He maintained balance in his sensations. He enjoyed playing with his friend. «Everything is good. I can play and jump,» he said. Only a small crimson scar under his jaw reminded about his former problems.
«Scars adorn a man,» I remarked.
«I have got enough of them,» my little patient said proudly
The boy reproduced the dynamics of recovery: steady internal heat remained after our meeting. «We were going to take him to the regional center for a more massive operation, but the need for this somehow disappeared by itself. The wounds began to heal,» his mother added. We communicated with him on February 8th, and on March 8th he was already at school. Later his health was improving steadily. His relatives noticed that in he also became calmer.
At the end of my communication with the boy his aunt expressed a desire to talk with me about her problems. It was an indirect sign of recognition of the connection between the session and the recovery by the boy’s relatives. A large lump of fresh cottage cheese, which I brought to Moscow to my children, seemed to me a great reward for my modest question: «What do you feel?»
When you can let happen transformations like those, described by my little patient, nothing else is necessary.
In a few other cases, the challenge is to make the sensations flow. Such transformations are the essence of therapeutic achievements.
Do not talk
To tell the truth, sometimes I almost fall asleep when the patient tries to describe in detail the story of his suffering, not hurrying to work through it. It happens not only to me. In the “Technique and practice of psychoanalysis” Ralph Grinson especially considers such cases when a psychoanalyst accidentally falls asleep during a psychoanalysis session. He recommends not to blame the patient. I can cope with it even without pinching my own hand, but I do not tend to overestimate the effectiveness of this method of psychotherapeutic session and try to warn the patient about the uselessness of just listing the facts.
To avoid this, at the first mentioning of a significant event for the patients, which left a mark in their soul, I prefer to work through the consequent of their experiences, to verify the expediency of its storage, instead of being limited to a simple listing the imprints of events in their soul. I call it the non-slip principle.
Though it is possible to talk as well
However, I must note that there is no need to impose a rather closed, non-objective language of body sensations, when a person calls for an open conversation on existential topics and the balance of their state is not in doubt. Indications for SPT method are very wide, but not unlimited. It is the way to restore the resource of a person. It is needed in almost 100% of cases, but it is not the only thing that the patient may need. Thus, the psychotherapist is not obliged to use the methods of SPT always and everywhere.
We will continue to talk about situations where the balance of the human condition still raises doubts.
The ending – to the beginning
With the time, the phase of communication between the doctor and the patient, conventionally called the “relaxation phase’, became increasingly valuable. I learned to perceive it as a kind of goal, the culmination of the process of psychotherapy,
I once noticed that I was not at all inclined to talk to a patient. Of course, I mean «conversation of minds.» Taking into consideration the importance of the influence of affective charges on a patient’s thinking, I found out that it made sense to «talk to the boss’ (unconscious), in the words of M. Erickson, and not with subordinates (thoughts of conscious mind).
It was easier to find «the boss’ by the sensations in the patient’s body.
The direct appeal to the sensations from the very beginning of the work marked the opening of a unique opportunity to change the state directly, without talking (in the usual meaning of this word). The old formula «conversation – relaxation – conversation’ was replaced by a new one: «relaxation – conversation – relaxation’.
The idea, that the analysis of the patient’s circumstances was usually given an exaggerated value, began to strengthen. In fact, not these circumstances are so important, but how the patient «stands’ in them. It is important to help a person to take a different position in relation to the circumstances, to find another their state. The further is the matter of their own life.
The second phase became the first. Conversations began to start with the analysis of a condition, instead of a situation. Somatopsychotherapy is an exceptional care for the patient’s condition.
Separation of the concepts of “patient’s condition’ and “patient’s problem’
Often the conversation with the therapist flows into the area of discussion of the patient’s problems. I think this is a minimally productive approach. But firstly, let us define what there is besides the patient’s problems.
«The patient’s problem’ is what makes the body react. The perceived information about the situation inside or outside the body, deviates from the optimal. So, the persons consider the restoration of its optimality to be their vital task. This is the basis for their concern.
What is meant to solve the problem is the patient’s state. This is the life resource, the certain configuration of sensations in the body.
Perceptions of situations and responses to them vary widely. What is a difficult problem for one, is nothing for the other; when ones react with all their beings the others can stay completely indifferent. This observation makes you think about the initial state in which a person perceives the situation, evaluates it and forms a reaction to it. The constitutional and genetic factors, the early history of the individual and so on, play an important role in the formation of the patient’s state. It is important that by the time of the meeting with the psychotherapist, the result of the life of this particular person (with his genes, personal history and education) is presented in the form of a state with a certain configuration of internal sensations.
Temperature above 39 degrees
There is a number of situations when the patient’s condition itself (for example, tension) is a problem. As the temperature in case of inflammation goes above 39 degrees. The increase in temperature is natural, of course, but not to such an extent.
Entering the psychotherapeutic room, the patients do not always know what they did it for: in order to solve their problems, or to change their condition. (The third option is the question of how to constructively apply their condition to the problematic situations without changing it a lot). In fact, the problems of the patients are solved outside the therapeutic room. They come here to rate their state of mind in which they try solving the problems and to optimize it.
Psychocatalysis of body sensations is a method of changing the patients’ state and restoring their resources. It is not about solving their problems, unless, we consider the state of their health a special problem. In this case it is a «metaproblem’, the solution of which determines the solution of all other problems.
Separation of the concepts of “psychotherapy’ and “exchange of experience’
It is known that some psychotherapists, including the most authoritative, like M. Erickson or A. Alexeichik, did not shy away from acting as advisers to their patients. There is nothing unnatural in it: a wise person shares with the other one, who is not so wise, their life experience, possibilities, and the program of actions. Such advice