Mendelevich psychology. Mendelevich VD Clinical and medical psychology: A practical guide. basic knowledge of computer diagnostics

Http://marsexx.narod.ru/psychology/mendelevich-klinich-psy.html#089 Mendelevich V.D. Clinical and medical psychology: A Practical Guide. - M.: MEDpress, 2001. - 592 p. The practical guide reflects the main sections of clinical (medical) psychology: research methods (clinical interviewing, pathological and neuropsychological experiments), the principles of differentiation of the norm and pathology of mental activity, the psychology of individual differences, the psychology of the patient and the psychology of therapeutic interaction, the psychology of deviant behavior, neurotic and psychosomatic disorders , developmental and family clinical psychology, psychological counseling, psychocorrection and the basics of psychotherapy, etc. Each section contains tests for programmed knowledge control. The guide is intended for medical and practical psychologists , psychotherapists, psychiatrists, doctors of various profiles, nurses, social workers, and is also intended for students studying clinical (medical) psychology. Psychological counseling Counseling in the process of providing psychological assistance involves a joint discussion of the doctor, clinical psychologist, on the one hand, and the patient or client, on the other, the problems that a person has, possible options for overcoming and preventing them, as well as informing the individual about his individual psychological qualities , specific types of response, methods of self-regulation. Counseling is aimed at developing an active position of a person in relation to psychological problems, frustrations and stresses in order to learn ways to restore or maintain emotional comfort in critical life situations. The diagnostic process in the structure of psychological counseling includes clinical interviewing (see Chapter 1) and the use of a battery of experimental psychological techniques to determine the functioning of mental processes and personality parameters. In practical terms, essential in counseling is the process of informing a person about the objective parameters of his mental activity and personality traits, as well as teaching methods of mental self-regulation. Informing the client is a rather delicate and complex process, since it involves not only impartial presentation of facts, but also taking into account the possible reactions of a person to information about himself. There are several communication strategies that differ fundamentally in the degree of use of evaluation categories, focus and terminology used. Taking into account the fact that a clinical psychologist or doctor receives a sufficiently large amount of objective data during the examination of a client (patient), different focusing is possible when informing. You can fix attention on: a) obvious deviations in the functioning of the body and psyche; b) all existing deviations; c) deviations that the individual is able to comprehend and change; d) the whole spectrum of manifestations - both normal and abnormal; e) normative signs and manifestations. There are three approaches to focusing attention and informing a person: optimistic, pessimistic and neutral. The same information can be perceived as positive, negative or indifferent. A classic example is informing about the amount of liquid in a glass of water: 1) the glass is half full, 2) half empty, or 3) the liquid in the glass takes up half the volume. It is possible to choose different objects of focusing a person's attention in the process of providing psychological assistance. These can be separate functions or activities of the entire organism of cash (“You have a qualitatively impaired process of motivational mediation of activity and a changed hierarchy of values” or “You have significant deviations in behavior due to character accentuations and violations of volitional regulation of activity”). In the process of informing, there is a different approach not only to focusing, but also to describing and evaluating the clinical phenomena identified in the process of interviewing and diagnosing. Evaluative or descriptive approaches are possible. In the first case, informing includes evaluation categories (adequate-inadequate, normal-pathological, healthy-sick, defective, etc.). In the second case, when informing, a psychologist or doctor tries to avoid evaluative categories and focuses only on the description of clinical phenomena, providing, if necessary, a multivariate interpretation of the facts obtained. - 476 The terminology used by the clinician (psychologist or doctor) is also essential in the informing process. He can use specific scientific terminology and even jargon (“diversity of thinking”, “use of causal attribution”, etc.) that are incomprehensible to the examined, or, taking into account the language and other parameters of the client, draw a conclusion in ordinary language. Teaching self-regulation skills in the process of psychological counseling is carried out in various ways with a focus on the priority of providing the client or patient with the maximum possible information about the methods and methods of psychological protection and compensation, sanity and pathogenetic patterns of thinking and forecasting, patterns of development, stages and outcomes of interpersonal and intrapersonal conflicts. In the process of counseling, an individual learns the skills of a reflective style of thinking, common sense and adaptive forms of response solely with the help of information, since the training method is included in the structure of another type of psychological assistance - psychocorrection. First of all, the client or patient acquires knowledge of the methods of psychological protection. Their essence is to maintain a balance between external forces acting on a person and internal resources. The following variants of psychological defense mechanisms are distinguished: rationalization, projection, repression, identification, compensation, hypercompensation, fantasizing, dominant ideas (M. Yarosh). Rationalization - the desire for self-justification, the search for the causes and motives of their actions in the external environment. Blaming, for example, other people for causing an illness or psychological problem. The patient at the same time tries to find the most convincing and plausible evidence of the external conditionality of his painful statements and inadequate actions, trying consciously or subconsciously to avoid recognizing the painful fact of the development of his illness. Projection is the attribution of unfavorable character traits to others. Such a mechanism of personal defense is most often noted in patients with borderline mental pathology (with personality disorders and neuroses). The patient consciously or unconsciously tries to give the doctor the impression that his painful breakdown is a consequence of negative traits character of those close to him. Repression - is manifested in forgetting, ignoring the obvious facts of incorrect behavior or symptoms of the disease, up to its complete non-recognition. Most clearly, repression is manifested in hysterical disorders - the patient often does not remember the most unpleasant and difficult events for him. Identification - the achievement of inner mental calm by comparing, identifying oneself with someone else (for example, with one's children - the desire that they achieve in life what he did not achieve himself). Compensation is based on the desire to achieve success in one area and, thus, to compensate for failures in another area, caused, for example, by insufficient physical abilities, lack of talent, speech defect (for example, increased music lessons in order to be different from to get someone's attention). Hypercompensation - the desire to achieve success and a sense of significance precisely in the area that has so far been the most difficult (physically weak, with the help of intensive training, tries to be the strongest in any sport, a timid and cowardly person hides behind feigned swagger and rudeness, deceitful a person strives to convince others and is partly even convinced of his exceptional honesty). Fantasizing manifests itself in the form of imagining the fulfillment of unrealizable desires or the successful resolution of some painful situation, in identifying oneself with some literary or epic hero. It helps to reduce painful intrapsychic stress caused by life failure or illness. Dominant or overvalued ideas are beliefs with a strong emotional charge that are taken as the most important in life and serve as a motivational stimulus to achieve a specific goal, despite the difficulties that arise. At the same time, one's own inconveniences and insults caused to others are not taken into account. According to P. Leister, the main protective mechanisms of the personality have both advantages and disadvantages, which is important to inform the client in the process of psychological counseling in order to form his conscious or unconscious attitude to psychological problems associated with life difficulties or intrapersonal conflicts (Table 22) . Assimilation by an individual of knowledge about the mechanisms of psychological defense is able to form a new look at their own psyche, patterns and features of mental response in stressful situations; change these perceptions if they are found to be unacceptable after appropriate analysis. Thus, in the process of counseling and obtaining information about the methods of psychological protection, the person himself will be able to choose from the options that suit him. Counseling does not impose on the client or patient the only correct way to solve interpersonal or intrapersonal problems, but provides a multivariate overview of possible behavior. Unlike psychocorrection and psychotherapy, the choice of a way to resolve problems or personal transformation remains with the individual. Psychological counseling is used for any psychological problems of a person as the initial stage of therapy and "personality reconstruction". Often its use is combined with the use of psychocorrection and psychotherapy. A specific target of counseling are psychological phenomena caused by identity crises and other worldview problems, as well as communication disorders. In the field of analysis and evaluation of worldview crises, existential problems, the use of psychocorrection or psychotherapy is considered unreasonable and ineffective. The only way to provide effective psychological assistance to a person during an existential crisis that is not accompanied by pronounced psychopathological manifestations is the use of psychological counseling - joint (client and psycho-479Table 22 Advantages of psychological protection Advantages and disadvantages of methods Disadvantages Self-esteem and self-affirmation against external criticism Businesslike and constructive discussion of the problem is eliminated, a person creates an obstacle for himself in order to look better from the point of view of other people Projection One can "not see the beam in one's own eye" and criticize it "in the eye of another." You can fight your own mistakes without doing anything with yourself Self-knowledge and maturation of the personality is difficult Impossible to objectively perceive the external world The projection is hardly distinguishable by the personality, this deprives it of realism Repression The unfulfillable unacceptable are repressed from the desire, and Repression requires energy to represent its maintenance. The problem of non-consciousness is solved for the sake of it, it remains, and it is peace that brings instant liberation of health as a threat to mental health. Identification Thanks to introjection, the formation of the Super-I occurs, the norms that bring liberation from conflicts are adopted. The controller (Super-I) becomes an internal tyrant. Man becomes a slave to introjected norms and therefore not free. Through identification with the aggressor and authority, the principle spreads further: what they do to me, I do to others. Sublimation The energy of tension will fully react in socially useful activities: creativity, sports, etc. The causes of tension are missed. Sublimated tension does not disappear, therefore, a more or less conscious state of frustration arises. Formation of reactions Masking already existing feelings, Formation of reactions leads to a decrease in tension due to lies, which also delays the newest types of interaction between a person and people around him Advantages Disadvantages Escape The person avoids criticism due to this Frustration and Observer position reduces the productivity and activity of a person, in the future there are problems with self-regulation Stunning Due to alcohol or Dependence on alcohol and narcotic drugs The change eliminates conflicts, organic structures, the disease of frustration, fears, guilt, a sense of strength is achieved. This is a salvation from the frightening reality Screening Fencing off from mental Symptoms disappear without eliminating stress, depressive causes. This leads to the accumulation of moods, fears, negative anxiety experiences in a short time. There is a transient feeling of peace, stability, relaxation, balance and, as a result, a satisfactory temporary release. Interpretation by impotence "I can not do anything - such are the circumstances" - thus the person avoids solving problems Psychological problems are not eliminated, but spread further. The danger of manipulation appears Role-playing The mask of the role brings the Failure to find oneself beyond safety. The need for put on, programmed security is stronger than the mask blocked freedom of self-expression of individuality Petrification, dulling of feelings Business mask, a picture of complete emotionlessness and mental equanimity. The shell on the feelings does not allow them to manifest themselves outside and get inside. A person is guided by the behavior of the automaton. Interpersonal contacts are depleted, repressed feelings become a burden on organs and muscles. Who does not allow himself to be emotional, then becomes physically and mentally sick (log) search for truth, consideration of the philosophical issues of being, life and death from various positions and points of view, as well as emotional support for a person. At the same time, it should be borne in mind that the choice of a method of action in such conditions remains with the individual. A classic example of a collision of various types of psychological influence is the suicidal intentions of an individual, due to interpersonal or intrapersonal conflicts. After excluding the psychopathological (unconscious or painful) motives of a person's desire to commit suicide, a clinical psychologist, as a rule, can choose three well-known ways of psychological influence on a person: "the path of counseling", "the path of psychocorrection" and "the psychotherapeutic path". His choice will be based, first of all, on theoretical preferences and understanding of the mechanisms of suicidal behavior, while the individual psychological characteristics of a potential suicide may not be considered at all. Due to theoretical (ideological and professional) views, a psychologist can choose either counseling using a joint discussion of existential issues and transferring responsibility for making a decision to the client himself; or psycho-correction, in the conditions of which he will engage in training aimed at maintaining the focus on saving life with the help of a system for eradicating the “wrong ideological attitude” to death; or psychotherapy, in which it will consider suicidal thoughts and intentions as a pathology requiring relief, for example, suggestion. The target for psychological counseling is also interpersonal conflicts: divorce, betrayal, dismissal, punishment, and others, which are considered by the individual through the prism of worldview and moral problems. External psycho-traumatic events are interpreted by a person as immoral and bring to life the fundamental questions of being - justice, fidelity, trust, etc. Therefore, in these cases, the use of psychological counseling should be recognized as the most adequate and given preference over other methods of psychological influence. A similar process occurs when a person has a somatic disease. It also requires not correction or therapy, but, first of all, counseling. The most famous methods that relate to psychological counseling are rational psychotherapy (P. Dubois), logotherapy (V. Frankl), self-realization psychology (A. Maslow), positive psychotherapy (N. Peseschldan), cognitive therapy (A. Vesk ), rational emotive psychotherapy (A. Ellis) and psychotherapy "common sense". Despite the fact that the term psychotherapy is present in the name of the methods, in fact these methods should be recognized as advisory. This is due, firstly, to the fact that psychological assistance is provided by influencing the worldview; secondly, because the main method is the method of informing the client and thirdly, because of the “therapeutic target”, which in this case is the worldview and worldview of a person and secondarily psychological problems and neurotic symptoms. Domestic methods, which should also be classified as advisory, first of all, include the so-called. pathogenetic psychotherapy based on the theory of personality relations by VN Myasishchev. The main task of pathogenetic psychotherapy is to inform the patient or client with the aim of: understanding the motives of their behavior, the characteristics of their relationships, emotional and behavioral reactions, awareness of the non-constructive nature of emotional and behavioral stereotypes of a number of their relationships, awareness of the connection between various psychogenic factors and neurotic (psychosomatic) disorders, awareness of the measure their participation and responsibility in the emergence of conflict and psycho-traumatic situations, awareness of the deeper causes of their experiences and ways of responding, rooted in childhood, as well as the conditions for the formation of their system of relationships, learning to understand and verbalize their feelings. learning self-regulation Pathogenetic psychotherapy is carried out in four stages. At the first stage, the patient's misconceptions about his disease are overcome; on the second - awareness psychological reasons and mechanisms of the disease; on the third - the solution of the conflict and on the fourth - the reconstruction of the system of personality relations. Logotherapy refers to the humanistic direction of psychotherapy in the broad sense of the term and aims to treat noogenic neuroses by acquiring the meaning of life lost by a person due to some reasons. The mechanism of development of psychological problems and neurotic symptoms is seen in the moral quest of a person, the conflict of conscience and, in general, in the "existential crisis". The task of logotherapy becomes the restoration or acquisition by a person of lost spirituality, freedom and responsibility, based on the well-known position of A. Einstein, expressed in the following words: “A person who considers his life meaningless is not only unhappy, he is hardly fit for life at all.” V.Frankl believed that it is possible to return the lost meaning with the help of the method of persuasion. Belief uses a system of logical justifications for the uniqueness of the values (meaning) of life with the absolute value of transcendence - the essence of existence. The basis of logotherapy is the healing of the soul through the formation of a meaningful desire for meaning and even for the final meaning (supermeaning) as opposed to the desire for pleasure or power. Within the framework of the psychology of self-realization, the emphasis is on developing a psychological strategy to make the most of one's own personal potential in life, which includes: 1. The inner nature of a person, his individual self in the form of basic needs, abilities, individual psychological characteristics. 2. Potential opportunities, not real final states, the realization of which is determined by extrapsychic factors (civilization, family, environment, education, etc.). 3. Authenticity - the ability to know your true needs and capabilities. 4. The ability to accept yourself. 5. The need for love. A. Maslow recognized that an individual has values of being (Values) and values that are formed according to the principle of eliminating scarcity (Values). The values of being include such as: 1) integrity - unity, integration, striving for homogeneity, interconnectedness; 2) perfection - necessity, naturalness, relevance; 3) completeness - finiteness; 4) justice - legality, obligation; 5) vitality - spontaneity, self-regulation; 6) completeness - differentiation, complexity; 7) simplicity - sincerity, essence; 8) beauty - correctness; 9) righteousness - rightness, desirability; 10) uniqueness - uniqueness, individuality, incomparability; P) ease - lightness, lack of tension - 484 - grace; 12) game - fun, joy, pleasure; 13) truth - honesty, reality; 14) self-sufficiency - autonomy, independence, the ability to be oneself without the participation of other people. Positive psychotherapy proceeds from the principle of a person's ability to self-development and harmony. The main goals of positive psychotherapy are: changing a person’s ideas about himself, his actual and basic abilities of knowing the mechanisms of conflict processing traditional for him, his family and culture, expanding his life goals, identifying reserves and new opportunities to overcome conflict situations and diseases For these purposes, a transcultural approach is used to assess certain psychological phenomena and painful symptoms. Its essence is to provide the client or patient with information about the attitude to similar psychological manifestations, symptoms, problems or diseases in other cultures. For example, with a pathological emotional reaction of an individual to alopecia (baldness) detected in him, he is given an example of the attitude to baldness in some African tribes, where the standard of beauty is not thick hair, but bald voices. Transcultural comparisons are aimed at developing a client's understanding of the relativity of life values. Another way in positive psychotherapy is a positive interpretation of any problems and symptoms (for example, impotence is interpreted as the ability to avoid conflicts in the sexual sphere, frigidity - as the ability to say “no” with the body, anorexia - as the ability to get by with a minimum of food, etc.). Particular attention in positive psychotherapy is paid to the formation of personal and characterological harmony by providing information on traditional transcultural ways of processing conflicts and forming values (see Chapter 4). Cognitive therapy considers the mechanisms of the emergence of various emotional phenomena in connection with the patient's deviations in assessing reality in the form of "systematic biases". It is believed that emotional disorders arise due to "cognitive vulnerability" - a predisposition to stress due to the use of cruelly given irrational delusions ("cognitive distortions") in the analysis of external events. Among them are: overgeneralization (unjustified generalization based on a single case) catastrophization (exaggeration of the consequences of any events) arbitrariness of conclusions (unproven and inconsistency in making conclusions) personalization (tendency to interpret events in the context of personal meanings) dichotomy of thinking (tendency to use in thinking extremes) selectivity of abstraction (conceptualization of the situation on the basis of a detail extracted from the context). The purpose of cognitive therapy is to correct the erroneous processing of information and modify beliefs in the direction of its rationalization and the development of a life strategy of common sense. Close in meaning to cognitive therapy is considered rationalemotive therapy, which aims to eradicate cognitive distortions, etc. "irrational attitudes and thoughts." A. Ellis described twelve basic irrational ideas that should be corrected in the process of counseling: 1. It is absolutely necessary for an adult that every step he takes is attractive to others. 2. There are vicious, bad deeds. And the perpetrators should be severely punished. 3. It's a disaster when things don't go as planned. 4. All troubles are imposed on us from the outside - by people or circumstances. 5. If something scares or causes fear - be constantly on the alert. 6. It is easier to avoid responsibility and difficulties than to overcome them. 7. Everyone needs something stronger and more significant than what he feels in himself. 8. One must be competent, adequate, reasonable and successful in all respects. 9. What has greatly affected your life once will always affect it. -48610. Our well-being is influenced by the actions of other people, so we must do everything so that these people change in the direction we want. 11. Going with the flow and doing nothing is the way to happiness. 12. We have no control over our emotions and cannot help but experience them. In accordance with the principles of rational-emotive therapy on the part of the client or patient, there must be a “rejection of requirements” to reality and to oneself, based on irrational ideas (attitudes), which are divided into four groups: attitudes of obligation (“people must be honest”, "the husband must be faithful"); catastrophic attitudes (“everything is terrible and irreparable”); setting the obligatory realization of one's needs (“I should be happy”); appraisal setting. The main method of therapy is the Socratic dialogue - a cognitive dispute using the laws of logic. The method of rational psychotherapy is also based on the logical persuasion of the client or patient, aimed at teaching a person to think correctly, avoiding logical errors and delusions in order to prevent the appearance of neurotic symptoms. Psychotherapy by "common sense" includes, along with elements of rational psychotherapy, i.e. persuasion of a person on the basis of logical argumentation and the formation of correct thinking based on certainty, consistency and evidence, the formation of a multivariate way of understanding reality. Oi is opposed to one-variant (rigid), which is part of the Pathological mental pattern with the so-called. causal attribution. The basis of a personal position in psychotherapy with “common sense” is considered to be “anticipatory consistency” (V. D. Mendelevich) - the ability of a person to anticipate the course of events, to build a forecasting process on a multi-variant flexible basis, using past life experience. It is believed that harmonious character traits and personality traits, as well as neurosis resistance, can be formed only if such principles are used as: a) refusal of claims (“no one owes me anything”); b) rejection of unambiguity (when interpreting ongoing events - “it can mean anything you want”); c) rejection of fatality (with -487 interpretation of future events - "everything is possible"); d) developing a strategy of "anticipating coping" and "anticipating sadness" instead of "anticipating joy". Psychological correction The purposes of applying psychological correction (psycho-correction) are the optimization, correction and normalization of any mental functions of a person, deviations from the optimal level of his individual psychological characteristics and abilities. There are five types of psycho-correction strategies (Yu.S. Shevchenko): 1. Psycho-correction of individual mental functions and components of the psyche (attention, memory, constructive and verbal thinking, phonemic perception, manual skill, cognitive activity, etc.), or personality correction. 2. Directive impact. or non-directive strategy of psycho-corrective 3. Correction aimed at the individual or focused on the family. 4. Psychocorrection in the form of individual or group lessons. 5. Psychocorrection as a component of clinical psychotherapy in the complex treatment of neuropsychiatric diseases, or as the main and leading method of psychological impact on a person with behavioral deviations and social adaptation. In contrast to psychological counseling, in psychocorrection, the role of the client or patient is not so active and even more often passive. Correction implies the development of new psychologically adequate and profitable skills in the process of specially designed training programs. The activity of the client or patient consists only in the desire to change, but by no means in existential work above oneself. A person is ready to “surrender himself” to a clinical psychologist or psychotherapist in order for him to fill in the existing shortcomings, correct deviations, instill new skills and abilities. Even if we are talking about the psycho-correction of personal or characterological properties, it means that the main way of changes and psychological help should be the process of learning to effectively accept oneself and reality, and not a philosophical understanding of one's place in the world, one's capabilities and abilities. Psychocorrection, in contrast to psychological counseling, uses manipulation, formation and control of a person as its main methods, having clear ideas about the desired state, the level of development of mental functions or individual-personal qualities. Standards and ideals are given. A person acts as a material from which an image that is optimal for him or ideal for society is “molded”. The responsibility for psychological change rests solely with the psychologist. The spectrum of manipulative techniques is classic: from Carnegie's advice to neuro-linguistic programming and various trainings (feminine charm, personal growth, sexual training, etc.). IN clinical psychology psychocorrection is used for psychological problems identified in the client, arising in connection with characterological deviations and personality anomalies, as well as for neurotic psychosomatic disorders. The development of optimal skills occurs in the process of training, among which the most famous are: auto-training, behavioral (behavioral) therapy, neuro-linguistic programming, psychodrama, transact analysis (E. Bern). Autogenic training (autotraining) is a technique aimed at mastering the skills of mental self-regulation using relaxation methods. Relaxation (relaxation) is understood as a state of wakefulness, characterized by reduced psychophysiological activity, felt either throughout the body or in any of its systems. In clinical psychology, especially in psychosomatic disorders and diseases, such varieties are used as the actual autogenic training with the so-called. neuromuscular relaxation and biofeedback technique. With progressive muscle relaxation, a person is trained to control the state of muscles and induce relaxation (relaxation) in certain muscle groups in order to relieve secondary emotional stress. Autogenic training is carried out in several stages, aimed at mastering exercises to relieve neuromuscular tension to a specific muscle or muscle group, followed by the formation of a “habit of rest”. -489 The biofeedback technique is based on the principle of conditioned reflex fixing of the skill to change one's somatic state while controlling it with the help of various devices (Figure 26). In the process of training, the patient independently controls the biological functioning of his body using the device (from the speed of elementary biochemical reactions to complex activities) and learns to change it using various methods of self-regulation. There are the following types of biofeedback (A.A. Aleksandrov): electromyographic biofeedback temperature biofeedback electrocutaneous biofeedback electroencephalographic biofeedback When electromyographic biofeedback is learning the process of relaxation of a specific muscle or muscle groups, as well as general relaxation. The temperature biofeedback technique allows you to acquire the skills of expanding and narrowing the peripheral vessels, which leads to a change in the temperature of the limbs and body. Electrocutaneous biofeedback makes it possible to learn how to control galvanic skin reactions by influencing sympathetic nerve activity. With electroencephalographic biofeedback, skills are formed to change the bioelectrical activity of the brain by changing the ratio of waves of different frequencies and, first of all, increasing alpha activity to reduce the level of excitability and calm down. Behavioral psychotherapy is replete with techniques based on the development of conditioned reflex activity in order to relieve psychopathological symptoms or skills of adequate habits instead of inadequate, neurotic ones. The most well-known techniques are those of "systematic desensitization" and "paradoxical intention" used to treat obsessive fears. With “systematic desensitization”, a person is immersed in a situation that causes fear (imaginary or real) with the formation of a new adequate reaction to the situation and the attenuation of the old painful one. The technique called “paradoxical intention” is aimed at changing the patient’s attitude to phobias by “turning” this attitude and bringing the situation to the point of absurdity (with ereitophobia, fear of blushing, learning to set yourself up like this: “Well, show everyone how you are you know how to blush. Let everyone see how you manage to do it”). The task of the paradoxical intention is to deprive the emotionally negative reinforcement of fears, replacing them with irony and humor. Neuro-linguistic programming is a system of psychological manipulations based on the study of the linguistic metamodel of a person, the essence of which lies in the recognition of the pattern for each group of people or one person of the linguistic system of knowing the world and oneself, expressing feelings and solving problems. To do this, in neuro-linguistic programming (NLP) there is the concept of modality - the most typical and characteristic way for an individual to perceive and reflect the surrounding reality. There are three types of modality: visual, auditory and kinesthetic. After identifying the dominant modality of a person, a correction of his behavior is expected, which may or may not be realized by the person himself. In the first case, we can talk about managing an individual, in the second - about manipulating him with the help of verbal and non-verbal methods. The goal of programming is to develop a specific behavioral strategy that is desirable for a person or environment. Within the framework of neurolinguistic programming, several techniques are used: "anchoring", "swipe", "explosion", "metaphor". -491 The main thing is "reframing" - the reshaping of the personality, giving it a new predetermined form. Reframing is based on the following basic provisions of neurolinguistic programming: 1. Any symptom, any reaction, or human behavior is initially protective and therefore useful; they are considered harmful only when used in an inappropriate context; 2. Each person has his own subjective model of the world, which can be changed; 3. Each person has hidden resources that make it possible to change both subjective perception, and subjective experience, and the subjective model of the world. Reframing is carried out most often in six stages. The first is to identify the symptom; on the second, the patient is invited to make a kind of splitting himself into parts (healthy and pathological, represented by a symptom) and come into contact with the part responsible for the formation and manifestation of the symptom, and comprehend the mechanism of its occurrence; on the third stage, the symptom is separated from the original motive (intention); on the fourth - the discovery of a new part capable of satisfying this intention in other ways with "setting an anchor" (an associative connection between events or thoughts); on the fifth and sixth - the formation of the consent of the whole I to a new connection. In the process of psychodrama, a person plays roles in order to study inner peace and developing skills for optimal social behavior. As a rule, psychodrama is used when an individual has characterological deviations and an "inferiority complex". A person in the process of playing activity learns stereotypes of behavior in various life situations, tests them, chooses the most suitable for him and thereby overcomes communication problems. Transactional analysis considers a person's personality as a set of three states of "I", conditionally named Parent, Adult and Child. Their essence is a genetically programmed pattern of behavior and manifestations of emotional reactions. The Child manifests himself with infantile character traits and attitudes towards reality, the Adult - with signs of mature mental activity, and the Parent is characterized by the presence of normative and evaluative behavioral stereotypes. Psychological interaction, from the point of view of E. Bern, occurs in the form of a dyadic contact (transaction) when using certain roles. The main goal of transactional analysis is to make the individual understand the features of his interaction with others using the appropriate terminology and teach him normative and optimal behavior. Psychotherapy Psychotherapy is one of the types of psychological assistance and psychological impact on the patient in order to relieve psychopathological (primarily neurotic and psychosomatic) symptoms. As shown above, psychotherapy belongs to the field of medical activity, because: a) it combines psychological and general medical knowledge regarding indications and contraindications; b) imposes liability (including criminal liability) on the psychotherapist for improper or inappropriate (unqualified) use of methods and methods of psychotherapy. Traditionally, there are three approaches to psychotherapy: psychodynamic, behavioral (behavioral) and phenomenological: Their differences are presented in Table 23 (N.Karasu). The goal of psychotherapy in the narrow sense of the term is to heal the patient from psychopathological symptoms within the framework of neurotic, characterological (personal) or psychosomatic disorders. The choice of a specific psychotherapeutic technique depends on a number of objective and subjective factors. Among the objective ones, the following stands out: the nature of the psychopathological symptom (syndrome) the etiopathogenesis of mental disorders the individual psychological characteristics of the patient Among the subjective parameters, importance is attached to: a) the individual psychological characteristics of the psychotherapist; b) the breadth of his psychotherapeutic knowledge and skills; c) situational moments (availability of time and appropriate place for a psychotherapeutic session). Orientation to the selected clinical parameters is justified by the effectiveness of certain methods practiced by certain psychotherapists in certain mental states and processes of the patient. -493Table 23 Differences in Psychotherapeutic Approaches Basic Dynamic Behavioral Phenomenological Thematic Approach Approach Approach Parameters Human Nature Moves Product of sexual and social aggressive learning and conditioning instincts; behaves on the basis of past experience Has free will and the ability to self-determination and self-actualization Main problem Sexual repression Mental alienation Concept of pathology Conflicts in the Acquired sphere stereotypes of instincts: behaviors unconscious early libidinal drives Existential alienation: loss of opportunities, splitting of "I", mismatch between thoughts, feelings and behavior (loss of authenticity) The concept of health Resolution of intrapsychic conflicts: the victory of "Ego" over "Id", i.e. the power of the "Ego" Symptom elimination: absence of a specific symptom or reduction of anxiety Actualization of personal potential: growth of the "I", authenticity and spontaneity Type of change Deep insight: understanding of the early past Direct learning: behavior in the current present, i.e. action or action in the imagination Immediate experience: sensation or feeling in the moment Temporal approach "focus" Non-historical: Absence of historicism: objective phenomenological present moment ("here-and-now") Historical: and subjective past Anxiety -494 Table 23 continued approach approach approach parameters Tasks of the therapist Understand unconscious mental content and its historical, hidden meaning Program, reinforce, suppress or form specific behavioral responses to eliminate anxiety Interact in an atmosphere of mutual acceptance conducive to self-expression (from physical to mental) Basic techniques Interpretation. Material: free association, dreams, routine behavior, transference and resistance Conditioning systematic desensitization, positive and negative reinforcement, modeling "Encounter" ("meeting"): equal participation in dialogue, experiments or games, dramatization or acting out feelings Therapist's role Neutral . Helps the patient explore the meaning of free association and other material from the unconscious. Teacher (trainer). Facilitator Helps (accelerator) the patient to replace personality maladaptive behavior with adaptive one. Active, action-oriented Nature of the relationship between therapist and patient Transference and treatment paramount: unreal relationship Real but treatment secondary: no relationship Real and treatment paramount, real relationship Treatment model Medical: doctor-patient. Authoritarian. Therapeutic Union Educational teacher-student. Authoritarian. Educational union Existential: communication of two equal people. Egalitarian (equal). Human Union -495- Growth The most famous and widespread psychotherapeutic methods are: opposite (hypnosis and other forms of suggestion), psychoanalytic (psychodynamic), behavioral, phenomenologically humanistic (for example, Gestalt therapy), used in individual, collective and group forms. Suggestive methods are understood as a variety of psychological influences with the help of direct or indirect suggestion, i.e. verbal or non-verbal influence on a person in order to create a certain state in him or induce him to certain actions. Often, suggestion is accompanied by a change in the patient's consciousness, the creation of a specific attitude to the perception of information on the part of the psychotherapist. The provision of a suggestive impact implies that a person has special qualities of mental activity: suggestibility and hypnotizability. Suggestibility is the ability to uncritically (without the participation of the will) perceive the information received and easily succumb to persuasion, combined with signs of increased gullibility, naivety and other features of infantilism. Hypnotizability is a psychophysiological ability (susceptibility) to easily and freely enter a hypnotic state, to succumb to hypnosis, i.e. change the level of consciousness with the formation of transitional states between sleep and wakefulness. He distinguishes three stages of hypnosis: lethargic, cataleptic and somnambulistic. With the first one, a person experiences drowsiness, with the second - signs of catalepsy - waxy flexibility, stupor (immobility), mugism, with the third - complete detachment from reality, sleepwalking and suggested images. The use of hypnotherapy is justified in hysterical neurotic, dissociative (conversion) disorders and hysterical personality disorders. Suggestion, used in the form of heterosuggestion (suggestion made by another person) and autosuggestion (self-hypnosis), is aimed at relieving emotional neurotic symptoms, normalizing a person’s mental state in crisis periods , after exposure to mental trauma and as a way of psychoprophylaxis. It is effective to use suggestive methods of psychotherapy to remove psychological maladaptive types of an individual's response to a somatic disease. Use indirect and direct methods of suggestion. In case of indirect, they resort to the help of an additional stimulus. Psychoanalytic psychotherapy proceeds from the unconscious mechanism of the formation of psychopathological symptoms (non-vrotic, psychosomatic) and, as a result, is aimed at translating unconscious drives into a person's consciousness, their processing and reaction. In classical psychoanalysis, such psychotherapeutic techniques are distinguished as: the method of free associations, reactions of transference and resistance. When using the method of free associations, a person produces a stream of thoughts, childhood memories, without giving in to their analysis and criticism, and the psychotherapist-psychoanalyst evaluates them, sorting them according to their significance, trying to identify pathogenic childhood experiences repressed from consciousness. Then the patient is required to respond (catharsis) to significant experiences in order to get rid of their negative impact on mental activity. In a similar way, the process of therapy occurs in the analysis of dreams, erroneous actions (slips of the tongue and reservations) of a person, behind which, as it is believed in psychoanalysis, there is a symbolic designation of symptoms and problems in connection with their displacement from consciousness. The main indication for the use of psychoanalytic psychotherapy is the patient's analyzeability (a phenomenon similar to hypnotizability and suggestibility in suggestive psychotherapy), which depends on the patient's personal characteristics, primarily on the intensity of motivation for a long process of therapy, as well as on the ability to remove control over one's thoughts and feelings and the ability to identify with other people. Contraindications include hysterical personality disorders. Behavioral psychotherapy is described in the section on psychocorrectional measures, since it is not fully therapeutically directed. Its essence is not stopping, i.e. treatment of psychopathological symptoms, introduction into the process of the etiopathogenesis of the disease, but learning and training. Cognitive psychotherapy is more correctly classified as a method of counseling than therapy. This is due to the formation of a personal position to a greater extent through the methods of dialogue and partnership between the patient (client) and the therapist. From the phenomenological-humanistic direction of psychotherapy, which is also close to psychological counseling, the most technically developed is Gestalt therapy. The main methods of gestalt therapy include: exercises aimed at expanding awareness using the principle of "here and now"; the formation of complete gestalts through the integration of opposites; work with dreams, etc. -497-

PSYCHOLOGY

Clinical interview

Experimental-psychological (patho- and neuropsychological) research methods

Pathopsychological research methods.

Pathopsychological assessment of attention disorders

Pathopsychological evaluation of memory disorders

Pathopsychological assessment of perceptual disorders

Pathopsychological assessment of thought disorders

Pathopsychological assessment of intellectual disabilities

Pathopsychological evaluation of emotional disorders

Pathopsychological assessment of individual psychological characteristics

Experimental neuropsychological study

Evaluation of the effectiveness of psychocorrectional and psychotherapeutic effects

Chapter 2 CLINICAL MANIFESTATIONS OF MENTAL NORM AND PATHOLOGY

Principles for distinguishing between psychological phenomena and psychopathological symptoms

Diagnostic principles-alternatives

Illness-personality

nosos-pathos

reaction-state-development

Psychotic-non-psychotic

Exogenous-endogenous-psychogenic

defect-recovery-chronification

Adaptation-disadaptation, compensation-decompensation

negative-positive

Phenomenology of clinical manifestations

PROGRAMMED KNOWLEDGE CONTROL:

Chapter 3 PSYCHOLOGICAL AND PATHOPSYCHOLOGICAL CHARACTERISTICS OF COGNITIVE PSYCHOLOGICAL PROCESSES

Semiotics

Feel

Perception

Attention

Memory

Thinking

Intelligence

Emotions

Will

Consciousness

Psychological phenomena and pathopsychological syndromes in mental illness

Neurotic disorders

Personality disorders.

Schizophrenia

Epileptic mental disorders

Organic mental disorders

PROGRAMMED KNOWLEDGE CONTROL:

Chapter 4 PSYCHOLOGY OF INDIVIDUAL DIFFERENCES

Temperament

Classification by A. Thomas and S. Chess:

Character

Personality

Personality structure (according to K.K. Platonov)

PROGRAMMED KNOWLEDGE CONTROL:

Chapter 5 PSYCHOLOGY OF THE PATIENT

Mental response to the disease and the psychology of the somatically ill

Age

Profession

Features of temperament

Character features

Personality Features

Psychological characteristics of patients with various somatic diseases

Oncological pathology

Obstetric and gynecological pathology

Therapeutic pathology

Surgical pathology

Defects of the body and sense organs

PROGRAMMED KNOWLEDGE CONTROL:

Chapter 6 PSYCHOLOGY OF THE TREATMENT INTERACTION

PROGRAMMED KNOWLEDGE CONTROL:

Chapter 7 NEUROTIC, PSYCHOSOMATIC AND SOMATOFORM DISORDERS

neuroses

Psychosomatic disorders and diseases

PROGRAMMED KNOWLEDGE CONTROL:

Chapter 8 PSYCHOLOGY OF DEVIANT BEHAVIOR

Aggressive behavior

Auto-aggressive behavior

Abuse of Substances Causing Altered Mental Conditions

Eating disorders

Sexual deviations and perversions

Overvalued psychological hobbies

Overvalued psychopathological hobbies

Characterological and pathocharacterological reactions

Communicative deviations

Immoral and immoral behavior

Unaesthetic behavior

PROGRAMMED KNOWLEDGE CONTROL:

Chapter 9 SPECIAL SECTIONS OF CLINICAL PSYCHOLOGY

Developmental Clinical Psychology*

Social and biological components of normal and abnormal human development

Mental characteristics and psychosomatic disorders during the neonatal period, infancy and early childhood

Mental characteristics and psychosomatic disorders in preschool and younger children school age

Psychology and psychopathology of early youth

Psychological characteristics and mental disorders of persons of mature, elderly and advanced age

Family Clinical Psychology

PROGRAMMED KNOWLEDGE CONTROL:

Chapter 10

Psychological counseling

Psychological correction

Psychotherapy

Parapsychology and psychic healing

PROGRAMMED KNOWLEDGE CONTROL:

APPS

APPENDIX to the topic: "PSYCHOLOGY OF INDIVIDUAL DIFFERENCES"

Strelyau Questionnaire

Eysenck test

Characterological questionnaire of K. Leonhard

APPENDIX to the topic: "PSYCHOLOGY OF THE SICK"

LOBI (Leningrad questionnaire of the Bechterev Institute)

APPENDIX to the topic: "NEUROTIC DISORDERS"

Clinical questionnaire for the detection and evaluation of neurotic conditions (K.K. Yakhin, D.M. Mendelevich)

APPENDIX to the topic: "PSYCHOLOGY OF DEVIANT BEHAVIOR"

Pathocharacterological Diagnostic Questionnaire (PDO)

APPENDIX to the topic: AGE CLINICAL PSYCHOLOGY

Test assessment of knowledge of youth psychology

ANSWERS to programmed control

INTRODUCTION

The history of the development of clinical psychology is a tortuous path. Located on the border between medicine and psychology, the new science now and then nailed to one or the other bank of the river called "human knowledge". For the sake of justice, it should be noted that until now the location of clinical psychology has not been fully determined, which can be explained by the interdisciplinary nature of this science.

The starting point for the emergence of clinical psychology can be considered the call of physicians "to treat not the disease, but the patient." It was from that time that the interpenetration of psychology and medicine began. Initially, clinical psychology, which was actively developed by psychiatrists, was aimed at studying deviations in intellectual and personal development, correcting maladaptive and delinquent forms of behavior. However, later the sphere of interest of clinical psychology was expanded by studying the mental state of persons with somatic diseases.

The term "clinical psychology" comes from the Greek kline, which means bed, hospital bed. In modern psychology, as a rule, the terms "clinical" and "medical" psychology are used interchangeably. In view of this fact, in what follows we will use only one of them. However, let's take into account the existing tradition of physicians to designate this field of knowledge as "medical psychology", and psychologists as "clinical psychology".

Clinical (medical) psychology- a science that studies the psychological characteristics of people suffering from various diseases, methods and methods for diagnosing mental disorders, differentiating psychological phenomena and psychopathological symptoms and syndromes, the psychology of the relationship between a patient and a medical worker, psycho-prophylactic, psycho-correctional and psychotherapeutic methods of helping patients, as well as theoretical aspects psychosomatic and somato-psychic interactions.

Today, there are a fairly large number of related psychological disciplines related to clinical psychology: pathopsychology, psychopathology, neuropsychology, psychology of deviant behavior, psychiatry, neuroscience, psychosomatic medicine, etc. Each of these disciplines combines medical and psychological knowledge. However, all of them are related to the clinic and, as a result, can be recognized as components of clinical psychology. In accordance with the traditions, the following sections are included in clinical psychology:

Psychology of the patient

Psychology of therapeutic interaction

Norm and pathology of mental activity

pathopsychology

Psychology of individual differences

Developmental clinical psychology

Family Clinical Psychology

Psychology of deviant behavior

Psychological counseling, psychocorrection and psychotherapy

neurosology

Psychosomatic medicine

Clinical psychology is closely related to related disciplines, primarily psychiatry and pathopsychology. The area of common scientific and practical interest of clinical psychology and psychiatry is diagnostic process. Recognition of psychopathological symptoms and syndromes is impossible without knowledge of their psychological antonyms - phenomena of everyday life that reflect the individual psychological characteristics of a person and are located within the normal variations of mental response. In addition, the process of diagnosing mental illness cannot do without “pathopsychological verification”.

Clinical psychology borrows methods for studying the mental characteristics of somatically ill patients from psychodiagnostics and general psychology; assessment of the adequacy or deviance of human behavior in psychiatry, developmental psychology and developmental psychology. The study of clinical psychology is impossible without medical knowledge, in particular, from the field of neurology, neurosurgery and related disciplines. The psychosomatic section of clinical psychology is based on scientific ideas from such areas as: psychotherapy, vegetology, valeology.

The most complete list of theoretical knowledge and practical skills of a clinical (medical) psychologist can be gleaned from the qualification characteristics of a specialist in this field. In accordance with the order of the Ministry of Health of the Russian Federation No. 391 of November 26, 1996, a medical psychologist must have the following

Theoretical knowledge:

Psychology and its significance for medicine: subject, tasks and interdisciplinary connections of medical psychology, the history of the formation of medical psychology as a field psychological science; medical psychology as a profession; main sections of medical psychology.

The main theoretical and methodological problems of medical psychology: brain and psyche, psychosomatic and somatopsychic correlations. Biological and social correlations, the problem of norm and pathology, genetic and acquired, hereditary and personal-environmental, development and decay of the psyche, organic and functional, conscious and unconscious, adaptation and maladjustment, deficit and adaptive.

Systems approach how theoretical basis understanding psychological structure disease, rehabilitation treatment and rehabilitation of patients.

Basic (fundamental) medical concepts: etiology, pathogenesis and sanogenesis, symptom, syndrome, clinical diagnosis, functional (multidimensional or multiaxial) diagnosis.

Related knowledge: fundamentals of general and private psychiatry, fundamentals of neurology, the doctrine of borderline mental disorders, self-destructive behavior, fundamentals of psychophysiology and psychopharmacology.

Psychological (psychogenic) factors in the etiology, pathogenesis and pathoplasty of mental and psychosomatic disorders, the concept of pre-illness, impaired mental adaptation, social stress disorders, crisis conditions.

Classification of methods of medical psychology, psychological diagnostics as a tool for targeted study of personality, methods psychological diagnostics in the clinic, computer psychodiagnostics, psychological correction.

The concept of psychological diagnosis, functional diagnosis as a result of the integration of the clinical, psychological and social aspects of the disease, the concept of psychological contact.

The main categories of medical psychology: mental activity, perception, attention, memory, thinking, intellect, emotions, will, temperament, character, personality, motivation, consumer

ness, stress, frustration, consciousness and self-awareness, self-esteem, conflict, crisis, psychogenesis, psychological protection, coping, alexithymia.

Theory of experiment, concepts of standardized and non-standardized methods, theory and classification of tests, basic psychometric concepts (validity, reliability, standardization, norm, etc.).

Fundamentals of Clinical Neuropsychology: systemic mechanisms of the brain in the organization of higher mental functions, processes and states, functional specialization of the hemispheres - basic concepts and practice, correlations of cerebral and local in neuropsychology, nosological specifics of higher mental functions disorders, specifics of neuropsychological research in childhood; main neuropsychological syndromes and methods of their diagnostics.

The concept of pathopsychology: correlation of qualitative and quantitative approaches in the analysis of psychodiagnostic data , Pathopsychological phenomenology, regularities and structural features of disorders cognitive processes, properties and conditions caused by the disease, nosological and syndromological specificity of pathopsychological phenomenology, differential diagnostic and expert significance of the pathopsychological experiment, pathopsychological studies in assessing the dynamics of treatment.

Age aspects of psychological disorders: age-related features of psychological disorders in various diseases, mental development of an abnormal child, childhood autism, the problem of dysontogenesis and delay mental development, psychological anomalies of adolescence, features of childhood and adolescent forms of pathological response, psychological aspects of mental infantilism, psychological problems of geriatrics and gerontology.

Teaching about character: the concept of accentuation and psychopathy, classification of character accentuations, diagnostic methods.

The doctrine of personality: basic concepts of personality in domestic and foreign psychology, diagnostic methods, the concept of personality defense mechanisms, personality and disease.

Basic concepts of psychosomatic relationships. Psychosomatic and somatopsychic. Internal picture of the disease and attitude to the disease, methodology and research methods, nosological specificity of psychological phenomena and the internal picture of the disease. Theoretical and methodological aspects, methods of psychological diagnostics in various types of expertise.

Theoretical, methodological and methodological approaches in solving the problems of psychoprophylaxis and psychohygiene, the concept of mass research
investigations, psychological screening, risk factors, mental maladaptation and illness.

Rehabilitation approach in medicine: concept, concepts, basic principles, forms and methods.

Psychology of extreme and crisis conditions, the concept of traumatic stress, social frustration and social stress disorders.

Basic principles of psychological support of the treatment process: organization of the psychotherapeutic environment in the medical units. Relationships doctor-patient, psychologist-doctor-treatment office, etc.

Psychological aspects of drug and non-drug therapy, placebo effect, psychological problems of preparing patients for surgery, prosthetics, psychological problems of chronically ill, disabled and dying.

Medical and psychological aspects of social behavior: communication, role behavior, interaction in groups, social normativity, etc.

Features of the work of medical psychologists in stationary, outpatient and preventive institutions of various types, psychological counseling, professional selection, career guidance.

Psychological foundations psychotherapy, restorative education and rehabilitation.

Basic psychotherapeutic theories: psychodynamic, behavioral, existential-humanistic; personality-oriented psychotherapy; medical and psychological models psychotherapy; main forms of psychotherapy: individual group, family, environment therapy, psychotherapeutic community, sociotherapy; mechanisms of therapeutic action of psychotherapy; nosological specificity and age aspects of psychotherapy and psychological counseling; psychological problems of non-verbal methods of psychotherapy: music therapy, choreotherapy, art therapy, etc.

Psychotherapy and psychological counseling in crisis situations.

Legal aspects activities of medical psychologists.

Deontological aspects behavior of a medical psychologist.

Practical skills:

The practical skills and abilities of a medical psychologist should provide a qualified professional solution to problems in the field of psychodiagnostics (including expert), psychocorrection and psychological counseling.

In the field of psychodiagnostics:

The ability to conduct a psychological examination, taking into account nosological and age specifics, as well as in connection with the tasks of medical and psychological examination; creation of the necessary psychological contact and adequate current control of psychological distance; planning and organization of research; selection of an adequate methodological apparatus; the ability to carry out a quantitative and qualitative analysis of the results of the study in connection with various goals: differential diagnosis, analysis of the severity of the condition, evaluation of the effectiveness of the therapy, etc., possession of the main interpretive schemes and approaches, adequate presentation of the available data in the psychodiagnostic report, possession of the main clinical and psychological methods (psychological conversation, collection of psychological anamnesis, psychological analysis of biography, natural experiment);

Possession of the main experimental psychological methods aimed at studying mental functions, processes and states: perception, attention, memory, thinking, intellect, emotional-volitional sphere, temperament, character, personality, motivational characteristics and needs, self-awareness and interpersonal relationships.

Possession of the basic techniques of neuropsychological research (methods for assessing the state of gnosis, praxis, speech functions, etc.);

Basic knowledge of computer diagnostics.

In the field of psychological counseling and the use of psycho-corrective methods:

The use of the main methods of psychological correction (individual, family, group) in working with patients and psychological counseling, taking into account nosological and age specifics;

Possession of methods of individual, group and family counseling healthy, taking into account age specifics in connection with the tasks of psychoprophylaxis;

Possession of the basic techniques of restorative education;

Possession of approaches to the organization of the psychotherapeutic environment and the psychotherapeutic community;

Possession of skills for conducting personal and professionally oriented trainings.

Picture 1.

	DOCTOR
NURSE	PATIENT	SOCIAL WORKER
	CLINICAL PSYCHOLOGIST

A clinical (medical) psychologist, along with a doctor, a nurse and a social worker, make up the closest circle providing medical and psychological assistance to a patient (Figure 1). At the same time, the role of a clinical psychologist is essential both in diagnostic and psychocorrectional and psychotherapeutic terms.

The practical guide is intended both for doctors (psychiatrists, psychotherapists, neuropathologists and representatives of other disciplines), medical and practicing psychologists, nurses and social workers, and for students studying clinical (medical) psychology.

What is psychology?

"Psycho" - the soul, "logos" - science, that is, the science of the soul. The fact that everyone has a soul, no one argues. Now, what is science? On the one hand, we are all very different: we perceive, feel, think and act differently. But situations with us are similar, we make the same mistakes. It turns out that if we start from the knowledge known in psychology about the laws of the brain, the phenomenon of human perception, the principles and logic of the work of the human subconscious, etc., then it is possible to predict, change the course of some life events, consciously make decisions and cause the expected reaction, and not spontaneous. Yes, the attitude of other people towards their person can be changed in the right direction, skillfully use the knowledge and methods accumulated by this useful “science of the soul”.

Why contact a psychologist?

Do you know the expression: "the soul hurts"? I think everyone faces this. Why do you think that “it will hurt and stop”, or “I can handle it myself”? When it comes to a problem in some organ or system, and a symptom of pain also appears - are we still in a hurry to seek qualified help (doctor)? There are, of course, lovers of self-treatment, but the consequences of such an approach to their health are known! Most often, this is the transition of the process into a chronic form: the body adapts to the problem, and the owner of this organism ceases even to hope for improvement, recovery and release from unpleasant sensations. It's the same with the soul. While it “hurts” it’s worth helping her, but when it “stops” - this means that psychological defenses have been developed, a model of behavior has developed (as a result) (up to accentuation). Are you sure that you need all these acquisitions, that they help you live, and do not interfere? A psychologist is a specialist with knowledge of the “science of the soul”. You call on him for help when the soul hurts, and even when it "does not hurt anymore." He should determine the cause of your feelings, or dissatisfaction with something, fears, give you information about the possibilities of getting out of the situation, instill confidence in you, “bless” you on the “path to positive changes and acquisitions.”

The psychologist is only an intermediary between you and your decisions. He does not dictate to you "what to do and how to do it right." The psychologist gives you the opportunity to see the truth.

How do psychologists work?

There are various methods and techniques in psychology. But there is no clear algorithm, instructions for work, from which every psychologist should build. Psychological help- a purely individual matter, in each case, the psychologist selects the means based on expediency, own practice, work experience. It is not enough just to have extensive knowledge in the field of psychology, today everyone has access to this information: a lot of printed publications, audio and video products, trainings, master classes, etc. But for some reason, not everyone is ready to call himself a psychologist and choose psychology as his profession? To answer this question, it is enough to recall Krylov's fable "The Monkey and Glasses". That is why it is absolutely useless (as practice shows) to study psychology in order to help oneself beloved.

A psychologist does not just "know", he must be able to "apply" his knowledge in order to obtain a certain result. What is the difference between a psychologist and an ordinary wise man? I will answer - the ability to use the "power of the word." We all know the saying: “The word heals, but the word also cripples.” This is a certain talent - to choose the right words correctly and in time, to name with them exactly the main idea that (note, on your own) should come into the client’s head and make him want something either to do or not to do this direction. A psychologist, by the way, has no right to give you advice and decide for you "whether you need it or not." If a psychologist, for example, recommends that you leave your husband, in no case quit, move, take your child out of this kindergarten, etc. - it violates professional ethics and the very principle of psychological correction.

How to choose your psychologist?

A psychologist will not "teach you to live", talk about those things that you are not ready to talk about, scold you, impose your point of view. The psychologist works only at your request and in your interests. "Yes, but there are so many psychologists and the methods they work with too. How can I find out which specialist is right for my situation?" - reasonably ask you. I will answer - a big role is played by a simple human factor. Trust your intuition, if a psychologist, as a person, causes you great sympathy, this is already a chance for success. If, after talking with him, you are filled with confidence and desires appear (one client, after a consultation, went to a cafe and ate ice cream heartily, sincerely wondering why she had not allowed herself such a pleasure before), and in your head "thoughts are coming in order" - this is almost guarantee that "YOUR PSYCHOLOGIST" and the result will be!

Clinical (medical) psychology

INTRODUCTION

Chapter 1 RESEARCH METHODS IN CLINICAL PSYCHOLOGY

Clinical interview

Experimental-psychological (patho- and neuropsychological) research methods

Pathopsychological research methods.

Pathopsychological assessment of attention disorders

Pathopsychological evaluation of memory disorders

Pathopsychological assessment of perceptual disorders

Pathopsychological assessment of thought disorders

Pathopsychological assessment of intellectual disabilities

^ Pathopsychological evaluation of emotional disorders

Pathopsychological assessment of individual psychological characteristics

Experimental neuropsychological study

Evaluation of the effectiveness of psychocorrectional and psychotherapeutic effects

Chapter 2 CLINICAL MANIFESTATIONS OF MENTAL NORM AND PATHOLOGY

Principles for distinguishing between psychological phenomena and psychopathological symptoms

^ Diagnostic principles-alternatives

Illness-personality

nosos-pathos

reaction-state-development

Psychotic-non-psychotic

Exogenous-endogenous-psychogenic

defect-recovery-chronification

Adaptation-disadaptation, compensation-decompensation

negative-positive

Phenomenology of clinical manifestations

^ PROGRAMMED KNOWLEDGE CONTROL:

Chapter 3 PSYCHOLOGICAL AND PATHOPSYCHOLOGICAL CHARACTERISTICS OF COGNITIVE PSYCHOLOGICAL PROCESSES

Semiotics

Feel

Perception

Attention

Memory

Thinking

Intelligence

Emotions

Will

Consciousness

Psychological phenomena and pathopsychological syndromes in mental illness

^ Neurotic disorders

Personality disorders.

Schizophrenia

Epileptic mental disorders

Organic mental disorders

^ PROGRAMMED KNOWLEDGE CONTROL:

Chapter 4 PSYCHOLOGY OF INDIVIDUAL DIFFERENCES

Temperament

Classification by A. Thomas and S. Chess:

Character

Personality

Personality structure (according to K.K. Platonov)

^ PROGRAMMED KNOWLEDGE CONTROL:

Chapter 5 PSYCHOLOGY OF THE PATIENT

Mental response to the disease and the psychology of the somatically ill

^ Gender

Age

Profession

Features of temperament

Character features

Personality Features

Psychological characteristics of patients with various somatic diseases

^ Oncological pathology

Obstetric and gynecological pathology

Therapeutic pathology

Surgical pathology

Defects of the body and sense organs

^ PROGRAMMED KNOWLEDGE CONTROL:

Chapter 6 PSYCHOLOGY OF THE TREATMENT INTERACTION

PROGRAMMED KNOWLEDGE CONTROL:

Chapter 7 NEUROTIC, PSYCHOSOMATIC AND SOMATOFORM DISORDERS

neuroses

Psychosomatic disorders and diseases

^ PROGRAMMED KNOWLEDGE CONTROL:

Chapter 8 PSYCHOLOGY OF DEVIANT BEHAVIOR

Aggressive behavior

Auto-aggressive behavior

Abuse of Substances Causing Altered Mental Conditions

Eating disorders

^ Sexual deviations and perversions

Overvalued psychological hobbies

Overvalued psychopathological hobbies

Characterological and pathocharacterological reactions

Communicative deviations

Immoral and immoral behavior

Unaesthetic behavior

^ PROGRAMMED KNOWLEDGE CONTROL:

Chapter 9 SPECIAL SECTIONS OF CLINICAL PSYCHOLOGY

Developmental Clinical Psychology*

Social and biological components of normal and abnormal human development

^ Mental characteristics and psychosomatic disorders during the neonatal period, infancy and early childhood

Mental characteristics and psychosomatic disorders in children of preschool and primary school age

^ Psychology and psychopathology of early youth

Psychological characteristics and mental disorders of persons of mature, elderly and advanced age

Family Clinical Psychology

^ PROGRAMMED KNOWLEDGE CONTROL:

Chapter 10

^ Psychological counseling

Psychological correction

Psychotherapy

Parapsychology and psychic healing

^ PROGRAMMED KNOWLEDGE CONTROL:

APPS

APPENDIX to the topic: "PSYCHOLOGY OF INDIVIDUAL DIFFERENCES"

Strelyau Questionnaire

Eysenck test

Characterological questionnaire of K. Leonhard

APPENDIX to the topic: "PSYCHOLOGY OF THE SICK"

LOBI (Leningrad questionnaire of the Bechterev Institute)

^ APPENDIX to the topic: "NEUROTIC DISORDERS"

Clinical questionnaire for the detection and evaluation of neurotic conditions (K.K. Yakhin, D.M. Mendelevich)

^ APPENDIX to the topic: "PSYCHOLOGY OF DEVIANT BEHAVIOR"

Pathocharacterological Diagnostic Questionnaire (PDO)

APPENDIX to the topic: AGE CLINICAL PSYCHOLOGY

Test assessment of knowledge of youth psychology

^ ANSWERS to programmed control

TABLE OF CONTENTS

INTRODUCTION

^ Clinical (medical) psychology - a science that studies the psychological characteristics of people suffering from various diseases, methods and methods for diagnosing mental disorders, differentiating psychological phenomena and psychopathological symptoms and syndromes, the psychology of the relationship between a patient and a medical worker, psycho-prophylactic, psycho-correctional and psychotherapeutic methods of helping patients, as well as theoretical aspects psychosomatic and somato-psychic interactions.

Psychology of the patient

Psychology of therapeutic interaction

Norm and pathology of mental activity

pathopsychology

Psychology of individual differences

Developmental clinical psychology

Family Clinical Psychology

Psychology of deviant behavior

Psychological counseling, psychocorrection and psychotherapy

neurosology

Psychosomatic medicine

^ Theoretical knowledge:

Psychology and its significance for medicine: the subject, tasks and interdisciplinary connections of medical psychology, the history of the formation of medical psychology as a field of psychological science; medical psychology as a profession; main sections of medical psychology.

^ The main theoretical and methodological problems of medical psychology: brain and psyche, psychosomatic and somatopsychic correlations. Biological and social correlations, the problem of norm and pathology, genetic and acquired, hereditary and personal-environmental, development and decay of the psyche, organic and functional, conscious and unconscious, adaptation and maladjustment, deficit and adaptive.

^ Systems approach as a theoretical basis for understanding the psychological structure of the disease, restorative treatment and rehabilitation of patients.

Basic (fundamental) medical concepts: etiology, pathogenesis and sanogenesis, symptom, syndrome, clinical diagnosis, functional (multidimensional or multiaxial) diagnosis.

^ Related knowledge: fundamentals of general and private psychiatry, fundamentals of neurology, the doctrine of borderline mental disorders, self-destructive behavior, fundamentals of psychophysiology and psychopharmacology.

^ Psychological (psychogenic) factors in the etiology, pathogenesis and pathoplasty of mental and psychosomatic disorders, the concept of pre-illness, impaired mental adaptation, social stress disorders, crisis conditions.

^ Classification of methods of medical psychology, psychological diagnostics as a tool for purposeful study of personality, methods of psychological diagnostics in the clinic, computer psychodiagnostics, psychological correction.

^ The concept of psychological diagnosis, functional diagnosis as a result of the integration of the clinical, psychological and social aspects of the disease, the concept of psychological contact.

^ The main categories of medical psychology: mental activity, perception, attention, memory, thinking, intellect, emotions, will, temperament, character, personality, motivation, consumer

Nosti, stress, frustration, consciousness and self-awareness, self-esteem, conflict, crisis, psychogenesis, psychological protection, coping, alexithymia.

^ Theory of experiment, concepts of standardized and non-standardized methods, theory and classification of tests, basic psychometric concepts (validity, reliability, standardization, norm, etc.).

^ Fundamentals of Clinical Neuropsychology: systemic mechanisms of the brain in the organization of higher mental functions, processes and states, functional specialization of the hemispheres - basic concepts and practice, correlations of cerebral and local in neuropsychology, nosological specifics of higher mental functions disorders, specifics of neuropsychological research in childhood; main neuropsychological syndromes and methods of their diagnostics.

The concept of pathopsychology: ratio of qualitative and quantitative approaches in the analysis of psychodiagnostic data, pathopsychological phenomenology, regularities and structural features of disorders of cognitive processes, properties and conditions caused by the disease, nosological and syndromological specificity of pathopsychological phenomenology, differential diagnostic and expert significance of pathopsychological experiment, pathopsychological studies in assessing the dynamics of treatment .

^ Age aspects of psychological disorders: age-related features of psychological disorders in various diseases, mental development of an abnormal child, childhood autism, the problem of dysontogenesis and mental retardation, psychological anomalies of adolescence, features of childhood and adolescent forms of pathological response, psychological aspects of mental infantilism, psychological problems of geriatrics and gerontology.

^ Teaching about character: the concept of accentuation and psychopathy, classification of character accentuations, diagnostic methods.

The doctrine of personality: basic concepts of personality in domestic and foreign psychology, diagnostic methods, the concept of personality defense mechanisms, personality and illness.

^ Basic concepts of psychosomatic relationships. Psychosomatic and somatopsychic. Internal picture of the disease and attitude to the disease, methodology and research methods, nosological specificity of psychological phenomena and the internal picture of the disease. Theoretical and methodological aspects, methods of psychological diagnostics in various types of expertise.

^ Theoretical, methodological and methodological approaches in solving the problems of psychoprophylaxis and psychohygiene, the concept of mass research

Follow-ups, psychological screening, risk factors, mental maladaptation and illness.

^ Rehabilitation approach in medicine: concept, concepts, basic principles, forms and methods.

Psychology of extreme and crisis conditions, the concept of traumatic stress, social frustration and social stress disorders.

^ Basic principles of psychological support of the treatment process: organization of the psychotherapeutic environment in the medical units. Relationships doctor-patient, psychologist-doctor-treatment office, etc.

^ Psychological aspects of drug and non-drug therapy, placebo effect, psychological problems of preparing patients for surgery, prosthetics, psychological problems of chronically ill, disabled and dying.

^ Medical and psychological aspects of social behavior: communication, role behavior, interaction in groups, social normativity, etc.

Features of the work of medical psychologists in stationary, outpatient and preventive institutions of various types, psychological counseling, professional selection, career guidance.

^ Psychological foundations of psychotherapy, restorative education and rehabilitation.

Basic psychotherapeutic theories: psychodynamic, behavioral, existential-humanistic; personality-oriented psychotherapy; medical and psychological models of psychotherapy; main forms of psychotherapy: individual group, family, environment therapy, psychotherapeutic community, sociotherapy; mechanisms of therapeutic action of psychotherapy; nosological specificity and age aspects of psychotherapy and psychological counseling; psychological problems of non-verbal methods of psychotherapy: music therapy, choreotherapy, art therapy, etc.

^ Psychotherapy and psychological counseling in crisis situations.

Legal aspects activities of medical psychologists.

Deontological aspects behavior of a medical psychologist.

Practical skills:

^ In the field of psychodiagnostics:

Possession of the basic techniques of neuropsychological research (methods for assessing the state of gnosis, praxis, speech functions, etc.);

Basic knowledge of computer diagnostics.

^ In the field of psychological counseling and the use of psycho-corrective methods:

The use of the main methods of psychological correction (individual, family, group) in working with patients and psychological counseling, taking into account nosological and age specifics;

Possession of methods of individual, group and family counseling of healthy people, taking into account age specifics in connection with the tasks of psychoprophylaxis;

Possession of the basic techniques of restorative education;

Possession of approaches to the organization of the psychotherapeutic environment and the psychotherapeutic community;

Possession of skills for conducting personal and professionally oriented trainings.

Picture 1.

	DOCTOR
^ NURSE	PATIENT	SOCIAL WORKER
	CLINICAL PSYCHOLOGIST