Psychotherapist or psychiatrist? How to understand when and who to turn to for help. Problems that should be addressed to a psychologist. What conditions does a psychologist deal with?

Psychotherapy is the treatment of mental illness using psychological methods. It is impossible to treat somatic diseases (those in which the normal functioning of the body, its organs and tissues is disrupted) using psychological methods. A psychiatrist treats with medication, however, no one prevents the psychiatrist from using psychotherapy.

Psychotherapy itself, that is, the treatment of mental disorders and diseases with psychological methods, can only be legally practiced by a psychotherapist - a person who has a diploma of higher medical education and a medical specialization as a “psychotherapist” (other examples of specializations are “otolaryngologist”, “surgeon”, etc. .). In Russia, in general, only a doctor - an accredited specialist with relevant experience and qualifications - has the right to treat (Article 69, paragraph 1 of the Federal Law “On the Fundamentals of Protecting the Health of Citizens in the Russian Federation” dated November 21, 2011 No. 323-FZ).

However, the reader should not succumb to the hypnosis of the white coat, so to speak. And the point is not only that even certified doctors can be amateurs, have misconceptions and make mistakes.

The problem is broader: in medicine there are a lot of scientifically unsubstantiated methods that, after objective testing, turn out to be useless and even harmful. Therefore, evidence-based medicine arose - a movement whose goal is freeing healthcare from ineffective methods .

So, a psychotherapist and just a psychotherapist are not the same thing at all. Almost anyone can call themselves a psychotherapist. Very often today there is a situation where a woman was a chemist, physicist or engineer, and at the age of 30 she went to some psychotherapeutic courses and then began to call herself, say, a Gestalt therapist or an existential-humanistic therapist, made herself a website and took up psychological consulting, coaching, conducting trainings and webinars. A similar case - a former engineer, chemist, physicist, railway worker, or generally a person with some dubious specialty (such as “manager”) declares himself the creator of his own method of psychotherapy and offers psychological counseling, coaching, group psychotherapy.

Therefore, the first thing you need to know when deciding whether to see a psychotherapist is that “psychotherapy” and “psychotherapist” are not legally protected concepts. This means that anyone can declare themselves a psychotherapist. And given that psychological quackery is easier to carry out than medicinal quackery (at least there is no need to spend money on jars and liquids or on creating pills), there are a great many charlatans under the guise of psychotherapy today.

What are we treating?

You may be surprised, but today psychotherapy is recommended for people without any mental disorders or illnesses. It is believed that even a healthy person must analyze his past, try to identify the contents of his subconscious or respond to his emotions.

With this approach, psychological counseling comes down to psychotherapy, and instead of solving a specific problem, the psychologist begins to “clean” your childhood, “free” you from “clamps”, achieve from you “spontaneity”, “non-judgmentality” and a constant presence “here-and-”. Now".

Today, many people do not even understand the difference between psychotherapy and psychological counseling. However, this difference is fundamental.

How does a psychologist solve clients' psychological problems? First of all, by providing them with objective information obtained as a result of scientific psychological research (in fact, any counseling - legal, financial - is carried out according to a similar scheme). For example, a woman complains that her husband constantly lies about doing more housework than she does. A psychologist explains to a woman that her husband is most likely not lying because we are all subject to a cognitive distortion called self-serving bias and we all think that our contribution to the matter is greater, be it writing a collective monograph or performing household chores.

If simple information does not help, the psychologist can arrange a kind of confrontation between this woman and her husband in his office so that they can discuss in a safe environment and without the risk of falling into a scandal again (the psychologist acts here as an arbiter) discuss the contributions of each to the performance of household duties . In a number of cases, it may be necessary to make a number of decisions, in particular, to redistribute household responsibilities, agree on the order of their implementation, introduce certain code words so that each spouse can, on the one hand, show dissatisfaction, but, on the other hand, not offend the spouse, do not provoke a new scandal.

If a psychologist notices that a client lacks certain skills, such as communication skills or self-control, he can develop these skills in the client through training. For example, in our case, the psychologist could notice that the spouses do not know how to listen to each other, and instead of dialogue, they slip into parallel monologues. The psychologist can report this and invite the spouses to attend training on constructive home communication.

As you can see, there is no search for repressed traumas or “reaction” of negative emotions.

Who invented psychotherapy and how?

The history of psychotherapy, even an extremely brief one, would require at least a separate article, but there are some things we absolutely need to know. Indeed, if someone wants to create a truly effective method, he must approach its creation from an objective position, focus on facts, not opinions, and objective data, not subjective impressions. How does psychotherapy deal with this?

Let's look, for example, at how one of the main authorities in the field, Sigmund Freud, created his psychotherapy called “psychoanalysis”.

Through dream analysis and free association, Freud believed he gained information about the early childhood of his patients. And in this childhood, Freud always discovered all sorts of unpleasant phenomena, such as a girl’s envy of her father’s penis or a boy’s desire to kill his father in order to take possession of his mother.

Did Freud test his clients' memories objectively? No, I haven't checked. And is it possible to check whether the child was really strictly toilet trained or whether the mother breastfed the baby incorrectly?

By the way, Freud initially created not psychoanalysis, but the so-called theory of seduction. His patients recalled, for example, that as children their father forced them to perform fellatio or worse. And Freud concluded that the basis of any neurosis is the seduction of a child by one of the parents. The scientific community rejected this theory, and Freud transformed it into the more harmless psychoanalysis. Now the patient's memories of his father forcing him to perform fellatio were interpreted only as the patient's fantasies. Well, really, what else can a three-year-old girl fantasize about if not about possessing her father’s penis?

Remember all

Over time, Freud was forgotten about this mess with his theory of seduction, and in the 80s and 90s of the twentieth century, a massive “Satanic panic” arose in the United States. Many psychotherapist patients began to recall that as children their parents forced them to participate in disgusting orgies and bloody rituals. Lawsuits began pouring in and investigations began.

And then it was scientifically proven that it is simply impossible to accurately restore memories using hypnosis, psychoanalysis, regression therapy and other things. American psychologist Elizabeth Loftus played a huge role in the discovery of this amazing fact.

It turned out that human memory is reconstructive, and remembering an event is not reading a record about it from some subcortex, but reconstructing this event taking into account new data and fresh information.

It became clear that even the testimony of witnesses to recently committed crimes must be very seriously filtered, let alone memories of early childhood...

Therefore, if a psychotherapist tells you that all your problems are rooted in childhood, that you will need to restore memories, that you have repressed the psychological trauma you received in childhood, feel free to leave this office.

Don't keep it to yourself!

By the way, not only the possibility of restoring memories, but also the popular concept of repression has also not received scientific confirmation. We do not forget about events that traumatized us psychologically and/or physically. On the contrary, we cannot stop remembering these realities. For example, a soldier who has lost his comrades in war cannot help but remember bloody battles, explosions and mangled bodies. So, if during a psychotherapy session you suddenly remember something painful that you never remembered before, then most likely, under the influence of psychotherapy, you acquired a false memory.

The concept of catharsis, on which many types of psychotherapy are based, has also not received scientific confirmation.

According to this concept, in order to free yourself from a negative emotion, you need to experience it again and again, for example, you should remember an event that traumatized you, and in a family conflict, anger does not need to be restrained, it needs to be expressed, although not with the help of insults, but with the help of , for example, so-called I-messages (for example, you should not tell your husband “you bastard!”, you should say “dear husband, because you began to dance with that girl in front of me and gently put your hands on her below the waist, I feel pain, resentment, fear, anger and the desire to scratch your face."

Scientific studies (like this one) have shown that expressing an emotion only strengthens it. So the Stoics were right - if you want to free yourself from a feeling, don’t feed it and don’t express it. Among modern psychotherapists, by the way, a recommendation not to express emotions will be received with anger: “not to express means to repress, it means to create neurosis!”

Do all problems come from childhood?

What about childhood traumas? Do the traumas we experienced in childhood really have no effect on us?

Looks like no. The fact is that the child’s psyche, as well as the child’s body, is very tenacious. Therefore, for example, post-traumatic stress disorder, an example of which is the mentioned situation of a soldier who cannot stop remembering the war, occurs much less frequently in children. This is true even in cases of sexual assault. And it’s a shame that the researcher who established this fact, Bruce Rhind, is often accused of legitimizing pedophilia...

And in general, this emphasis on childhood, which is inherent in many movements of psychotherapy, is completely unfounded. Of course, if a person has not learned to speak in childhood, then he is unlikely to master his native language to a degree sufficient to not seem imbecile, but otherwise, perhaps, there is no such age when reality would cease to influence us, and we would cease change under these influences.

So, if a psychotherapist is trying to look for the roots of your problems in childhood instead of analyzing your current situation, it is better to look for another specialist.

And it helped me!

Advanced people can ask the following question here: “How can this be?! After all, the effectiveness of psychotherapy is confirmed by scientific research!”

Who would argue!

Indeed, such studies exist. And they exist primarily because there are currents of psychotherapy that are not built on the concepts of repression, childhood trauma and catharsis. We are talking about behavioral and cognitive-behavioral psychotherapy and rational-emotive psychotherapy by Albert Ellis. Here is a fairly extensive review of research into the effectiveness of cognitive behavioral therapy.

In addition, you need to understand that when trying to evaluate psychotherapy objectively - within the framework of scientific research - mistakes can be made. We should not forget, in particular, that a double-blind method in psychotherapy research is impossible (the patient knows that he is receiving psychotherapy, and the psychotherapist knows that he is using psychotherapy). In addition, it is difficult to organize a placebo control in a psychotherapy study: a standard placebo - dummy pills - is hardly suitable; you need to use what can conventionally be called a procedural placebo (instead of psychotherapy, arrange, for example, shamanic dances).

In addition, the famous American psychologist Scott Lilienfeld identified as many as 26 factors that create the illusion of the effectiveness of psychotherapy in scientific research. By the way, he is one of the main participants in the movement of evidence-based practices - an analogue of evidence-based medicine in psychology.

One of these factors is the so-called selective attrition: clients who leave psychotherapy are simply not counted in the study, when they should have been counted among clients who did not benefit from psychotherapy.

Another reason for the apparent effectiveness of psychotherapy is the distortion of complaisance: the client is helped not by psychotherapy, but by another factor - obedience, conscientiousness, which forced the person to turn to a psychotherapist, as well as take other actions to overcome his problem and improve the situation.

And, of course, among the reasons for the apparent effectiveness of psychotherapy, one cannot fail to mention the so-called justification of effort: a client who has spent a lot of money and time on psychotherapy is simply forced to demonstrate improvement in order to maintain his bright image in his own eyes and in the eyes of others. Justifying effort, by the way, involves a cognitive bias called the sunk cost bias.

Train on cats!

From experience, I know that all these arguments do not convince either psychotherapists or fans of these psychotherapists. They may even admit that psychotherapy is a scientifically dubious field, declare that “we are only at the beginning of the path,” that “psychotherapy is an art,” etc. So be it, but I think everyone can decide for themselves , whether to become a guinea pig and spend your money and time on psychotherapists trying to create truly effective methods for solving psychological problems. Moreover, most psychotherapists still rely on subjective and inaccurate approaches in trying to test the effectiveness of their work.

Or maybe I should see a psychiatrist?

If you have objective problems, you should contact a psychologist. For example, you just can’t find a job, you’re too nervous during an interview, and having found a job, you quickly fall into conflict with management and again find yourself looking for a suitable vacancy? Go to a psychologist. A psychologist can detect a deficiency in communication and self-regulation skills, he can teach you, train you, and everything will work out. On the other hand, a psychologist may find that you have an inadequate level of pride and aggression. In this case, he may recommend that you see a psychiatrist to rule out mental illness.

If there are no obvious problems, you are doing well, you have a family, friends, housing, a stable job, the opportunity to regularly relax, have fun, but you still feel bad, it is better to start by visiting a psychiatrist. Perhaps a course of antidepressants will quickly return you to normal.

With phobias, obsessive actions and obsessive thoughts, it is also better to start by going to a psychiatrist. By the way, perhaps he will not treat you with medications, but will conduct psychotherapy with you or refer you to a psychotherapist. However, having received a diagnosis of “neurosis” or “phobia” from a psychiatrist, you yourself, taking your medical card with you, can find a psychotherapist and make an appointment with him.

There is no need to be afraid of going to a psychiatrist: it is unlikely that you will be immediately registered at a psychiatric dispensary, and no one has canceled the secrecy of the diagnosis. Moreover, in any case, it is better to register with a psychiatric patient (by the way, it is not permanent, but temporary) than to jump out of a window because a psychologist tried to do something about your depression using purely psychological methods.

Now I conditionally divide everyone involved in psychology professionally into two groups: diagnostic psychologists and psychologist-trainers. Both are equally important and necessary.

Diagnostic psychologists are those who examine individuals and groups of people (industrial, sports and educational groups) using tests and, based on the test results, give appropriate conclusions to the test customer or recommendations to the psychologist-trainer. They are as important as laboratory assistants, radiologists, fibrogastroscopy specialists for medicine, criminologists for investigators, accompanists for singers.

I don’t want to pit one against the other, although I myself am more of a trainer than a diagnostician, although in the early stages I was very passionate about diagnostic work. But I want to emphasize that without diagnostic psychologists, psychologists-trainers in some cases would be helpless, like blind kittens. In this field you can make a decent career, make good money and become famous. Who doesn’t now know the names of the test creators: Lüscher, Eysenck, Cattell, Leary and many others!

When I was mastering diagnostic methods, I was simply shocked that within 1-2 hours you can penetrate the secrets of a soul person and learn more about him than in several years of relatively close acquaintance. When I started working as a psychiatrist, and there were no full-time psychologists, I myself conducted psychological examinations of patients. This was very helpful both in clarifying the diagnosis in particularly difficult cases, and in creating a treatment plan and monitoring the progress of recovery. There is, for example, a simple test that determines the level of performance. The patient already subjectively feels good and wants to get to work, but when testing for performance it is revealed that his attention is still unstable, he gets tired quickly and begins to make a lot of mistakes. This makes it possible to keep him on sick leave and adjust his treatment. If upon re-examination the performance returned to normal, then this was an indication for the end of treatment. When professional psychologists appeared in our clinic, that’s all they did, freeing doctors from such work. Moreover, their conclusions were much more accurate.

An even greater role of diagnostic psychologists is noticeable when conducting psychological work in work and sports groups. There it is necessary to determine the psychological state of not only individuals, but also the collective as such. Here's a good example. One of the major league football teams was “in danger of leaving it, although based on the skill of the football players the team could have been, if not among the winners, then at least in the safe middle. When the psychological state of each participant and the structure of interpersonal relationships were examined, it turned out that each Of the players and even the second coach, in principle, they felt good, but the relations between many of the players were hostile, there was a fairly large group of players who had a negative attitude towards the senior coach. It is clear that the team was not a cohesive team, but cooperation. One could be sure to say that the leading players and the second coach already know which teams they will work for if their team is “relegated” from the major league. The senior coach was given the appropriate recommendations. Now I would really like to say: “He followed them, and the team remained in the major league."

One more example.
A group of psychologists examined a large construction association, which included a number of construction and installation departments, a timber industry enterprise, concrete plants, a woodworking plant, etc. A number of points were identified that showed that if the management style in this organization was maintained, the association would inevitably disintegrate, it was indicated , in what order this association will lose its units, and appropriate recommendations were made. The manager put the materials under the cloth. But when the psychologists’ predictions began to come true and one construction and installation department had already left the association, then the manager decided to listen to the opinion of psychologists. This rather expensive examination was carried out once again, and the necessary measures were clarified.

In universities, all future psychologists are trained in diagnostic work. Some people are so passionate about this work that after graduating from university, this is all they do. And they do the right thing if their interests are satisfied by this work and their abilities match them. But the trainer also needs to be familiar with diagnostic work in order to know the diagnostic capabilities, formulate the tasks that interest him during the examination, and in order to understand the conclusions of the diagnostic psychologist.

By the way, here I want to say what abilities you need to have to become a psychologist. Anyone, as long as there is a desire to become a psychologist, because the areas where one can apply one’s abilities are unlimited in psychology.

We provide some simple tests in the app. Conduct an experiment with yourself and your loved ones. See if you like this job. If you like it, it will become clear to you where to go to study. And if your conclusions coincide with reality, then the subjects will look at you as a gifted psychologist. Remember that a diagnostic psychologist never makes mistakes and always conducts an experiment on two people - the subject and himself. And if his conclusion does not correspond to the mental status of the person he is examining, then it certainly suits the psychologist himself. And if a psychologist makes a conclusion about the lack of intelligence of the person he examined, but in fact it turns out that his ward is a very smart person, then we can safely conclude that the psychologist is insufficiently qualified.

When you conduct experiments with your loved ones, you should take into account that everyone wants to hear about themselves that they are a “good guy”, but, on the other hand, it is necessary to tell the truth, that is, to say something bad about the person . This is where intelligence is needed, because the test cuts straight to the truth. One psychologist examined the head of an institution, wanting to demonstrate the capabilities of psychology and conclude a profitable contract. According to the text of the test, it turned out that the subject was an intelligent, indecisive and timid person. The psychologist gave his conclusion with the same words. Now guess if he signed a cooperation agreement? Of course not. His competitor ran the same test with the same executive and got the same result. But I told him something like this: you are a smart person, but you doubt yourself and spend a lot of time making a decision and miss many opportunities. Trust your mind more, and things will go better for you. A cooperation agreement was concluded.

A diagnostic psychologist has another advantage. He does not need to work particularly hard on his personality and master the skills of psychologically competent communication. In real life, he may turn out to be an ordinary person and make the same mistakes as those who turn to him for help. Nevertheless, his conclusions will have their value, for he draws conclusions based on well-known psychological tests developed by others or even by himself, tested many times by various studies. For example, the now widely known and often used in modern psychological diagnostics, the Luscher color test was created as follows. Approximately 20 thousand people were placed sequentially in rooms upholstered with drapery in all eight colors: blue, green, red, yellow, crimson, brown, black and gray. They all underwent a thorough examination in every room. Based on the results of this examination, a test was compiled.

When we created a color sociometric test on the basis of this test, we tested 100 groups of 10-15 people each simultaneously using the sociometric methods known to them and ours and showed that ours, not inferior in reliability to the already known ones, reveals the kind of information that can be obtained according to those tests it is impossible.

So, if the testing is done correctly, then it is better to trust the test than your impressions.

Now a few words about the psychologist-trainer. A specialist of this profile must help a person get rid of behavioral stereotypes that hinder him and teach new ones, rid him of timidity, indecisiveness, shyness, arrogance and everything that often forms the structure of his personality and character and prevents him from achieving his goals and meeting his needs.

This is long, painstaking work. It takes time (sometimes months and years) to get rid of personality traits that interfere with life and to develop character traits and forms of behavior that allow you to achieve your goals.

Therefore, a psychologist-trainer, before starting coaching work, must himself get rid of some qualities, which he will then help his wards get rid of, and master all the skills that his wards must learn. It is difficult for me to imagine how a shy trainer can teach his client to be sociable or help teach certain forms of behavior if he himself does not master them. Of course, it happens later that capable students outperform their teacher, but he must master the primary elements of skills. A psychologist-trainer must be physically healthy, have a high social rating and be well-off financially. Of course, the psychologist will never have such wealth as the capitalist oligarch whom he will train, but he simply needs to be financially independent from him, otherwise he, willingly or unwillingly, will be afraid of losing it and he will be worried not about the truth, but about the desire to please his client, that is, become a sycophant, which will make his work ineffective. And in general, as Seneca said, you can only calmly possess what you are not afraid to lose.

In particular, in our trainings we teach our students the principle of amortization, i.e. to agree with all the statements of a communication partner, at least at the beginning, so that a conflict does not arise, and then express their point of view. This is very difficult for many, but when they learn it, they get the necessary results. And now some examples of how a psychological trainer works. Listen to the story of one of my students.

A teenager aged 15, physically well developed and looking older than his years, always an exemplary boy, serious, active, involved in a sports school and showing great promise, unexpectedly became interested in a 20-year-old girl. He began to return home late, skip training, and do worse at school. The girl he was dating had a lot of sexual experience, which also frightened his parents. The son said that he loved her, that he was already an adult and knew what to do. Convictions and scandals had no effect. The mother was constantly crying, the father was depressed: he had to go sailing soon, and the mother had to be admitted to the hospital.

The depreciation was carried out by the father, who completed a short training course. This is what it looked like:
- Son, I'm sorry that we interfere in your life. We somehow missed that you have already grown up. You really understand more in life and are nobler than us. And you can love better. Really, what does it matter that she is older and already has sexual experience? Maybe this is even better. By comparing you with others, your chosen one will be devoted to you.

I won’t describe my son’s amazement. I didn't see it myself. I know from my father’s words. Relations improved after three days. The mother also mastered the shock absorption technique and was discharged from the hospital. The son, left to his own devices, soon figured out his chosen one and after a week stopped meeting with her. This example is more complicated.

Communication skills are best developed in psychological games. There are a lot of them. One of them, developed by me, “Royal Court,” by solving a number of other psychological problems, allows you to learn management. The breeder, a volunteer from the group, undertakes to form a royal court from the members of the group, that is, he chooses the king, queen, favorite, jester, prime minister and the entire cabinet, executioner, jester, princess, whipping girl, etc. And according to this, As the manager does this, it becomes clear to himself and those around him that he does not know how to manage. The voice is uncertain, the orders are amorphous, and he does not dare appoint people to unpopular positions. If the training is successful, after two or three attempts the choice becomes more accurate, the orders become clearer, and the voice becomes more confident.

It’s better to decide now who you decide to become. If you are a coach, then go to a club at the department where you can gain coaching skills and at the same time solve your personal problems. But do not forget that this does not exempt you from mastering diagnostic techniques.

If you decide to become a diagnostic psychologist, then it is better to go to a circle in a department that not only deals with testing, but also develops tests itself.

If your interests suddenly change during your studies, try to use yourself in another area. The main thing is that you enjoy studying. As W. Shakespeare wrote,

What there is no pleasure in, there is no point.
Study what you like.

It’s better to try options at the university so as not to rush around after graduation. In real life, I observed different options. It happened that the psychologist remained a diagnostician. The growth of his career went like this (you understand that I mean a specific person). At first he was a medical psychologist and examined patients. He never cared about coaching. His qualifications have increased. He began teaching psychology at one of the universities. I wrote my Ph.D. thesis based on materials from an examination of the mental status of criminals and identified some patterns that can be used to change parenting methods. And he still doesn’t want to get involved in coaching. But psychologists-trainers and psychiatrists are happy when he agrees to examine their patients. His social status and material support are quite sufficient for a decent life.

I can give you a lot of examples when diagnosticians became trainers and did not regret doing diagnostic work for some time.

Some, immediately focused on coaching, soon realized that it was necessary to know the basics of diagnostics.

Of course, you can master both to the same extent, but if you want to achieve significant heights, you should be more specific.

There is probably a sofa in his office, but rarely does a client lie on it. The session is not about finding meaning in an inkblot or playing association games. Clients come with certain requests and, together with a specialist, sort them out. No romance with clients, it's unethical! As well as discussing other people's problems.

2. Don't confuse him with a psychiatrist

A person can work as a psychologist after advanced training courses, while psychiatrists study at a medical school. Courses are different, and so are the specialists after them.

3. There is no appointment plan

Unlike a lesson, during a visit to a psychologist there is no clear structure of what will be done with the client. It all depends on the original request and the techniques that the client responds best to.

4. Trust is not created immediately.

At the first appointments, the psychologist asks a lot of questions, but the client is not obliged to immediately lay out all the ins and outs. No one will rush! When people begin to share more details and experience stronger emotions, then trust arises.

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5. People communicate a lot without words.

Sometimes a person says one thing, but his body language - posture, gestures, facial expressions - indicate something else. That is why they try to invite both participants to analyze family situations.

6. Sometimes it seems that a psychologist is unable to help.

A psychologist does not have a magic wand to remove all problems in one fell swoop. He will listen, offer behavioral strategies, discuss the situation, but the main work is still done by the client.

7. The client base does not appear instantly

If a psychologist is in private practice and is not a social media superstar, it takes years to develop a client base. He can accept people from colleagues, promote himself on the Internet and by word of mouth, but he doesn’t have to wait in line for those interested.

8. Don’t “psychologize” your family

The task of a psychologist is to balance work and personal life. If his spouse, children, parents do not want psychotherapy at home, you should not force yourself on them.

9. No one admits that he is a psychologist.

Otherwise, everyone is the first to start talking about their problems, wanting to consult for free. An experienced psychologist either does not reveal himself or gives out his business card with a phone number for making an appointment.

A clinical psychologist is a qualified specialist in the field of medical (clinical) psychology, engaged in research within this psychological area, diagnosis and correction of certain problems, including borderline conditions.

Despite the fact that in the context of clinical psychology a certain emphasis is placed on the medical component of the profession during training and work, specialists in this field also have basic psychological knowledge. This moment opens up more opportunities for a clinical psychologist for self-realization and helping people.

Before you get an idea of ​​the main nuances of the profession, you need to understand what differences exist between the so-called “simple” psychologists and narrow medical specialists.

In the modern system of higher specialized education, the training of specialists in the field of psychology can be divided into two branches:

• pedagogical, which gives the opportunity to teach in schools or institutes;
• medical, due to which students must undergo a number of specialized subjects, resulting in a diploma of a medical psychologist.

However, despite this feature, psychology as a professional direction is dominant. If a qualified doctor, during diagnosis and treatment, relies on medical methods and has the ability to conduct drug therapy, then in the case of a clinical psychologist, the main methods of correcting the client’s (patient’s) condition remain psychological methods of influence.

What do these specialists teach?

You can obtain such a specialization at any higher educational institution where there is an appropriate department.

Unlike students studying in other fields (general, social, etc.), during their studies, future medical psychologists often study subjects such as neurology, narcology, psychiatry and others in depth and in more detail.

Within the clinical direction, special attention is paid to the following sections:

• psychosomatics;
• pathopsychology;
• neuropsychology.

Unlike doctors, a clinical psychologist does not have the task of completing an internship. Further training is usually carried out independently. Such a specialist can additionally take courses in counseling or running training groups, and study in detail certain psychological areas and techniques.

What are the features of their work?

A specialist in this field can be both a theoretician and a practitioner. In most cases, the emphasis is still placed on psychodiagnostics and psychocorrection.

A clinical psychologist needs to have the skills to work and interact not only with sick people, but also with individuals who are conditionally or completely healthy. Due to this nuance, such specialists do not exclusively deal with patients with borderline conditions, for example, neuroses or depression.

We work with people who have mental disorders due to somatic diseases (serious injuries, including traumatic brain injuries, strokes, cancer, and so on). The emphasis is on contact with the patient’s immediate environment when there is a need to teach family members how to properly interact with a sick person.

Intervention may be relevant to correct conditions in children, including those with increased anxiety, an abundance of fears, and the initial stages of neurotic conditions.

Another feature of this profession is that a specialist can engage in family counseling when the internal climate is disturbed and can negatively affect both physically and mentally. A psychologist trained on a medical basis often pays attention to social work. He can engage in educational activities, work with hospital and clinic staff, and participate in the development of plans for mental hygiene or psychoprophylaxis.

Such a specialist is part of a team to determine a person's condition before prescribing disability for any reason. Increasingly, the help of a clinical psychologist is being resorted to during medical and forensic examinations. As part of a general diagnosis of the patient’s condition, a clinical psychology specialist works together with psychiatrists, psychotherapists, neurologists and other representatives of medical professions.

The specifics of this profession involve conducting psychocorrection and diagnostic procedures with persons with various addictions, eating disorders, and in general.

Despite the fact that in recent years the states and Europe have been considering the option of expanding the rights, opportunities and responsibilities of medical psychologists, such a specialist does not have pharmacological therapy in the arsenal of basic methods. The main “working tools” in treatment and rehabilitation and what the specialist does are:

Working as a medical psychologist

Thanks to the peculiarities of this psychological education, the skills that specialists in the field of medical psychology possess after receiving a diploma, the scope of activity is as extensive as the places of employment. Where can a clinical psychologist prove himself after receiving the necessary qualifications?

Where do representatives of this profession work?

A medical psychologist, just like a psychologist of a different direction, has the opportunity to conduct consultations and engage in private practice. In this option, interaction often occurs with people who are not sick, but with those who are in a crisis situation when there is no way to cope with the problem or condition on their own.

Representatives of this profession work in clinics, at psycho-neurological dispensaries, in psychiatric hospitals and clinics, where they treat patients with neuroses and other borderline conditions. The clinical psychologist's place of work may be a hospice, children's or adult hospital. In this option, the psychologist provides support to patients with various forms of somatic diseases, “guides” the patient throughout the entire treatment period, monitoring the dynamics of the condition, correcting psychological problems and influencing the prevention of the development of mental illnesses.

A person with this specialization may be in demand in nursing homes, boarding schools and orphanages where there are children with various developmental disorders (physical, mental). Specialized educational institutions, sanatoriums and rehabilitation centers of various types also cooperate with such specialists.

The profession of a medical psychologist involves extensive work with completely different people who can influence the psychologist himself. Because of this, there is a risk of professional and emotional burnout. A person who chooses this path for himself must have certain personality traits, for example, resistance to stress, a significant level of patience and a desire to help others. And also be prepared for all possible difficulties that arise on your professional path.

Question to a psychologist

Hello. I am 31 years old. I work in the police. After 10 years of service, a departmental psychologist identified schizoid accentuation (psychopathy) in me. Tell me, does the psychologist have the right to make such a diagnosis or should he refer me to the Center for Psychiatry to see a psychiatrist, do I need observation in hospital, what will happen to me if the diagnosis is confirmed? Thanks in advance!

Hello, Sergey! The diagnosis can only be made by a doctor (psychiatrist, clinical psychologist). Accentuation of character is not a disease, but changes in character. Observation in a hospital is not necessary unless indicated by a neurologist. You can contact a psychologist you trust and take a course to work with the problem.

Best regards, Larisa.

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Hello, Sergey! Accentuation is not psychopathy!!! and especially not a diagnosis!!! and you don’t need to be observed anywhere!!! this is simply a variation in personality quality above the average statistical norm and this suggests that you are simply a more withdrawn person in communication, and fewer contacts are enough for you, it can also go together with an introverted personality, it also speaks of your internal self-sufficiency (i.e. because you don’t need a big company to satisfy your needs) and many people can have such an accentuation and, on the contrary, it helps many people - they are more thoughtful, less susceptible to emotional outbursts, their inner world is rich and sufficient, and they are more guided by rationality when making decisions and logic!

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Sergey, is there anything that worries you other than the name? How are you feeling? How are relationships in the family and in the team? What's the question? It is advisable to “check” diagnoses (such as “you have gastritis”) with a couple of doctors. Everyone can make mistakes. And here, according to the test... Read Leonhard's classification. Here's the quote" Schizoid accentuation is characterized byisolationthe individual, his isolation from other people. Schizoid people lackintuitionand the ability to empathize. They have a hard time establishing emotional connections. They have stable and permanent interests. Very laconic. The inner world is almost always closed to others and is filled with hobbies andfantasies, which are intended only to please oneself. May occasionally show a tendency to drink alcohol, which is never accompanied by a feelingeuphoria"There is something about you, who knows more about yourself than you?

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Sergey, good afternoon! Schizoid accentuation is a pronounced expression of certain traits in your character. And despite the scary name, it is not a disease! Those. there is some tendency towards psychopathy, but this is not psychopathy itself, which is already a disease. The psychologist probably simply failed to convey this clearly to you or you did not understand him. There is no need to see a doctor for this. Most likely, your profession, due to its peculiarity, has led to some deformations over 10 years. And no wonder - your profession is highly “harmful” to psychological health. Now just calm down, talk to a psychologist (of your choice, not necessarily a departmental one) about how to help your loved one become more balanced. This will be useful for your physical health and your peace of mind, and will be useful for further work. The psychologist will correct some points and teach you how to maintain maximum stability and harmony under constant stress.

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Hello, Sergey! Accentuation is not a diagnosis, but the increased influence of a given factor in your character - this is not a pathology, and besides, a psychologist does not make diagnoses at all - only a psychiatrist has the right to do this. How do you feel about yourself? are you comfortable? Do you feel satisfied with life - is your isolation and excessive isolation from other people bothering you? That is, this in itself does not threaten you with anything, it’s just possible that after 10 years of working in the police, your character has transformed and you have become more closed, so as not to show your emotionality, since it can interfere with your work. These are the questions you should think about. And it is possible to turn to a psychologist so that he can help you better understand yourself and your worldviews and emotions. Best regards, Maria

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