolstoy and F. Dostoevsky, O. Balzac, G. Maupassant and Charles Dickens and other writers.

P., 1956). In general, hypnotherapy is considered an adequate and effective method in the psychotherapy of neuroses in children and adolescents starting from the age of 6 (Rozhnov V. E., 1971).

used in psychotherapy of children and adolescents with obsessive-compulsive disorder (Kovalev V.V., Shevchenko Yu.S., 1980). Family psychotherapy is considered indicated not only for neuroses, but also for psychopathy in adolescents (Eidemiller E. G., 1973). In a broader context, family psychotherapy is included in the so-called “environmental psychotherapy,” which often acquires decisive importance in the system of treating a child with neurosis (Rozhnov V. E., Drapkin B. Z., 1974; Kovalev V. V., 1979).

The question of the advisability of treating children with neuroses in inpatient or outpatient settings is decided in favor of the latter. V. A. Kurshev (1973) notes unsuccessful attempts to treat children 2-5 years old in a hospital. B. 3. Drapkin (1973) considers the disadvantage of inpatient treatment to be the separation of the patient from the conditions of normal life, family and group of healthy peers, which can increase the number of relapses of the disease after discharge. B. 3. Drapkin was able to eliminate many of these shortcomings in the psychotherapeutic adolescent department he leads, where a flexible treatment regimen is used, providing adolescents with independence in organizing leisure time, and activating the process of group psychotherapy.

The basic principles of the prevention of neuroses in children are the early detection of neuropsychic abnormalities (Davidenkov S.N., 1954), close contact between the pediatrician and the neurologist and psychiatrist (Pivovarova G.N., 1962), and proper upbringing of children (Yakovleva E.K., 1958 ; Ushakov G.K., 1966), a wide range of psychohygienic and psychoprophylactic measures (Ozeretsky N.I., 1934; Osipova E.A., Izhboldina O.F., 1934), thoughtful psychological preparation for kindergarten (Golubeva L. G. et al., 1974, 1980; Vlasov V.N., 1978).

Review of foreign literature.

Due to the large number of studies, we will focus only on the main areas

3 Gilyarovsky V. A. Psychiatry. M., 1938, p. 719.

(Finn-Scott M., 1930). Subsequently, rational psychotherapy underwent a number of changes, mainly due to the inclusion of elements of discussion, i.e., the development of two-way contact between the doctor and the patient.

The founder of the school of individual psychology, A. Adler (1928, 1930), made a significant contribution to the development of rational psychotherapy for neuroses and characterological disorders in children. In his opinion, behavioral motivation based on feelings of inferiority is the center of a neurotic personality. The neurotic character aims at limitless compensation for a reduced sense of personality, primarily in terms of gender identity, which is expressed, especially in boys, by protest reactions, negative behavior and stubbornness. At the same time, the child, with his weakness and dependence, tries to direct the care of others to himself.

Both lines of behavior guarantee compensation for a reduced sense of personality and allow one to get rid of the demands of life. This is the fictitious, predetermining goal of the neurotic, his life position. Neurosis is thus regarded not only as a disease, but also as a kind of “trick”, a “dominant fiction”. Despite all the value of these conclusions, one cannot help but see in them a one-sided refraction of the problem of neuroses.

for painful personality development. Rebuilding the relationship (position) of children with neuroses in a relatively short period of time compared to psychoanalysis, A. Adler appeals to consciousness, self-esteem, clearly explains the causal relationship between characterological and neurotic manifestations, uses goal and perspective as the basis for changing the individualistic position, Children are widely attracted to “masculine” professions as a means of developing appropriate character traits. deserve

attention to targeted discussions with parents with the aim of changing their relationships and organizing joint discussions between parents and teachers.

predetermining role as a cause of nervous and mental illnesses. In his opinion, the pathogenesis of neuroses lies in the repression from consciousness into the sphere of the unconscious of affectively colored sexual experiences of the first years of childhood, represented by the “Oedipus complex” and the internal conflict between instinctive and social demands.

Subsequently, S. Freud more than once clarifies that “a person becomes ill due to a conflict between

the demands of instinctive life and the resistance that arises within a person against this”4.

4 Freud S. The Complete Psychological Works. Stanford ed. 1944, v. 22. p. 57-77.

At the same time, the analyst tries to penetrate the patient's defense mechanisms in order to make him aware of his own anxiety and hidden conflicts, because only then can they be dealt with rationally. This is a slow process, as too rapid awareness may be unnecessarily traumatic for the patient and result in increased rather than decreased anxiety.

In psychoanalysis there is no guidance for the patient, his education, or active change in relationships. It is believed that psychosynthesis in a patient, if the necessary conditions are created for this in the form of “decomposition” of symptoms and the elimination of resistance, occurs without the intervention of the analyst, automatically and inevitably. If awareness of the repressed is the goal of psychoanalysis, then

The main concepts in psychoanalysis as a therapeutic method are free associations, transference and resistance. A distinction must be made between the theoretical concepts of psychoanalysis, that is, the interpretation of the data obtained, and the practical techniques of examination and treatment. If the interpretation of data and the premises of psychoanalysis by many

Since researchers are considered tendentious and often do not meet the criteria of clinical reality, then diagnostic methods, as well as a thoughtful, unhurried, serious approach to the experiences of a neurotic and taking into account his relationship with the doctor, have left a deep mark on the further development of foreign psychotherapy.

Psychoanalysis is most vulnerable when it goes beyond the boundaries of psychiatry, and this often gives rise to fair criticism. If we turn only to the clinic of neuroses, it turns out that indeed unconscious pathological motivation can largely predetermine the behavior of patients with neurosis, at least in terms of the creation of involuntary defensive attitudes. It will also be true that a patient with neurosis, unlike a healthy person, often lives in his own subjective, irrational-affective world, which for him is often more significant than the real world. However, these variations in psychoanalysis turn into dogma, which prevents the doctor from changing his view of the patient in the process of treating him.

In our observations, phenomena resembling transference do not occur so often, apparently due to a different strategy of psychotherapy than in psychoanalysis. For the most part, they occur in single-parent or conflict families, when the doctor involuntarily fills the unsatisfied need for communication with one or another family member. More frequent transference in adolescence and adolescence, primarily in hysterical neurosis, is explained by the need to achieve recognition from family and peers in relations with a doctor.

expressions of mild disturbances in the development of the body diagram in children with neuroses, when they feel their body worse than their healthy peers and coordinate their actions. There are reasons for this, and among them are excessive intellectual stimulation, restrictions on physical activity, general, nervous and somatic weakness.

As is known, the structure of the “Oedipus complex” includes the libidinal attachment of children aged 5 years to a parent of the opposite sex, the resulting competition or hostility towards the parent of the same sex and, as a consequence, the repression of incestuous experiences into dreams, feelings of guilt and anxiety.

In 1978, we conducted an extensive study (961 patients 3-16 years old without neuropsychiatric

gender-appropriate behavior in communication with peers, the standard of which is a parent of the same gender. Identification with him is associated with emotionally warm relationships, especially among girls. The foregoing allows us to conclude that children at the studied age, imagining themselves in the place of a parent of the same sex and identifying themselves with him, also experience the need to imitate his attitude towards a parent of the other sex, i.e. boys, just like the father , want to be “married” to their mother, and girls want to be “married” to their father.

Therefore, the parent of the same sex is not an object of hostility, but an object of imitation and authority. We see that S. Freud expanded the sphere of the sexual, essentially replacing it with the emotional and cognitive sphere of personality development, while all of them

act in unity and mark a certain maturity of genetic and socially determined personal development by the age of 5-6 years.

S. Freud did not specifically engage in psychoanalysis of children. Classical psychoanalysis in children

The 20-30s are represented by research.Huq-Helmuth, M. Klein and A. Freud. If M. Klein

conducts the analysis without intervention and guidance, then N. Huq-Helmuth and A. Freud carry out, if necessary, active management of the patient, changing his relationships and re-education.

N. Huq-Helmuth sees the task of education “in the ability to find the proper measure in encouraging the development of some drives and in inhibiting others”5. Emphasizing respect for the natural course of child development and the pathogenic significance of an insoluble internal conflict, she is the first to practice medical and pedagogical consultations on educational issues, the purpose of which is to alleviate the tense relationship between parent and child. The technique of psychoanalysis itself remains unchanged, even down to the use of a couch during the session.

A. Freud derives all childhood conflicts from the process of “maturation”. Manifestations of neurotic

The latter is feasible when the child has a clear awareness of his “defect” and a desire to get rid of it. Children's drawings are also used for analysis (Freud A., 1971).

M. Klein in the 30s associated the origin of neuroses with depressive reactions when interacting with the mother in the first year of life, masturbatory fantasies and fear. The latter is derived from masturbatory fantasies, fear of castration and the Oedipus complex. The development in the process of analyzing children of a transference neurosis similar to adults is implied, but the method of free associations is replaced by the spontaneous activity of children in play with toys that reproduce the real world. The game itself is interpreted psychoanalytically; the sexual symbolism of one or another game action is literally explained to the child. The method of symbolic interpretation of play activities. MKlein is further referred to as play therapy.

A. Freud and M. Klein in the 20-30s, G. Pearson (1949) and I. Kessler (1966) for a better understanding of the child’s conflicts, observe the game in order to give an interpretation after it. Unlike

name of the directive.

The subsequent development of psychoanalysis follows the path of reducing its duration (already with M. Klein the duration of the analysis was not several years, but 8-10 months with 4-5 visits to

5 Huq-Helmuth N. New ways to understand childhood. Per. from German, L., 1926, p. 63.

week) and providing directed psychoanalytic guidance to the educational process.

In 1939, at the IX Congress of Psychoanalysts of French Language Countries, the concept of family neurosis was formulated. The child's neurosis is considered as a product and revealing factor of family anomalies. The need to analyze children together with their parents, especially the mother, is noted. Thus, psychoanalysis began to go beyond just individual work with the child, when parents were considered only as reflections on the screen of his associations (Duche I., 1967). Currently, psychoanalysis is no longer considered the ultimate truth, but by limiting its expansiveness and preserving its own field, it is considered useful in a number of cases. One of the most prominent representatives of modern psychoanalysis, E. Erikson (1968), agreeing with the classical provisions of psychoanalysis about achieving greater mobility of the “it”, tolerance of the “super-ego” and the ability of the “ego” to synthesize, adds that the analysis of the “I” should take place in connection with historical changes that dominated the period of childhood and adolescence, social adaptation in adulthood.

Psychoanalytic and non-psychoanalytic methods of treating neuroses, using a number of general principles, are combined under the name psychodynamic therapy. It is aimed at eliminating the causes of neurosis rather than its symptoms. In the psychodynamic approach the main

The determinants of neurotic behavior are intrapsychic processes and subconscious motives, and the main concepts are anxiety and defense. The problem, as we have already seen, is not that they exist, but how the mechanisms of their origin are interpreted.

Such well-known foreign psychiatrists of a non-psychoanalytic direction as K. Norney (1950) and N. Sullivan (1953) see in anxiety the general dynamic basis of neuroses and derive it from the experience of early interpersonal relationships. It is believed that psychoneurotic personality disorders

the individual cannot. Symptoms of these disorders consist either of direct sensations and expressions of anxiety, or of automatic attempts to control it through defense mechanisms such as conversion, dissociation, repression, the formation of phobias or obsessive thoughts and actions. Neurosis, according to K. Norneu, occurs when the potential for development collapses or is blocked by “internal pressure.”

Awareness of the significance of emotions, drives and other irrational components of the psyche in the origin of neurosis is the goal of psychodynamic therapy in all its variants. Therefore, it is defined primarily as an insight (intuitive) type of therapy. But if psychoanalysis is aimed mainly at reconstructing the patients’ past, then in the non-psychoanalytic psychodynamic approach more attention is paid to current dynamic processes. According to K. Norney, the goal of treatment is to help a patient with neurosis realize his real “I” and develop the possibilities of his mental growth.

In psychobiology (Mauer A., ​​1934), personality is considered as a holistic entity in the context of its historical formation; mental disorders are studied as dynamic maladaptive reactions of an individual to tension, stress and conflict. In a casual conversation, the main attention is paid not to finding subconscious motives and mechanisms of neurotic behavior, but to actual situations and circumstances. Transference is not given any significance, and the psychiatrist strives not for the patient to relive his early experiences, but for him to understand their today's meaning. Discussion with a psychotherapist is intended to help the patient trace the origin of his disorders. Such biographical analysis also includes an examination of somatic factors and a panorama of the patient's psychosexual development. Only those facts that are clear to the patient are discussed

or figured prominently in his life experiences. After the various experiences, situations and symptoms have been analyzed and discussed, the patient is asked to reformulate them into a dynamic autobiography with motivations so that he can, if possible, understand their meaning and evolution.

The views of A. Mauer were not so widespread in the era of the dominance of psychoanalysis, but as an expression of the branch of psychodynamic therapy that is most distant from psychoanalysis, they played their role, and, in our opinion, affected the development of a systematic approach in foreign psychotherapy. (Masserman I., 1969).

The psychotherapeutic approach, based on the patient's experience and placing him at the center of interaction with the doctor, is developed in the form of relationship psychotherapy or “client-centered” psychotherapy by S. Rogers (1965). It views the unconscious and the conscious as a unity in terms of experience and perception. Neurotic disorders are explained as a consequence of unfulfilled vital needs, psychogenic blockage (“blockage”) of experience and loss of its congruence with the “I”. S. Rogers is wrong

is concerned with the patient's past, like a psychoanalyst, and does not involve transference and interpretation as operative factors in psychotherapy. The focus is not so much on the connection between anxiety and defense, but on the neurotic's reduced self-image and sense of self-esteem. The relationship between the doctor and the patient (client, according to S. Rogers) is built

according to the principle of egalitarianism, i.e. at the level of “person-person”, and not “doctor-patient”, as in the psychoanalytic approach. What matters more is not what the doctor says, but what he is: the personality of the therapist is his main tool (Rogers S., 1965). The psychotherapist does not lead, but accompanies, participating in the patient’s direct experience, creating conditions for him to feel a sense of security; he does not think for the patient, but thinks and evaluates together with him; does not give

the opposite concept of “catalysis” to analysis - facilitating, accelerating the process of self-actualization. All this does not exclude the general direction of the positive evolution of the patient, for whom conditions are created for a calm, purposeful monologue - the patient speaks and reasons as if with himself, the doctor only inserts words that indicate his interest and keeps the conversation in line with essential issues. Thus, the patient is encouraged to correctly formulate his problems and often finds a way out of the situation himself, constructing the right motive. Your own, sufficiently convincing and specific motive becomes the best incentive for activities leading to mental balance. In the process of psychotherapy, the following personality changes are observed: the patient “1) the patient evolves to a state of more complete internal agreement (harmony), he is more open to his experience and less protected; 2) its perception is more realistic, more differentiated and more objective; 3) he becomes more and more capable of solving his problems; 4) his mental functioning improves and develops in an optimal sense; 5) vulnerability decreases due to increased agreement between the “I” and experience; 6) positive consideration of oneself increases, and the subject increasingly perceives himself as the center of evaluation”6. As a result mainly of a decrease in anxiety and an increase in internal agreement, the patient can identify, experience and accept by his own means the psychogenic aspects of his disease state. As he develops the ability to respect himself, he becomes increasingly able to respect and appreciate other people.

The psychotherapeutic approach. Rogers has found some widespread use in the practice of foreign pedagogical work, when students and teachers change roles in a game and the group acts in these conditions for some time. It should be noted that the theoretical premises of psychotherapy by S. Rogers are more developed than the practical part. A number of provisions of this psychotherapeutic approach can be found in the Socratic oral dialogic teaching method, designed for the “inner voice” of the student. The art of conversation, according to Socrates, requires starting from what the interlocutor already knows, and not suppressing him with erudition and incomprehensible truths. Socrates believed that listeners could, with his help, discover a lot of beautiful and reasonable things in themselves, however, if this was already inherent in them (Nersenyants V.S., 1977).

Relationship psychotherapy by S. Rogers has developed in the direction of non-directive

play therapy, when the psychotherapist does not interfere with children’s spontaneous play and does not interpret it, as in the directive direction discussed above, but creates an atmosphere of warmth, safety and unconditional acceptance of the patient’s feelings and thoughts through the game itself (Alien E.,

1942; Axline V., 1947; Moustakas S., 1970). In this form, play therapy is considered primarily for children with long-term neurotic disorders, emotionally tense, suppressing their feelings (Alien F., 1942). Play therapy should help the child see and understand himself, his strengths and weaknesses, difficulties and successes. This is facilitated by the principles formulated by V. Axline (1947) on which the behavior of the psychotherapist is based: 1) acceptance of the child, achieved by a friendly, warm, non-suppressive manner of communication; the doctor does not show impatience, dissatisfaction or disagreement, refrains from praise and approval, which limit the freedom of the child ; 2) establishing permissibility in play, security in relationships, which allows the child to express his feelings and experiences; 3) giving him the opportunity to independently choose his line of behavior; the doctor is most often outside the game and can only sometimes lead it at the request of the child; 4) refusal to force therapy, which leads to loss of contact; 5) reflection of feelings - the doctor refuses to interpret the child’s statements and actions, using his own symbols in the game. A psychotherapist is a mirror in which a child sees himself.

6 Rogers S., Kinget G. Psychotherapy et relations humames. Theorie et pratique de la therapy non-directive. Lohvain-Pans, 1965, p. 209.

With this construction of therapeutic situations, children have the opportunity to act out and thereby react to their tensions, frustrations, aggressiveness and fears. By playing out these feelings, they transfer them outward, open them. By facing them face to face, children learn to control their feelings and behavior in general. According to V. Axline, as a result of the game

only three types of restrictions: the constant duration of the session, the ban on damaging the game material and on using the doctor as an object of aggression. S. Moustakas (1970), who worked actively with children in the 50s, considers the most important aspect of the therapeutic relationship to be the establishment of such restrictions that connect psychotherapy with reality and remind the child of his responsibility to himself and the psychotherapist. The development of positive relationships in play becomes possible only when an adult responds to

the child's feelings and sincerely believes in. The child then moves towards expressing clear positive or negative attitudes that enable him to feel worthy and develop his real abilities. Because a child's emotional problems and symptoms are reflections of his relationships, they will disappear as they change.

A notable contribution to the therapeutic use of play was made by E. Erikson (1964), who considers spontaneous play a way to resolve life’s difficulties by creating model situations and mastering reality through experimentation and planning. Therefore, play looks like the most natural self-healing measure that childhood is capable of.

allows you to express internal conflicts and aggressive tendencies in the group. Group catharsis

situational and varies depending on group dynamics. Exceptional attention is paid to the selection of psychotherapy participants. Groups, depending on the purpose, are divided into closed (simultaneous start and end of treatment) and open (gradual replacement of participants). Eventually

N. Ginott (1961) applies group psychotherapy to characterologically inhibited children. Pointing out that it is almost impossible to avoid fear in a group, N. Ginott, like S. Slavson, reproduces situations that cause fear in the process of spontaneous and guided games and helps its playful and verbal expression. Currently, group psychotherapy has become widespread in regular schools as part of a program to help children with emotional disorders (Anderson N., Marrone R., 1977). Positive results of group psychotherapy, according to various authors, are observed in only 1/3 of cases (Abramowitz S., 1976), which is due, in our opinion, to the insufficiently critical use of indications for group psychotherapy, the use of unproductive group psychoanalytic techniques without the development of the group process speakers.

The psychotherapeutic concept of psychodrama by J. Moreno, created in the 40s, is based on the socio-psychological patterns of communication, which best meets the requirements of real life. The therapeutic effect of psychodrama is based on cathartic mental “cleansing” and relief, which Aristotle wrote about when explaining the mechanism of action of ancient tragedy on the viewer. The source of catharsis, according to J. Moreno, is spontaneity, by which he understands the ability to adequately respond to suddenly arising circumstances.

This ability is weakened in a neurotic person. He also has an imbalance between the world of reality and the world of imagination. Psychodrama, combining reality and imagination, bridges this gap. The goal of psychodrama is to create conditions under which the performance of a role will be perceived by group members as a natural expression of the self, which will relieve many of their overstrains. The main character of the psychodrama is the protagonist

Depicts himself in various problematic situations. The supporting characters he appoints from among those present reflect and change the nature of his interactions.

If necessary, the game director plays a similar role. According to J. Moreno, the use of an auxiliary “I” in role-playing action distinguishes psychodrama from group psychotherapy.

A psychodramatic session includes three stages: psychological warm-up, action and subsequent discussion. Warm-up is an interview and analysis of upcoming game situations, which should be relevant and interesting for the participants, if the game is overly traumatic. The tensions that arise in psychodrama are reduced with the help of fictitious situations, changing roles and repeating the play theme. The ability to “enter” the desired role is considered in psychodrama as a means of relieving excess mental stress. At the same time, the influence of the audience - the group and those present at the session - is essential in the system of teaching adapted behavior. As a result of psychodrama, emotional response, awareness and resolution of problems occur among its participants with a simultaneous improvement in their mental state (Moreno J., 1946).

In its expanded form, classical psychodrama is used mainly among adolescents (Lebovici S., 1961). There are numerous attempts to simplify psychodrama. G. Lehmann (1968) proposes an improvisational group game to reduce neurotic pubertal inhibition

into a fairy tale. I. Corman (1973) and R. Gardner (1975) use dramatization in individual work

With children. The psychodrama method has become widespread in socialist countries. IN

GDR, in addition to G. Lehmann, it is practiced by S. Krauss, V. Scholz, M. Knopfel (1977), S. Palmer and R. Rank (1978); in Czechoslovakia M. Bouchal, D. Dufkova, M. Robes, Z. Sekaninova (1973), etc. These authors refract rhythm, pantomime, and outdoor games in a psychodramatic way.

Of the various variants of psychodrama that combine it with group psychotherapy, the so-called kinetic psychotherapy should be noted. Schachter for children with

some moments and verbalization of the actions of its participants. The psychoanalytic interpretation of the game consists of responding to failed stages of sexual development, transferring images of mother and father to psychotherapists, opening the “Oedipal family structure” and analyzing individual and group resistance in the treatment process (Monod M., Bosse J., 1965; Cosnier I. et al ., 1971; Testemale G., 1971).

The principle of desensitization, which forms the basis of behavior therapy, can be found in the great French educator Rousseau: “... all children are afraid of masks. I will start by showing Emil a mask with pleasant facial features, then someone will put it on his face in front of his eyes: I will start laughing, everyone will laugh, and the child along with others. Little by little I will accustom him to masks with less pleasant features and, finally, to disgusting figures. If I have maintained the gradation well, then not only will he not be afraid of the last mask, but he will laugh at it as at the first. After that, I’m not afraid that they’ll scare him with masks.”7

pedagogical. The patient learns new emotional and cognitive behavioral alternatives that must be rehearsed and experienced inside and outside the therapeutic situation. Learning eliminates the need for insight and catharsis. The couch method (in classical psychoanalysis) is replaced by the pulpit and classroom methods, and the relationship between therapist and patient resembles that between teacher and student. The behavior therapist views himself as an instrument of direct influence, intervention and control, as well as a social enhancer for the patient (Hollander M., 1975). In behavioral

7 Rousseau J. Emile, or On Education. M., 1896, p. 228.

In therapy, encouragement techniques are widely used, punishment is used less frequently, and the results of therapy are carefully monitored (Wolpe J., 1958; Eysenck H., 1959).

There are three main modifications of behavior therapy. In systematic desensitization - reciprocal inhibitory therapy (Wolpe J., 1958) - a list of objects of fear is compiled in advance, starting with the weakest. The patient is asked to imagine a situation that initially causes mild fear for a few minutes, and then is instructed in relaxation techniques. This process is repeated until there is complete absence of anxiety in the imaginary situation of expressed fear. In another variant, relaxation precedes the presentation of a fear stimulus, which, moreover, may be most intense at the beginning, but since the presentation of fear occurs against the background of general relaxation, its weakening (desensitization) occurs. In children, relaxation is not always possible, but the very principle of gradual and indirect presentation of fear stimuli has found a wide response, including in the treatment of school phobias, often associated with the fear of separation from the mother (Duvano

I., 1962; Garvey W., Hegrenes I., 1966). A radical behavioral technique called “immersion” is described, where children are placed in an environment that causes anxiety and where they remain for a long enough time to cope with it (Lamontague V., 1975).

Another modification of behavioral therapy aims to directly reinforce desired behavior through the use of dosed procedures of reinforcement, and less commonly, punishment.

especially in preschool children. According to this method, treatment, for example, of dog phobias consists of 8 short-term periods in which fearful children watch with the help of a movie how other children approach dogs without fear and pet them (Bandura A., 1969).

To date, behavioral therapy has undergone a number of changes. There is less maximalism in it, more attention is paid to interpersonal diagnostics, psychological training of self-confidence, as well as group and family forms of therapy. Many of the techniques of behavioral therapy have become firmly established in the arsenal of modern psychotherapy; the doctor’s ability to “cope” with fixed symptoms is no less important than their pathogenetic analysis.

The development of social psychology and social psychiatry in the 50s and 60s also influenced the development of family psychotherapy, in which emotional problems in children are studied from the point of view of the functioning of the family as a whole. Fundamentals of a holistic approach to the family as a unit

will not create family psychotherapy. The latter is understood as a method of introducing the psychotherapist into the family system in order to promote the maturation of the family process. For the success of family psychotherapy, the correct choice of the primary patient is important, that is, the person who has the greatest pathogenic influence in the family. Through joint and separate interviews, the nature of family disorders is established, which is reflected in a dynamic “family diagnosis”. The point of view of N. Ackerman and I. Howells about the simultaneous treatment of parents and children by one doctor is supported by many modern researchers (Bell J., 1957; Carroll E., 1960; Buckle D., Lebovici S., 1966; Graham Ph., 1976; Minuchin S., 1974).

There are various approaches to family psychotherapy, including psychoanalysis (Grotjahn M., 1960: Ville-Bourgoin E., 1962; Berge A., 1965), behavioral therapy (Liberman R., 1970),

a combination of psychoanalysis and behavioral therapy (Skynner A., ​​1976), group psychotherapy

two doctors working with spouses (Martin P., Bird H., 1953), and even three specialists, if one of them is engaged in psychotherapy of children (Sandler I., 1966). Widely used methods

diagnostics of family relationships (Van Krevelen D. A., 1975). Mental health centers have become widespread to provide preventive psychological and psychiatric assistance to families who are in a crisis period of their development (Caplan G., 1964).

Modern foreign psychotherapy is characterized by the mutual penetration and complementation of various psychotherapeutic approaches, which is reflected in the difficulties of differentiated assessment of their effectiveness. This gives grounds for such a well-known

Comparing the achievements of foreign and domestic psychotherapy for neuroses in children, it should be noted the priority of domestic research in a number of areas of psychotherapy, primarily in hypnotherapy and group (collective) psychotherapy. The principles of medical and pedagogical work with families were also formulated earlier. In general, the medical and pedagogical aspect predominates in domestic research, while in foreign research more attention is paid to psychotherapeutic methods themselves. Much of what was achieved in Russian psychotherapy was lost in the mid-30s, when a one-sidedly understood physiological approach to the problem of neuroses and their treatment delayed the development of the psychological aspect of the problem. The situation begins to improve in the 70s. The introduction of the nomenclature position of a child psychotherapist and training in this specialty will accelerate the development of child psychotherapy and the implementation of effective measures for the psychoprophylaxis of neuroses in children and adults.

Our experience of psychotherapy has been formed since the early 60s. Some of the psychotherapy methods we have independently developed have analogues in foreign experience. This applies to family psychotherapy, the use of games and groups as a therapeutic tool, and behavioral therapy techniques. The essence of our approach is not in the application of certain

Psychotherapy as the main method of treating neuroses can be defined as the process of directed psychological (mental) influence of a doctor on a patient in order to restore impaired mental functions, strengthen them and develop them. In this sense, it consistently acts as a unified process of therapeutic and pedagogical measures, which does not allow the replacement of the therapeutic aspect by the pedagogical one, which is fraught with the danger of using educational measures where the elimination of painful manifestations is required.

personality-oriented psychotherapy. This process includes socio-psychological mechanisms of communication, and primarily the mechanisms of interpersonal contact.

If we combine the noted aspects of psychotherapy, it will look like a personality-oriented process of interaction between a doctor and a patient, aimed at restoring and strengthening the mental unity of the patient’s personality and achieving an acceptable level of socio-psychological adaptation. Here it is important to maintain a balance between individual and social requirements, that is, between the requirements of the patient and the requirements of reality. At the beginning of psychotherapy, the doctor mostly proceeds from the requirements and hopes of the patient as a person, helping him to find himself, explore his capabilities and establish himself in

Psychotherapy is conventionally divided into family, individual and group, which constitutes a single pathogenetic complex, the sequence of which is determined by the clinical and personal characteristics of patients. For neurotic reactions, a short course of treatment consisting of elements of suggestive, explanatory and play psychotherapy, as well as some recommendations for parents, may be quite sufficient. Psychotherapy of patients with chronic neurosis and unfavorable personality changes, as a rule,

parents of the reasons for the child’s painful condition, improvement of their mental state and

Removing painful manifestations, strengthening the psyche and nervous system as a whole, restructuring the patient’s relationship with himself and others and changing his unfavorably formed character traits occur in the process of individual and group psychotherapy.

IN As a result of the restructuring of the relationship between parents and children, the normalization of their interpersonal relationships and the cessation of the conflict are observed. Improving the family environment creates the prerequisites for restoring the patient’s broken relationships in social and psychological spheres of communication.

IN In general, the effect of psychotherapy, including its individual techniques, is derived from both

from the personality of the psychotherapist, his human qualities, life and professional experience, and from the personality of the patient, primarily his desire for a cure, faith in the doctor and the treatment method, the clinical severity of the condition, characterological changes and personal capabilities.

situations. Feeling this situation and managing it in the interests of the patient’s recovery is an integral part of professional psychotherapeutic experience.

The personality of the psychotherapist, his knowledge and experience are one of the most significant factors in the success of psychotherapy. Each psychotherapist has his own range of therapeutic capabilities, which largely depends on his personal and typological characteristics. Psychotherapists with an introverted personality structure often prefer analytical, explanatory methods of psychotherapy and may be prejudiced towards it, games and behavioral modifications, while other psychotherapists pay more attention to them.

The age of the psychotherapist is also an important parameter. Beginning doctors strive first of all to master hypnosuggestion, which rather confirms their professional ability to treat. As they age, many creative psychotherapists expand their therapeutic

the child's parents or exceeds it. This manifested itself to a noticeable extent in our practice of family psychotherapy, when not only increased experience, but also the suggestive effect of age allowed us to achieve better results in correcting family relationships.

Of exceptional importance in psychotherapy are the art of persuasion, speaking in a clear and understandable language for the patient, self-confidence in critically reflecting on experience, as well as flexible tactics of psychotherapeutic interaction, combined with the psychotherapist’s ability to defuse and stabilize the patient’s emotional reactions. The tone of the doctor, his cheerful, optimistic attitude, opposing the pessimism and skepticism of the patient, sincerity and spontaneity in treatment, encouraging the patient’s activity in treatment are also essential in psychotherapy.

Within certain limits, the doctor does not interfere with the expression of the patient’s aggressive fantasies and thoughts; he accepts him as he is, providing an opportunity for emotional

responding to internal stresses in order to direct them in a more acceptable direction and develop self-control abilities.

In most cases, the doctor acts as an object of imitation and authority for the patient. You need to skillfully use this, without making the patient dependent on yourself and without undermining the authority of the parents. The psychotherapist must be warm, kind and sympathetic in order to understand the patient's weaknesses, but strong enough to be able to tolerate and eliminate them.

Being with the patient in a situation of interpersonal contact, completely trusting him and believing in his human qualities, the doctor helps to strengthen the patient’s confidence in his own capabilities and abilities. Thus, the doctor increases his sense of personal value, balancing it with the requirements of the surrounding reality.

The psychotherapist proceeds from the concept of the fundamental reversibility of neurotic disorders and strives, other things being equal, to apply those methods of psychotherapy that resonate more with the patient. The optimal option is to achieve psychotherapeutic resonance when the techniques used correspond to the patient’s preliminary expectations regarding the method of his treatment. Then the psychotherapeutic effect finds the most active positive emotional response in him. In turn, the timely and even somewhat anticipatory emotional response of the doctor to the needs and requests of the patient, to his way of responding in the process of psychotherapy is a model of human

responsiveness and contributes to the formation of similar emotional responses in patients. Imbued with the patient’s feelings and thoughts, the psychotherapist often experiences the treatment situation to a greater extent than the patient himself, while simultaneously managing the treatment process and relationships in it.

The need to remember the individual uniqueness of each patient, his dynamics in the process of psychotherapy creates mental stress for the doctor, not to mention a significant waste of his nervous energy. Therefore, he can retain in his professional memory the experience of working with only a limited number of patients. It is difficult to give specific figures here due to their variability depending on the individual characteristics of psychotherapists. In our opinion, it is possible to effectively manage no more than 10-12 patients simultaneously in the process of individual psychotherapy, the same number in group and hypnosuggestive psychotherapy, i.e.

In the end, no more than 30-40 patients. A significantly larger number of them may occur with follow-up observation and supportive treatment.

Psychotherapy is complicated by such manifestations of the doctor’s personality as insincerity, playfulness, aplomb, distrust, bias, anxiety and conflict, which can seriously undermine psychotherapeutic communication with the patient. Insincerity is perceived by the patient as a “mask”, reminds of the traumatic experience of relationships and causes distrust in the words and actions of the doctor. In preschoolers, this is accompanied by anxiety if the doctor deliberately

anxiety in the doctor's office. In adolescents, psychotherapeutic contact is complicated by the doctor’s excessive familiarity, imposition of opinions, and lack of discussion of issues of concern. A well-produced doctor’s voice without deliberate amplification or muffledness, and especially without shades of irritation and threat, moderately expressive facial expressions, plastic movements and the entire manner of behavior have an impact on the patient through the inductive mechanism of imitation, reviving his facial expressions, increasing tone and developing the ability to express himself.

As a result, a number of principles of psychotherapy can be formulated as follows:

1) conduct an appointment without a medical gown and be just a person for the child;

2) leave the table, approach the child and directly contact him;

3) play together and be a partner for him;

4) proceed from the feelings and desires of the child to a greater extent than from one’s own ideas and professional aplomb, burdened by medical experience, elevated to the degree of authoritarian assertion of power over the patient;

5) do not rush into re-educating a child without knowing what he is like and what he is capable of;

6) do not forget that, in addition to the doctor, there are also parents who are ready to both give the child completely to the care of the doctor and jealously perceive his successes in the contact and development of the child;

7) believe in yourself and your ability to heal before convincing your child to believe in himself and

V possibility of cure.