From the author: This article would be useful to read for those people who are afraid to turn to psychologists and psychotherapists, as well as for those who are interested in “how it all works.” When and why you need a psychotherapist that most potential patients turn to a psychotherapist during periods of problems, losses, and suffering. But the desire to get rid of suffering or inconvenience almost always collides with a reluctance to turn to anyone for help. In most cases, going to a psychotherapist is almost the last thing people resort to. This state of affairs is associated with shame, pride and mistrust. Indeed, when turning to a psychotherapist, a person will be forced to tell very intimate things about himself, and this is not easy for everyone. Pride forces you to “handle it yourself” until the last moment, and mistrust may be associated with previous disastrous experiences when frankness entailed serious consequences. All these points will be taken into account and discussed during the work process. The patient has the right to tell as much and as much as he deems necessary, and in case of distrust or strong antipathy towards the psychotherapist, he can turn to another specialist. Often the future patient expresses a desire to save him from some local inconvenience or suffering and “not touch everything else " Alas, this is impossible. The psyche functions normally in integrity. To treat one area of ​​the problem, one has to deal with many other areas that may not be directly related to the problem. That is why the process of psychotherapy is a very long process. “Entering” psychotherapy and establishing a trusting working relationship occurs gradually. The treatment itself is also slow. Hurry and the pursuit of a quick result do not lead to the desired result. In the process of work, in a good case, the patient understands that therapy gives him some new, healthier foundation for building his life. We can say that the goal of therapy is to enable a person to find the optimal balance between his capabilities and the limitations of reality. Based on this new balance, all other tasks are solved in an optimal way, and tasks that cannot be solved in principle are abandoned. Psychotherapy is a “medicine” that acts gradually and treats not only visible problems. But still, as a rule, the first request looks something like this: “Help me cope with self-doubt (become attractive to the opposite sex, get rid of fears, etc.)” - psychological suffering. “I am tormented by headaches (tics) , colitis, allergies, etc.)” - psychosomatic suffering. There are also such requests as “I have an existential crisis, everything has lost its meaning” or “I can no longer create” or “I want to finally understand who I am.” Whatever the request, this is always the tip of the iceberg, this is just a reason to start. It is important that the psychotherapist, just like the patient, does not know specifically how psychotherapy will go, where it will lead and how the symptoms will behave during the treatment process. The psychotherapist and the patient unite for the duration of psychotherapy, as employees who pursue one common goal - to improve the patient’s quality of life, to make him more free and adapted in reality. But this does not mean that the psychotherapist can fulfill the patient’s order specifically and within a specific time frame. For example, “make sure I get married in a year.” It is quite possible that a patient with such a request will get married in a year, but this will be a consequence of treating the patient’s entire psyche, and not some piece of it that “prevented” her from getting married earlier. So, if we talk about the external side of the issue, then People turn to a psychotherapist to treat depression, anxiety, general dissatisfaction, loneliness, fears, due to loss of taste for life, creative crises, psychosomatic problems or the inability to survive some important loss - the death of loved ones, breakups, loss of love, work, etc. p.This external request should be respected and treatedhim carefully, but it is important to remember that the causes of visible suffering may be rooted in deep layers of the psyche and may obviously not be related to the stated request. The psychotherapist is not a magician, not a hairdresser or a surgeon, he cannot, at the patient’s request, repair “here a little and here’s a little bit.” For good psychotherapy, you need to study the patient’s psyche, changing it gradually and not in accordance with some given plan, but in accordance with the natural processes that are triggered by psychotherapy. Every patient is an unknown and a challenge. And so, let’s say, the therapeutic couple took place. The therapy process began. What does it consist of? The essence of the method of psychoanalytic psychotherapy can be described in two words - “change in the psyche.” But what is change and what is the psyche - hundreds of words will be needed to describe this, and questions will still remain. Speaking schematically, a person has consciousness, unconsciousness and biochemical processes in the nervous tissue (the latter is dealt with by a psychiatrist, if there is necessity). Consciousness is the totality of what we understand and know. The unconscious is something invisible, unknown and unknowable to the fullest, but nevertheless, something that greatly influences our lives. In the unconscious, memories, emotions, feelings, fears that organize a person’s life are “stored” and live their own lives. It can be presented as a dump of everything - good and bad, a logic incomprehensible to consciousness reigns in it, there is no time and space in it. This is a kind of primary broth from which our perceptions, habits, actions and choices are born. To understand and change the unconscious it is very important to have access to it, therefore the unconscious is the subject of special attention in psychoanalysis and psychoanalytic psychotherapy. At the same time, consciousness does not fade into the background; after all, it is with its help that we cognize and change the unconscious. The unconscious frightens us with its unknown. Many patients rebel against the recognition of reality unconsciously because they perceive its presence as an evil and autonomous force within them that cannot be controlled. However, the unconscious is not only a source of problems, it is also a source of strength and creativity. Yes, it remains unknown, no matter how much you realize it, but life itself is also unknown, no matter how much you study it. Clarifying your relationship with your unconscious helps to improve your relationship with life as a whole. The unconscious does not speak, but it hints; it not only interferes, but also helps. Demonization and deification of the unconscious lead to unnecessary extremes that only complicate life, but its denial does not add comfort. One of the important components of psychotherapy is to help a person recognize the existence of his unconscious, understand it (as far as possible) and use its resource. And so How is the unconscious explored and cognized in the process of psychoanalytic psychotherapy? First of all, these are dreams, their interpretation, but it is also what seeps into the communication between the therapist and the patient between the lines - slips of the tongue, forgetfulness, gestures, tone of voice and much more. The psychotherapist “hunts” the patient’s unconscious, trying to understand him and decipher his messages. The unconscious not only hides from the psychotherapist and the patient, and puts a spoke in the wheels of therapy, trying to maintain its previous state, it also hints at itself, shows itself, but it cannot speak. There is an opinion that the unconscious “wants” to be understood in exactly the same way as it “does not want” to be discovered and changed. As a person develops, starting from the moment of birth, certain processes occur in his unconscious that lay the foundation psyche. These are all kinds of scenarios, identities, semantic patterns, persistent fantasies. Often, it is in these semantic constructions that the causes of actual human suffering lie hidden. But they also contain positivepotential. Everything is like this in the psyche - it wants to change and does not want to, it is the source of problems, but also the source of joy and strength. The psychoanalytic process proceeds in the same way - it brings relief, pleasure and partial satisfaction, but is also accompanied by frustration, tension, overcoming the usual, and requires discipline. Outwardly, the process of psychotherapy looks like a conversation, but this is not an ordinary conversation, it is built according to special laws. Firstly, this conversation is limited in time, it lasts 50 minutes. This limitation has a special meaning, in addition to the utilitarian one (to organize the work of psychotherapy so that it is possible to schedule visits to milestone patients). 50 minutes is a certain portion of shared time, this is the “dose” of time that two people agree to give each other. You could say that this is a model of our limitations. We cannot live forever, we cannot completely belong to another and we cannot ignore the fact that the other sometimes wants to leave when we would like to stay with him. Likewise, an analytical session has its beginning and end, whether we like it or not. The agreement to limit the session time symbolizes and implements the principle of reality, makes it possible to feel the boundaries between two people and their lives. Each patient, in one way or another, has to deal with some inconvenience that this rule brings (fixed session duration). Discussion of these inconveniences leads to an understanding of previously hidden important meanings and to the release of suppressed feelings. Secondly, this conversation will not contain the usual advice and assessments for communicating with friends. Advice is a way to share experience, show another what he may not see, a demonstration of how the listener would behave in the situation of the speaker. There is nothing wrong with advice at the everyday level. Advice, of course, has unconscious roots, but as a rule, in everyday life, we consider it only from the point of view of consciousness. But since in psychotherapy we deal with the unconscious, advice takes on a completely different meaning. Again, for each patient, advice will mean something different, for example, it could be a way to shift responsibility for making an important decision to the therapist, a way of fighting (you advise me something, and I will do the opposite, because I want to show that I can get by without you) and other implicit, hidden meanings. Therefore, the psychotherapist does not give advice, but is ready to discuss the desire to receive advice and even fantasize about the topic - and for that to happen, the patient gets advice from him. This is the general rule of psychotherapy: there are no prohibitions on certain topics, you can discuss anything, but certain restrictions are imposed on actions. These restrictions should not be perceived as educational measures. Each of them has a certain technical meaning, namely, a ban on actions opens up space for feelings and thoughts. It is the patient’s feelings and thoughts, their awareness and experience that are the main active forces in psychotherapy. Thirdly, in this conversation the therapist does not say anything about himself. The space and time of therapy is intended for the patient, it must be filled with his material. If the therapist appears as a person with his own problems and views, he will lose the anonymity and neutrality necessary for the process and will simply become, perhaps, a more knowledgeable interlocutor. But at the same time, the therapist will not be able to use the method to its fullest extent to help the patient. The neutrality of the therapist allows the patient to begin to fantasize, to see in the therapist those characters from his inner world that he himself may not know about. In this way, the patient’s hidden fantasies, fears and hopes come to light. There is another technical point that raises many questions and even bewilderments. This is the rule for paying for a session missed due to the patient’s initiative (circumstances). The meaning of this rule can be explained at different levels. The first one is more ordinary and concrete: if a session is missed, the therapist is deprived of the opportunitykeep her busy with something, for example another working hour. That is, by missing a session, the patient not only cancels joint work, but also limits the therapist’s financial capabilities. If a patient visits a therapist several times a week, and goes, say, on a business trip for a week, and is sick the next week, he causes significant financial damage to the therapist (what if there are several such patients?). After all, it is impossible to occupy these hours with work. All sessions are scheduled in advance, all working hours are assigned to specific patients. Psychotherapy is not like seeing a doctor at a clinic. Each patient has his own fixed hours, and new patients are admitted during free hours. The other cut-off has a symbolic meaning. The patient and therapist are connected by their work together, but their lives do not intersect or influence one another. If a patient cancels a session and does not pay for it, he thus affects the life of the therapist, that is, isolation is broken, and the illusion of living together arises. Let's say a patient gets sick and this illness becomes not only a subject of discussion and sympathy on the part of the therapist, but it affects his - the therapist's life, its way of life. Moreover, this rule - payment for each missed session (except for the patient's vacation) - in some cases helps patients not to miss sessions, which ultimately improves the quality of the process. Let’s say that during the work unpleasant moments were touched upon, the patient, not fully understanding this, wants to avoid developing a complex topic and... his unconscious manages in such a way that suddenly “a bunch of more important things” arise. If missed sessions may not be paid for, then the possibility of missing them in this case increases, but payment makes you think and maybe still come to the session. Such situations are always accompanied by the patient’s dissatisfaction, but this dissatisfaction is very important material for work. Perhaps it would be easier for the therapist not to charge for missed sessions; the process would then proceed more peacefully and calmly, but many important meanings would remain outside the scope of therapy. The duration of therapy cannot be determined in advance. There is short-term therapy that is not aimed at a systemic and profound change in the patient’s psyche. This is something like an ambulance to get out of the crisis. This therapy can last several months. Long-term therapy, which I talk about above, lasts at least two years. There are also many doubts among future patients about the duration of therapy. Why so long? Is the end in sight? Where are the guarantees that all this will pay off? Here it is necessary to explain that, living in a world of specific tasks and specific solutions, we transfer the properties of some situations to others, measuring everything with a single measure. The psyche is not a body or a thing; the laws of its changes differ from the laws of changes of things and the body. The psyche resists change; it needs time to adapt to the new. Sometimes mental problems are so disguised that months pass before they become obvious. This is not a treatment for an infection - I did a test, selected an antibiotic and told me how many times a day it should be taken until recovery. Here the diagnosis is made in the process of work, the psyche is opened and changed in layers. Therefore, the duration of therapy is determined during the therapy itself. Naturally, the patient is free to interrupt the treatment process at any time. But such a break is like an injury. Therefore, a certain time is allocated for completion, it is planned and they move towards it systematically. It is clear that it is neither possible nor necessary to cover all the nuances and features of this method in an information article. In the process of work, various questions arise about the method that are impossible to predict, questions that make the psychotherapist himself think. Psychoanalysis (and psychoanalytic therapy) is a branch of knowledge that involves constant development and change. This is not an exact science, but also not mysticism or religion. Therapy helps patients with a bias towards rational thinking to open up the category of the unknown..