Автор 
Благодаря Андрею Иришкину (Канада) нашлась потерявшаяся в 2009 году статья о дианализе. Спасибо, Андрей!
Dianalysis as integrative psychotherapy and counseling
Vladimir Zavyalov
PhD, Professor of psychiatry, chief of the department for psychotherapy
of Novosibirsk state medical university Novosibirsk, Russia.
of Novosibirsk state medical university Novosibirsk, Russia.
Abstract. Every method of
psychotherapy should be adapted for real people, be adjusted to a
concrete case so as to match it to a client’s mentality. This initial
axiom is considered to be a creation basis for dianalysis. The purpose
of the present article is to acquaint the reader with the new approach
in the field of psychotherapy and psychological consultation –dianalysis
and its axioms. This modality of the psychotherapy is based on the
highest level common sense armed with absolute dialectics of Russian
philosopher A. Losev. In article main principles of the dianalysis and
the scheme of carrying out of dianalytical session are discussed.
Keywords: #dianalysis #absolute_dialectics #axioms_for_psychotherapy #personalism #help #symbol #therapeutic #idea #integration
Introduction
The mentality is understood here as a
habitual or characteristic mental attitude that determines how a client
of psychotherapist will interpret and respond to life situations.
The modality dianalysis has a clear
and self-consistent theory of the human being, of the therapeutic
relationship, and of health and illness. Health (in psychological sense)
is understood as a state of wellbeing acquired thanks to the process of
mind-synthesis, the ability to find a solution in some problem domain
and the ability to integrate parts of global “sociocultural code” of
life.
Illness (in psychological sense) is
viewed as a state of unwellness, anxiety and loss of good behavior
control, because of poor mind-synthesis, inability to find a solution in
some problem domain and inability to integrate parts of global
“sociocultural code” of life.
History and Background
Dianalysis as a system of integrative
psychotherapy and counseling has been created, formulated and developed
by Professor V. Zavyalov. It represents the results of his practice for
more than 30 years as a scientific researcher in the field of clinical
psychological analysis of personality of alcohol addicts [16] and as a
clinical psychologist and diagnostician working with the Rorschach test,
TAT, MMPI, Szondi test and others, and, of course, as a psychotherapist
in different clinics and hospitals in Novosibirsk.
In 1975, his first book “Emotions and
Imagination, clinical-psychological research” written together with
Prof. Banschikov and Prof. Korolenko was published. The idea of
imagination as treatment with mental images was developed in the book
and contributed much to the author’s personalistic outlook and
dianalysis. Imagination is considered to be the highest cognitive
function that connects the Past and the Future and unites all separate
meanings in a person. For many years, Prof. Zavyalov had been calling
the therapy he practiced as the Imago therapy.
Till 1993 the author of dianalysis
had been participating in various educational programs and projects
fostering such modern methods of psychotherapy as Transact analysis,
Ericksonian hypnosis, Neuro Linguistic Programming, Existential therapy,
Cognitive therapy of A. Beck, the Reality Therapy of W. Glasser ,
Direct Confrontation Method of Jack Rosberg among Russian
psychotherapists [18].
After getting acquainted with the
works by the famous Russian philosopher A.F.Losev (prohibited under
Soviet power and published only in 1993), his “Dialectics of Myth” in
particular, Prof. Zavyalov understood how exactly those numerous methods
in psychotherapy and clinical psychology could be integrated into one
system embracing all the sides of therapy practice in psychotherapy.
It is worth mentioning that A.Losev
expanded the phenomenological method of Husserl to include symbolism and
mythology [6, 7]. Prof. Zavyalov has derived Losev’s method of absolute
dialectics and the absolute mythology and after processing this method
has been adapted and incorporated into psychotherapy. Thus, the ideas of
dianalysis have been elaborated and formulated.
Postulates
There are five formulated postulates
(or axioms) — the propositions that are accepted as true in order to
provide a basis for logical reasoning:
• Help-axiom
• Problem-axiom
• Reality-axiom
• Person-axiom
• Symbol-axiom
Help
“All you need is help.” It is the
slogan for the psychotherapist. The only thing that he/she can give to
the client is help; not “the Influence on psyche for the purpose of
treatment”, not “correction of the mentality”, not “love” (including
“therapeutic love” and its analog — “agape” or “true Christian love”),
not “struggle against illness”, not “the best programs for brain
activity”, not “the right way in life or Dao”, not “environment
improvement”, not “normalization of social ecology” and not give money
or any real recourse, certainly. Only help in “reorganization of mental
content during live dialog”; this is the maxim of dianalysis or moral
maxim.
Help-axiom is the courageous
acceptance of the evidence of the existence of necessary restrictions in
the client-therapist relationship because this relationship is paid.
Money or its equivalent (missionary mood, self-knowledge through the
client, any use of the client for own needs) is ineradicable mediator
between client and therapist because psychotherapy is professional
activity and every psychotherapist exists in market field,
psychotherapist should sell its service favorably, in other words — to
make the real bargain with the client, hence the mutually advantageous
transaction. Psychotherapist cannot sell the welfare to the client, only
“protect the welfare to the client” according to “Statement of ethical
principles of the EAP” [11], cannot sell the mental and body health
also, cannot sell the “new person” or even “new look on the world”.
A psychotherapist can sell its
“qualified working hours” only. The predicate “qualified” means legal,
well educated (“completed successfully the preparatory and specialized
training in psychotherapy” [11, 12] and humanistic higher education),
ethical (corresponding to ethical standards and professional duties of
psychotherapists) and specialized in separate discipline of
psychotherapy (modality).
The term “working hours” means “the
exercise of psychotherapy” [11] applied to certain problems and special
inquiries of the client. The last is itself real work and first is the
quality of this work.
Essence of Psychotherapy according to
dianalysis is special help -“psychological help” or even “just logical
help”, hence “the help theory” should be the base theory, but not “the
theory of personality”. Such theory should be determinate by the purpose
of “therapy” (necessary changes and transformations in mind state,
intellectual condition and behavior of the client), tasks, ways of
decision-making and the plan for execution of collaboratively found
decisions in mutualism style.
The Idea of Mutualism as
“help-exchange” among people is very accepted in dianalysis. This idea
is based on the well-known book “Mutual Aid: A Factor of Evolution” [5]
of the Russian researcher and philosopher Prince Peter Kropotkin;
because of his title of prince and theory of anarchy, he was known as
«the Anarchist Prince». Oscar Wilde described him as «a man with a soul
of that beautiful white Christ which seems coming out of Russia»[15].
So, this singer of personal freedom certainly should be the important
figure (as some image and ideal) in the context of any psychotherapy for
a Russian soul and Russian-speaking people.
After examining the evidence of
cooperation in nonhuman animals, «savages,» «barbarians,» in medieval
cities, and in modern times, Peter Kropotkin concludes that cooperation
and mutual aid are as important in the evolution of the species as
competition and mutual strife, if not more so.
Modern scientist, Douglas H. Boucher,
argues that «Kropotkin’s ideas, though unorthodox, were scientifically
respectable, and indeed the contention that mutual aid can be a means of
increasing fitness had become a standard part of modern sociobiology”
[3].
Last years that opinion proved to be
true that there was a wide social Self-help movement: more 700 000
groups in America only [4].
Problem
“All you need is the mind.” It is the
next slogan. What is the mind necessary for? To understand the
inevitable problems and correctly explain the world. If the person does
not understand his problem, then another person or some organization
will resolve his or her problem for their advantage. In dianalysis
problem is understood as contradiction in mind and attempts to reconcile
its contradictions, for example, harmonize one’s goals with one’s
abilities, getting two things, two wills, and two ways and so on to
correspond. No mind — no problem. There are no problems — the mind is
not necessary. It is evident.
The term problem is used instead of
the term illness or disease. If we give help, instead of a treat, then
this term is necessary to us. Moreover, then the help-axiom and the
problem-axiom supplement each other. The problem is the reflection of
external conflicts and the mixed life events and also internal conflicts
and body/mind events in mental level. “Problemless” existence is not
real, even the deepest dream Includes contradictions, unresolved
conflict of opposites and struggle of “unconscious tendencies and hidden
forces” (banal nightmare).
Most brightly the problem is
expressed in a paradox phenomenon. On dianalytic slang, it sounds as
“logical centaur”. For example, there are some well-known paradoxes:
• Socratic paradox:»I know nothing at
all.» This “centaur” consists of knowledge (head) and ignorance (body).
The knowledge and ignorance — full contradictions — belong to the same
system of knowledge. It is absurd, but at the same time it is the very
high moral principle: to be poor in spirit is to acknowledge honestly as
it interprets Christian Beatitude in the New Testament.
• The paradox of hedonism: When one
pursues happiness itself, one is miserable; but, when one pursues
something else, one achieves happiness. This is ethical “centaur” with
happiness-body and head- something else. While the head is occupied by
something strange, the body stays in a happy condition. Moreover,
“Happiness cannot be pursued; it must ensue, and it only does so as the
unintended side-effect of one’s personal dedication to a cause greater
than oneself or as the by-product of one’s surrender to a person other
than oneself”. Possibly, it was the preparation for techniques creation
«paradoxical intention» — paradox contra paradox.
• Buridan’s ass: How can a rational
choice be made between two outcomes of equal value? Buridan allowed that
the will could delay the choice to more fully assess the possible
outcomes of the choice. Ass — a metaphor of the person which cannot make
decisions because of the weakness of the rational argumentation — a
person, who has “wooden brains” (Eric Berne) or “straw brain”. So-called
“straw man” is «a person of no means,» or one who deliberately accepts a
liability or other monetary responsibility without the resources to
fulfill it, usually to shield another party. To «attack a straw man» is
to create the illusion of having refuted a proposition by substituting a
superficially similar proposition (the «straw man»), and refuting it,
without ever having actually refuted the original position (Wikipedia).
Moreover, so on. There is a whole
library of paradoxes. The Classical paradox in psychotherapy is the
neurosis. Is neurosis disease? Yes and No simultaneously! Yes, because
abnormal functioning is present. No, because illness (organic disease)
is not present. Illness without illness? Yes. It is “logical centaur”.
To be (disease) or not to be
(disease) that is the question… for assessment and psychotherapy
appointment. One of the decisions of this clinical paradox is
recognition of the existence of so-called “factitious” disorders — “not
real, genuine, or natural” as it is described in DSM-IY. So, such
disorder exists but does not exist, in fact: exists in the mind only.
What to do? To deal with a problem or hidden paradox in the mental space
of the person, which the seeks psychological (logical) help.
Pertinently to remind here, that the psychotherapy has appeared as a way
of treatment of neurosis’s — imagined illnesses (after historical
discussion about Franz Anton Mesmer’s method and phenomenon of “animal
magnetism” [9]).
The context of any problem is a state
of helplessness: a man cannot resolve the life’s problems because does
not accept the help from other people, does not use “prescribed
recourse”. Sometimes such context turns to an independent problem, for
example, depression.
Helplessness itself is the reason of
various difficulties which the psychotherapist faces in real practices.
Learned helplessness, as it is known (Seligman, 1975), is a
psychological condition in which a human being or an animal has learned
to act or behave helpless in a particular situation, even when it has
the power to change its unpleasant or even harmful circumstance.
Learned helplessness theory is the
view that clinical depression and related mental illnesses result from a
perceived absence of control over the outcome of a situation. It is
paradoxical, the person requiring the help and capable to receive it
from the other person, does not accept this help.
Reality
“All you need is peace.” What for?
Peace is necessary because a person should have the possibility to
resolve external conflicts and have successful self-realization in the
social environment. The third postulate of dianalysis also is
fundamental despite its simplicity: human reality is the social one.
Reality philosophically is the
synthesis of the Thing and its Name. Human reality is named reality,
“talking reality” (Losev). Reality is the state of the world as it
really is rather than as one person might want it to be, but one person
might be able to understand the world or reach any understanding through
naming (to receive the true names of real things from people and
culture standards). Only in the reality there is an antagonism of
various interests, forces, the parties, currents, and groupings.
Conflicts in mind — are personified
(and more often deformed) mental representation of external conflicts.
However, a person also is a part of this reality; he enters into a set
of opposing groups and so on. The person is both the participant and the
witness of both the event and the situation. Thus, human reality is
very complex and difficult for simple understanding because it is like
plural reflections in the system of parallel mirrors. The helper adds to
this system one more — his system of “parallel mirrors” which is not
easier than mental mirrors of his client.
Reality is also understood as duality
of Nature and Culture, in other words — “nonhuman environment” and
“human environment” according to some researchers [1]. Reality is a
strange amalgam of contradictory of Nature & Culture, Object &
Name, that different people see in some different way. The third
postulate asserts that the world consists of real objects with which the
person establishes semantic (comprehended to some extent) relations.
The world is objective and is given to us in subjective expression through a symbol.
When we think, we mean not simply
words — phonemes, morphemes etc., but real-life objects. More often we
operate not with real objects and not with «mental analogues» — images
and representations, but with hidden relations between them — «Clamps of
Being» (Losev).
If a split between objects and names
increases, then the world becomes incoherent for any person: this person
has the deficiency of “clamps” or “not enough connections” in terms of
dianalysis. He or she has to cope with such duality which is endured as
rupture in consciousness and is expressed with symptoms.
We can find the similar ideas in
Reality Therapy developed by Willam Glasser. As unsatisfactory or
non-existent connections with people are the source of almost all human
problems, the goal of Reality Therapy is to help people reconnect. This
reconnection almost always starts with the counselor/teacher first
connecting with the individual, and then using this connection as a
model for how the disconnected person can begin to connect with the
people he or she needs.
Person
“All you need is sense.” What for?
For Understanding Oneself and the Other, eliminating inner conflicts and
being the real person with well-developed Personality. What are
distinctions between the person and the personality? As Losev in his
work “Dialectics of a myth” wrote: “The person is a fact. She exists in
history. She lives, struggles, is born, flourishes, and dies. She is
always a life rather than a pure concept. A pure concept must be
realized and materialized. It must appear with a living body and organs”
[6, p.74]. The pure concept is necessary for reflections and
construction of judgments about the concrete human being as the notion
“Personality”.
According to philosopher Nikolay
Berdyayev, the human personality is the dynamic system like a cosmos: it
must be maintained in proper balance to facilitate positive
interactions with other individuals with nature. Russian word «lichnost»
may be translated as either “personality” or “individuality”, but
Russian thinkers have argued that its essential spiritual meaning should
not be confused with the notion of atomized, lone individual that
predominates in the West [2].
The Christian Ontological Personalism
(unreligious variant) is accepted as a clear, self-consistent and
adequate theory of the human being an unreligious variant of which is
presented in the works of Russian philosophers Losev and Berdyayev.
According to the theory a human being is influenced by two global
processes i.e. biological evolution and cultural coevolution within
particular historical time and specific geo-politic place.
The human being has the dual nature.
This basic point of view is supported by “culture-historic theory of
development of the human psyche” (sociocultural approach) of Vygotsky
and by “The Meta-Theory of Mental Processes” of Vekker [13,14,17].
Philosophically the personality is
defined as «synthesis of the subject and objects». It is the first of 12
synthetic maxims of Losev in «Dialectics of Myth». Psychologically the
personality can be defined as «semantic all-unity of the person» instead
of notorious “Identity” or “Self” (Zavyalov, 2004). So, this postulate
of the personality is the statement of the obvious truth — first of all
each person has his name, his history, the destiny and full freedom in
choosing. The person is wholesome and indivisible. The body shares on
parts, but not the person.
The Person — the carrier of problems.
To carry on itself as a Cross (on which Jesus was crucified) means that
the person himself is not the principal cause of problems, at the best
the person is the co-author of the problem together with the Reality.
“To carry on” also means “to have a free interpreted version of real
events and hold it in the mind.” As it was proved still by Benedict
Spinoza, Man’s soul has not any problems and does not contradict itself.
Symbol
“All you need is the name.., secret
names for understanding the problem”. The Symbol is an expresser of a
problem (while the Reality is a source of problems; the Personality is
the carrier of problems, and the Problems themselves are subjects of the
professional interest of the Helper). Symbol definition in dianalysis
is the following: “another-being-of-sense”. It means that one thing
(visible) specifies in another thing (invisible) like some semantic
pointer or an ideal index. Thus, the first one can be taken as the
symbol and as independent single thing.
So, any symbol has dual semantic
areas: itself and the other. Here “itself” refers to some object, which
is chosen as “expresser“ of something, and “the other” refers to some
area of the consciousness of the one who learns something. Symbol will
be never exhausted because refers just to the consciousness but not to
another thing. If one thing points to another thing (now invisible),
then it will be only a “sign” but not “symbol”.
Certainly the word (in the sense of
“the name”) is the main symbol for the psychotherapist. Any non-verbal
sign can be taken as a symbol also, but sign is always exhausted in any
way and can be deciphered by anyone, for example, so-called in the
technique of “reading” people, according to some dictionary of language
of a body [10]. The symbol concerns to representational process or any
basic cognitive process in which some entity comes to stand for or
represent something else, therefore symbol-axiom plays the major role in
disclosing of a root of a client’s problem.
In any case the true meaning of a
word or body expression is reached with the help of therapeutic
“symbology”: symptom or its analogy (narrative, complaints, hints on
certain difficult circumstances, even gossips on own private life and so
on) is accepted as symbol and hence is distinguished as expression of
personal meaning, personal myth and visage of the personality of the
client and of course as a attempt of synthesis of any contradictions ,
which in this time was not absolutely successful.
Shortly, symptom (Problem) in
therapist’s communication (Help) taken as expresser of a problem
(Symbol) shows us the Personality in all its concrete embodiment on the
fields of fight for survival needs-satisfactions and self-realization
(Reality).
Method
Dianalysis is the art of connection,
the art of meanings connection. It is continuation of the tradition of
Socrates and his «smart talk», or dialectics, or “clever conversation”
among free men of the Ancient Greece. Here we may recall the work of
Paul Dubois «Les psychonévroses et leur traitement moral» (1904), in
which an ancient dialectics named «Socratic dialog» is described as
«persuasion therapy» and so-called rational approach for treatment of
neurotic disorders.
By the way, Dubois believed it was
necessary to appeal to a patient’s intellect and reason in order to
eliminate negative and self-destructive habits.
He also believed it was necessary for
the physician to convince the patient of the irrationality of his/her
neurotic feelings and thought processes [9]. In dianalysis “Socratic
dialog” has been transformed into “pentad dialectics”.
The basic method of dianalysis is
logical designing (Logos) using «pentad models». The pentad is a logic
structure of reason which has been deduced from Losev’s works. Pentad
dialectics differs from Hegel’s dialectic triad as the real maintenance
(the fourth moment, namely — «factuality», «corporality») is brought in
it. This form of
dialectics is based on “absolute
dialectics” [22, 23] — synthesis of the dialectic logic and the general
mythology. It represents some set of methods united in “Five Moments of
Essence Knowledge” or so-called “Pentad” [20, 21]:
1. The One. The stage of syncretic
and abstract thinking “in-all” and “wholeness” — the starting point of
dialectics and intellectual intuition while grasping fusion of
something.
2. The Many.The stage of the
differential and conceptual thinking using five main dialectical
categories: being, identity, difference, rest, movement.
3. The Becoming. The stage of
transcendent thinking or thinking the unthinkable. It is the synthesis
of the stable and formed being with the unstable and amorphous other.
4. The Fact. The stage of concrete thinking about embodied or incarnated ideas.
5. The Symbol and the Myth. The
stage of mystical and symbolic thinking about “not- becoming-thing” or
the myth (personal myth of the client).
The symptom taken as the symbol can
be considered :as the “one” (1), as a class of “many things” (2), as a
transcendence process in the person’s life or “becoming personality”
(3), as a single fact in some context (4), as a personal myth and the
symbol of “other-life-of-person” or “the second destiny” in which the
symptom is incarnated. Thus, the main method in dianalysis is the
all-round consideration of a given problem.
This rendering of the symptom is an
original form of therapeutic intervention in dianalysis . The method
itself uses techniques of help for a person without any direct or
apparent effect on Psyche with some medicine, physical influence, social
control and power. It only changes the personal meaning of
psychological content of his real behavior. There are five ways to
change personal meaning [19]:
• Abundance of conceptions( conceptual machinery) is diminished through dianalytic interview;
• Uncertainty in cognition and perception is eliminated in the course of dianalytic discussion (variant of Socrates’s dialog);
• Dianalytic imagination helps to overcome occupation with unrealistic and “unhappy end” images (go around “Curve of Meaning”);
• Dianalytic reorganization of some combinations of elements in a person’s experience stops chaos process in mind;
• Amplification of meaning of life
through dianalytic narration techniques demand using creative procedures
such as “myth designing”, “story telling,” dream interpreting, plot
construction within a frame of a personal myth.
Methodology
Methodology is the collection of
theories, concepts or ideas, the comparative study, and the critique of
the individual methods that are used in a given discipline or field of
inquiry (Wikipedia). In dianalysis many theories and concepts concerning
psychotherapy and counseling are integrated into two big groups named
“Pentad” and “Decalogue”. Pentad is the set of logic and ways of
understanding a problem. Decalogue is the set of principles of
processing a problem (10 principles in all).
Pentad. Pentad in methodological
point of view is the well packed and compact set of historically
developed types of thinking: naive-naturalistic thinking or common sense
(1), scientifical-demonstrative thinking (2), phenomenological thinking
(3), critical thinking (4), and myth-poetical thinking (5).
The “pentad dialectics” is embodied into practical ways of therapeutic work: diagnosis and intervention forms.
Dianalysis maintains the tradition of
diagnosis and assessment set forth in Multiaxial Evaluation System of
DSM-1V. In dianalysis, there are Five Levels for recognizing,
understanding and coping with personal problems very similar to Five
Axes Diagnoses in Multiaxial Evaluation system of DSM-IV.
Such traditional form of intervention
as Socrates’s dialog is practiced in dianalysis as well. Treatment is
focused on supporting personal meaning.
Thus in dianalysis there are Five Levels for recognizing, understanding and coping with personal problems where
Level 1 is focused on naming a Problem (assumption, supposition, presupposition, “theory”);
Level 2 is focused on content of Psyche (cognitive content, mental objects, knowledge, noesis);
Level 3 is necessary for processing
and transforming Psyche Content (goals of behavior, motivation, drives,
perspectives of future);
Level 4 is for the realization of the Person Becoming in a functional State (embodiment of an idea);
Level 5 gives the symbolic
representation in Symbols of Life (artifacts, personal myth, narration,
mental potential and other symbols of living personality).
Understanding personality as the
highest form of synthesis (person as a myth, and myth as
conscious-verbal-personal form unfolding itself in history) and not as a
variant of the human being adaptation can be regarded as some new
aspect in understanding of human nature.
Dianalytical theory of help is
seeking an answer to the main question: how to help a person without any
direct or apparent effect on Psyche by a medicine,through physical
influence or social control and power but only by changing a personal
meaning of psychological content of his real behavior.
There are five ways “forms”) to change personal meaning:
• Abundance of conceptions( conceptual machinery) can be diminished with dianalytic interview;
• Uncertainty in cognition and perception is eliminated in the course of dianalytic discussion (variant of Socrates’s dialog);
• Dianalytic imagination helps to
overcome occupation with unrealistic nd “unhappy end” images (going
around the “Curve of Meaning”);
• Dianalytic reorganization of some combinations of elements in a person’s experience can stop chaos process in mind;
• Amplification of meaning of life
through dianalytic narration’s techniques demands using creative
procedures such as “myth designing”, “story telling”, dream
interpreting, plot construction within a frame f a personal myth.
The interview or questioning of the
person in a special manner is the main and universal way of our help to
the client. The interview and include the other “forms” of the
dianalysis such as discussion, imagination, reorganization and
amplification to the extent where their application will be dictated by
tasks formulated. Any session of dianalysis begins with the interview
and comes to its termination with interview (consultation or
conversation with the client). Because dianalysis ranks among the
integrative psychotherapies (in Russian sense — “integrative” means
“all-included”) every session can comprise other psychotherapeutic
procedures inducing change: psychological interventions such as Insight,
Interpretation, Paradoxical Intention (V.Frankl), Modeling and Role
Playing, Cognitive Restructuring (in A.Beck’s or Ellis’s manner),
Systematic Desensitization, Systematic Intervention by Johnson (for
alcoholics), and others. In that case dianalysis smoothly passes to the
Polymodal Psychotherapy by V.V. Makarov [8].
The philosophical slogan of
dianalysis is as following: “Peering at the Eidos design Logos”. The
Eidos means personality in all senses: personal visage, personal miracle
history given in words (“myth” in Losev’s interpretation), total
expression of the person including symptoms of the disease or any
difficulties.
Decalogue. The so-called Dianalytical Decalogue gives a clear rationale for treatment and intervention.
It represents 10 principles or
strategies of getting a person from pathological state and describes the
results to be fixed by new definitions and through new structure of
consciousness so that a person can catch and hold the changes needed.
Empirically found in the course of 35 years of practice in psychotherapy
the order of principles represents the order of succession of therapy
accomplished.
The names for the principles are the names for the domains, each domain being the field for the most important definitions.
Decalogue can be used in two ways as
an algorithm of succession in therapy and intervention as well as the
content of help that can be specified endlessly.
Ten principles of accomplished psychotherapy describe competence of Dianalysis in such areas as
• interpersonal relations (Diada)
• knowledge-mining and system analysis (Diagnosis)
• communication ability (Dialog)
• reasoning by elimination or analysis of a problem and alternatives (Dilemma)
• problem-solving technique (Dynamic)
• synthetic thinking (Dialectic)
• transfer of the positive result of psychotherapy into new fields (Diversification)
• social-support (Divergence)
• good consumption counseling (Dietetics)
• narration and speech making skills (Diatribe)
These principles of accomplished psychotherapy are used for three purposes:
1. Modeling of desirable result of therapy (the description of requirements of the client in terms of Decalogue);
2. Realization of the plan of therapy and the description of the process of therapy or intervention.
3. Fixing of the reached results in 10 areas of activity of the person in conformity with the classification in
Decalogue.
All these principles of work are carried out in the Protocol of Dianalysis (see it lower).
Terminology
Dianalysis is a method of integrative
psychotherapy registered in Russia and methodology of client
organizations and individuals counseling as well.
The name Dianalysis was invented to
define a new system of notions in psychotherapy and counseling in our
attempt to avoid using the names of well-known trends and modalities in
world psychotherapy.
The word “Dianalysis” means “together with a client”-di- and “through analysis”-analysis.
Dianalytical therapy requires analytical thinking from both — a psychotherapist and his client.
Analysis is focused on revealing the
meaning of client’s emotional experience and the sense for his personal
growth, dialogical and dialectical thinking being a tool for relieving a
client’s mind from so-called mental viruses and mental misconceptions.
Dianalysis is built on dialectics
where one should take into consideration the opposites and reconcile
them in some third notion.
Dianalysis tends to integrate human
mind through the synthesis of the opposites to overcome the damage done
by multiple forms of personal, professional and social narrow-mindedness
and to enhance the quality of life.
Problematics of dianalysis
Some addictions ( alcohol, drugs,
computer, game, work), inner conflicts represented as neurotic symptoms,
neurotic disorders, psychosomatic symptoms resulting from neurosis,
personal crisis in persons emotionally unstable and having difficulty in
coping with personal relations are defined as areas for enquiry and
application.
Duality of consciousness causing
dissociation and fallacy in logical argumentation is the main goal for
research in dianalysis. Dianalysis is practiced as individual
psychotherapy in medical centers and for out patients as well, in
counseling and coaching for businessmen, in counseling persons with
marriage problems, in family therapy, in making examination of some
dubious decision of experts for legal advice offices [20, 21].
Case presentation
Our client is a neurotic with
heartache waiting for a possible infarction. There is no infarction at
the moment, but around its possible appearance on the stage of life some
events keep developing: the husband hopelessly waiting for his
infarction is terrorizing his wife making her suffer from his possible
death with a prospect to live without any money left. He is writing fake
wills, and he is demanding his wife to confess her adultery as he wants
to know the whole truth before he dies. He pretends to be saint and
innocent himself torturing his wife with his words. For example, “I’ll,
die, and you will be blossoming without me.
So beautiful and attractive for those
males round you…” “When I die, bury me near my sweet home.” “How will
you live without me beside you?”
How to organize his life so as to
make him take charge of his business and stop his sinking into useless
fantasies about diseases and premature death? First of all, let’s ask
ourselves: is our client in “preinfarction state” or is he in hysteria?
It is definitely no infarction nearby, any signs of myocardial ischemia,
only hypochondria, his ideas about possible disease, but not a disease
itself.
Much time will pass, 40—45 years at
least or more, till he may die of infarction, and it is a good time
resource. The reorganizing of the content of the symptom was taking
place in sincere conversation, in deep personal contact between the
psychotherapist and his client, the constant verification of the
client’s experience interpretations being made with no reference to the
client’s clinical experience. The contents of the symptom had been taken
as a symbol.
In dianalysis the “pentad dialectics”
is used as the main cognitive tool in revealing the deep meaning of the
client’s life experience. First of all, the main components of the
conduct situation were picked out.
In our case, there were six main
components or the characters, all of them having been equal in their
importance for the client.
The components picked out were given
some independent status, each having some personal name and the meaning
of existence, hence each component having its ontological status.
While trying to find the meaning of
existence for each component it is of importance to distinguish between
nomen and phenomenon (after Husserl).
It helps the client start thinking independently about each component.
Thus in his consciousness his
pathological way of connecting the content with the component begins to
ruin, and there appears the possibility for each component to have an
independent development in his consciousness. Everything takes place in
close personal dialog between the client and the psychotherapist.
Then the facts are separated from
their interpretations. A fact is taken as some fixed element of the
consciousness. The client is quite unable to do it himself, and the
therapeutic conversation can help the client to fix the things that can
be taken as facts and to distinguish them from their interpretations.
Then a new meaning for each component was found, and new connections
between the components were established.
Thanks to this process, the client
began to differentiate these two states — between problematic state with
fear to die of infarction and the positive state with care for his
wellbeing.
The changed state of care is
so-called “therapeutic idea.” The differentiation between fear and care
appeared in the client’s consciousness and then was fixed there in the
course of therapeutic work with the client (табл. 1).
Tabl. 1
The main results of symptom reorganization according to the Protocol of Dianalysis®
Components of the situation
|
Fate for the components in the state “Fear of infarction”
|
Changed fate for the components in the state “Care for wellbeing”
|
Kate, his wife, he seems to have no sex appeal for her
|
A nurse in home hospital
|
A friend who is interesting enough to live with in comfort
|
Gala, his girlfriend, a fool who wants too much
|
A blackmailer, who is extorting money
|
A pleading woman
|
His father, reminiscences about his death of infarction
|
A vampire
|
A teacher of life
|
His business Alpha Plus, he is sick and tired of
|
A vehicle that is moving so slowly
|
A locomotive of life
|
His money, invested into some vague business
|
All profits missed, his Past
|
Bright profitable Future
|
His sensitive and painful body
|
Dreary and gloomy thoughts about living with broken heart that doesn’t work at all
|
A body with a big spacious heart to accommodate so many good things
|
The Protocol of the Dianalytic Session
General notes. The Protocol
represents some general plan of treatment for some problem’s state of
the person and the way of fixing everything that occurs during the
session. Each session should be finished as if it is a unique session of
psychotherapy and disposable meeting with the client.
In Russia, almost all cases of psychotherapy belong to short-term psychotherapy [24].
Last five years all cases in my private practice are distributed in such order (sequence):
Single session — 35% cases
2—5 sessions — 30% cases
6—12 sessions — 20% cases
More than12 sessions — 10% cases
More than 50 sessions — 5% cases
Thus, 85% cases belong to the class
of «out-patient intensive short-term psychotherapy» and only 5% to the
long-term psychotherapy, some cases having lasted for 4-5 years.
The stages of a session. Any session
of dianalysis consists of five formal stages generated by dialectical
analysis («Pentad») of the psychotherapeutic process:
1. Situation (One)
2. Interpretation (Many)
3. Moving Idea (Becoming)
4. Realization (Fact)
5. Summery (Personal Myth)
The first stage or step involves
defining the client’s presenting his or her problem which at this moment
seems to be a stream of the most different events. Certainly, such a
«stream of consciousness» should be divided into classes of events
interesting to us for the further reorganization: therapy in dianalysis
begins with the first-dropped word of the client (or when he/she frowns
suddenly). Moreover, first of all we should know a real situation: «What
is going on actually?» It is not so easy because we never are real
participants of events in the life of our client (thank God). We can be
only «virtual observers» led by our intellectual intuition trained
beforehand at training sessions. The situation of help given-taken and
the client-therapist relationship is one of the parts of a big class
named shortly «The Situation».
The second stage involves the pilot
study of the client’s epistemology: «How does he or she get to know the
situation and turn it into understandable one?» This is client’s
situational know-how: his or her manner of thinking over the last
events, the ways of interpretation of the facts, using conceptions and
so-called «stereotypes» and so on.
Step by step, the therapist supports
the client for the paradigm shift from «problem-as-story» to
«problem-as-synthesis of contradictions». Very often client learns with
surprise that his or her symptom is more or less successful attempt to
connect his or her opposite intentions, or the combination of ideas into
a complex whole, or the creation of any synthesis in terms of
dianalysis. At this stage the main aid of the therapy becomes obvious
that the real purpose of the therapy is making a synthesis of
oppositions more successful for the client without eliminating the
symptom and its psychological content (symbolic cognitive content).
The third stage requires the
gathering of more precise data for creating the Therapeutic Idea, which
should cause the important changes in emotion, cognition, behavior,
spirit, and even body state of the client.
The Therapeutic Idea includes many
concrete ideas united round the understood problem and possible
decisions in a context of the personality growth of the client.
This is a «moving idea» indeed
because such idea moves person towards some new perspectives in his or
her life, gives a «new look» at the old coping strategies in some areas
of the life. The very important point is the establishment of true goals
which the client should pursue and separate them from a pure dream.
A dream is an unrealistic goal in
life, but the beautiful dream can decorate any life with the high sense
of self-esteem, self-belief, and self-confidence.
Without such high sense of a dream, a
successful activity in life would not be achieved. The fantasy dream
should amuse the person; the visible goal should be reached any way. It
is one of the rules in dianalysis.
In the fourth stage, we establish a
working process regarding the variables of realization of the moving
idea. The realization ways are modeling of benevolent outcomes,
role-playing to assess skills, mind-mapping and using several forms of
visualization of the problem, mutual planning of a treatment and so on.
The client should be ready to make an act now or in the nearest future.
This act will express the increased personal responsibility, freedom
expansion in reality interpretations, and the innovative approach to
some difficulties of life of the client.
The main purpose of the fifth and
final stage is to fix the reached results through some procedures.
Positive changes in a condition of the client are fixing through the
procedure of naming the new qualities of the person in behavior,
thinking, spirit, and personality.
This is an old traditional ceremony
in Russia; roots are connected with magic of a word: «To call things by
their proper names». It is important to find these «proper names»
The Name in Russia is real social
reinforcement because «The Word» expresses and articulates the
«Constants of Culture» [25]. Thus, new names connect the person with his
or her native culture and people shared the same culture.
If we believe a society is the
carrier of culture then it is necessary to recognize that in culture
there are all answers and all solutions (in ethically sense), but they
should be thought over and matched with the current time and real place
(«here-and-now») as well as with «current state» of the client. We make
with client the positive innovations («innovation» means here the first
attempt to carry something out into practice) in his or her life, but
not inventions («invention» means here the first occurrence of an idea
for a new product or process). «Nothing is new under the Sun.»
Innovations are new ways for the client doing useful things and applying
the old tested methods of survival and growing up (табл. 2).
Tabl. 2
General scheme and schedule of the Protocol of the Dianalytic Session
Stage
|
Points
|
Client’s Side
|
Therapist’s Side
|
SITUATION
|
External event
|
Life Event
|
Occasion
|
Internal event
|
Complaint
|
Cause
|
|
Expression
|
Symptom
|
Inquiry
|
|
INTERPRETATION
|
Detalization
|
Problem as a story
|
Problem as a logic
|
Conceptualization
|
Hypothesis
|
Not good Synthesis
|
|
MOVING IDEA
|
Attainable goals
|
Aims of a life
|
Access to Resource
|
Unattainable purposes
|
Dreams
|
Therapeutically Idea
|
|
REALIZATION
|
Alternatives
|
Alterations
|
Modeling
|
Activity
|
Actions
|
Tasks&Plans
|
|
Comprehension
|
Motives
|
Mutual Planning
|
|
SUMMERY
|
Generalization
|
Conclusion
|
Short Resume
|
Termination
|
New Problem
|
Term-in-End
|
Explanations of the parts of the
protocol. There are 24 parts: 12 parts are on the client’side, and 12
parts are on the therapist’side. Of course, this is super formalization
of any genuine dialog between the therapist and the client. Each side is
a kind of mirror and completes the other one. The cumulative effect of
treatment or consultation depends on work on both sides of such a
«barricade». An ideal execution of the dianalytical session as in any
other modality in psychotherapy depends mainly on full cooperation
between the client and the therapist. Fight in a reception room is the
worst variant. Fortunately dianalysis is directed on revealing and
managing internal and external conflicts.
Conclusion
The dianalysis has been created at
the beginning as methodology of psychotherapy for Russian-speaking
people. We had to comprehend and modify real avalanche of Western
methods of psychotherapy that had been rushing through Russia from the
end of 80-years up to the present moment. This process of the
modification and adaptation of western modalities exported from Europe
and the USA to Russia has not been finished yet. There appeared a number
of national modalities with dianalysis among them. About 40 new
modalities nave has been registered in PPL — Russia Branch of EAP by
this moment.
The future of the psychotherapy is an
integration according to the president of PPL professor Victor Makarov:
«The best and most original ideas from each modality can be handed down
and assimilated by an integrative, multimodal, polymodal and another
system of psychotherapy» [8]. Meanwhile, any theory of the personality
could not unite such a variety of approaches in the field of
psychotherapy and psychological consultation. Any theory of
psychopathology or abnormal psychology could not unite western
modalities and eastern approaches as well. Dianalysis is an attempt to
develop an integrative approach which would include «the most original
and the best from each modality» and should have some strong logical
structure connecting «a set of sets» of numerous ways of help to people.
Instead of some «theory» we offer «simple common sense» (whenever
possible highest level) armed with dialectics tempered by time.
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