Report

"A person gets sick through his own fault, from the misfortunes that happened to him, and thereby causing himself suffering!"

It has always been a special wisdom to convince a person to know himself, to find his inherent strength and weakness, to determine from which side the threat comes, and which of the vices are the easiest to overcome! Any thought affects the body, and bodily forms, in turn, affect the moral side and character. Thus, studying these forms in accordance with intuition, it is possible to know the human character, and in the future, with the problems that await in this life. Every person, no matter how much, no matter how beautifully complex, is born with a vulnerable side, with the germ of destruction, which is in the subconscious and is looking forward to mistakes from us in order to further teach through psychosomatic diseases!.

"If a patient does not feel better after talking to a doctor, then this is not a doctor!" V. Bekhterev

• The doctor should not treat diseases, but the patient
• When a doctor cannot do any good, let him not harm
• And do not forget that the best medicine is to do without it
• Wisdom consists in knowing all that is created by nature. Hippocrates.

What is psychotherapy?. The answer to this question remains open, and experts now start arguing again about determining the place of psychotherapy in the modern field of scientific knowledge, then return to the capacious definition of B.D. Karvasarsky, according to which psychotherapy is a system of specific effective therapeutic forms of effects on the psyche and through the psyche on the human body in order to ensure and preserve its health. In the science– practice continuum, psychotherapy tends to practice to a greater extent, but many questions arise: on what scientific and methodological basis is this practice carried out, how can we talk about the effectiveness of psychotherapy based on the paradigm of evidence-based medicine based on positivist and neo-positivist concepts of the philosophy of science?.

V.N. Myasishchev's concept is the only holistic system in our country that includes as a methodological basis psychological theory (psychology of relationships) and interrelated concepts of the psychological origin of neurotic disorders (pathogenetic concept of neuroses) and psychotherapeutic system (pathogenetic psychotherapy). The conceptual unity that these ideas form was the foundation for the formation of a psychotherapeutic system, its practical application and the training of specialists. It should be emphasized that V.N. Myasishchev's psychological ideas are not just theoretical constructs, but form the basis for building a psychotherapeutic process within the framework of the pathogenetic psychotherapy system developed by him.

The basic concept of V.N. Myasishchev's psychological concept is the concept of "attitude". Personality is considered as a system of relations, which is "a conscious, active, selective, holistic, based on individual socially conditioned experience, a system of temporary connections of a person as a personality-subject with the whole reality or with its individual sides expressed in his actions, reactions, experiences" (Myasishchev V.N., 1960). It is possible to distinguish both the essential characteristics of relationships (integrity, activity, selectivity, consciousness) and various sides and levels of their analysis: analysis of the components of the relationship (cognitive, emotional, and behavioral), analysis of the relationship system (hierarchy, level of development and structure), analysis of the dynamics of the relationship and the system (variability over time – formation and development). V.N. Myasishchev, within the framework of his concept, considers neuroses as a personal disorder of a psychogenic nature, as a violation of the system of relations – violations of their individual characteristics and violation of the system of relations as a whole, first of all, its hierarchy. In particular, a violation of the essential characteristics of a relationship may manifest itself in insufficient awareness of the relationship (consciousness), incomplete reflection of the object of the relationship and an imbalance of the characteristics of the object /subject (integrity), inadequate understanding and assessment of the significance of a particular relationship (selectivity), etc. Violation of the relationship system prevents the resolution of internal psychological conflicts, transforms the conflict into a neurotic and subjectively insoluble one. This leads to interpersonal conflicts, increased anxiety, which entails functional disorganization of the personality, manifested at the physiological (clinical) and psychological levels. When considering a traumatic situation, V.N. Myasishchev emphasized its subjective insolubility, subjective traumatism: "The insolubility of contradiction is rooted in the correlation of objective necessity and subjective personality qualities, in the contradiction of logic and affect, in the contradiction of affect itself." (Myasishchev V.N., 1960). This means that a traumatic situation acts only as a trigger mechanism, actualizing and manifesting already existing violations of the relationship system.

V.N. Myasishchev's ideas about the personality and nature of neurotic disorders formed the basis for the development of a new psychotherapeutic system – pathogenetic psychotherapy. An important advantage of this system is the clearly traceable relationship between the content of psychotherapy and the theoretical understanding of personality and the nature of neurotic disorders. Its goal is to restore, rebuild, and reconstruct the disrupted system of patient relationships, and specific tasks reflect the gradual movement of the psychotherapeutic process from studying the personality of the patient and the patient, through various stages of awareness to changing the disrupted system of relationships. The first task is related to the study of the personality of a neurotic patient and, above all, the identification of significant relationships and their hierarchical relationships. It should be emphasized that in this psychotherapeutic system, the study of personality is of particular importance, because unlike most other approaches, where the main content of the neurotic conflict has already been postulated theoretically, here V.N. Myasishchev constantly emphasizes the individuality and uniqueness of the neurotic conflict in a particular patient, which requires a subtle and careful analysis of the personal content. The second task is aimed at investigating the etiopathogenetic mechanisms of the neurotic state. In many psychotherapeutic systems, the necessity of this stage is questioned, since such an understanding in itself does not have a pronounced therapeutic effect. However, V.N. Myasishchev does not accidentally single out this task, because, as practical experience shows, it is the understanding of the causes and conditions of the neurotic disorder that forms a stable motivation for the patient to participate constructively in the psychotherapeutic process. The next task is interrelated with the previous one and consists in understanding the causal relationships between the situation, personality and disease, in other words, in understanding the patient's psychogenic nature of his disease. Such awareness helps the patient to abandon the understanding of the causes of his disease as exclusively organic or caused only by external psychological factors or traumatic events. Understanding one's own role in the development, maintenance and enhancement of neurotic symptoms has the most significant impact on the formation of a patient's stable motivation and active participation in psychotherapy. The fourth task is to make the patient aware of the nature of violations of his relationship system. Here, the focus is on the most significant personal relationships and their essential characteristics (awareness, significance, integrity, selectivity), as well as the system of relations in general, in particular, awareness of contradictions between significant relationships underlying neurotic conflict. V.N. Myasishchev emphasized that awareness of neurotic conflict is facilitated not only by the patient's understanding the causes of the occurrence and development of his own disease, but also an understanding of the interrelationships of his disease with various significant relationships for him. In other words, in the process of psychotherapy, the patient himself identifies the "etiopathogenesis" of his own disease, realizing and analyzing his relationships.

When doing scientific research in psychotherapy, one has to overcome many difficulties in substantiating the design of the study, in choosing the methodology and method, and in proving the results. Usually, work in the field of psychotherapy is defended in two specialties: psychiatry and medical psychology, which are based on based on the theory and practice of the psychotherapeutic method, as well as the object and subject of the study. However, in my opinion, the subject of psychotherapeutic impact research can be phenomena and phenomena representing the fields of other scientific specialties, especially philosophy, which is closest to a number of psychotherapeutic directions. As an illustration, in the passport of the scientific specialty "Philosophical Sciences" I find such areas of research as the problem of the unconscious and subconscious in reflection in relation to conscious thinking, operational and potential memory, verbal and non-verbal forms of thinking. Modern understanding of intuition and its relation to formalized types of evidence, types of intuitive creativity and productive imagination. The interconnection, mutual influence, and sometimes the unity of philosophy, psychiatry, and psychology (psychotherapy) determine the potential for resolving inevitable crises in scientific knowledge. Returning to the question of psychotherapeutic influence and realizing the complexity and risk in generalizing its mechanisms in different areas of psychotherapy, I propose to consider the focus of this influence as a system of human self-regulation carried out from the point of view at five levels: bodily, emotional, behavioral, cognitive, communication and relationships (with the world of objects and the world of people). My proposal is based on the bio psychosocial approach generally accepted in medicine, modern discoveries in the field of neuroscience (for example, the paravagal theory of Stephen Porges, neuropsychoanalysis of Mark Solms), as well as on the philosophical and psychological foundations of the theory of self-regulation, considered in the works of modern philosophers and anthropologists. As a result of self-regulation, the body retains its integrity (boundaries) and develops in accordance with the requirements of the environment and its own growth. All these levels are closely interrelated and operate in parallel. Any restrictions (age, constitutional, introduced by the disease) determine the originality of the process of self- regulation, and the symptom (behavior) is considered as a creative adaptation and as a reflection of impaired regulation. The point of recovery and the entrance to restore the work of this system is determined by the psychotherapeutic direction (bodily processes, emotions, behavior, cognition (including meanings and belief system), connection with the mother, a holistic approach considering the process of contacting as a whole, parallelism and interrelation of all levels of response).

The development of the cognitive system of self-regulation inevitably goes with the improvement of the worldview, the perception system, the formation of a belief system and the search for the meaning of one's own life. These questions have always worried mankind and prompted them to seek answers to these questions in search of finding happiness in overcoming life's difficulties. It is necessary to recognize the historical primacy of philosophy in the practice of "Self–care", its very emergence was the result of a person's desire to understand the meaning of his being and the nature of the world - the inevitable questions of human existence. Psychology (psychiatry), having separated from philosophy at the end of the XIX century, since the time of K. Jaspers and M. Foucault continue to look for points of their own identification.

1. Karvasarsky BD. Psychotherapy. St. Petersburg. 2008.
2. Alexandrov AA. Psychotherapy. A study guide. St. Petersburg, St. Petersburg. 2004.
3. Linde ND. Fundamentals of modern psychotherapy. M Academy. 2002.
4. Makarov VV. Selected lectures on psychotherapy. M. 2000.