Clinical psychology. Cheat sheet: briefly, the most important

Lecture notes, cheat sheets
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Clinical psychology. Cheat sheet: briefly, the most important

Lecture notes, cheat sheets

Table of contents

1. Clinical psychology as: an independent science. Definition of clinical psychology

Clinical psychology is a branch of psychological science. Her findings are of theoretical and practical importance for both psychology and medicine.

In some countries, the concept of medical psychology is common, but in most countries the concept of "clinical psychology" is more commonly used.

In recent decades, in Russia, the question of the convergence of domestic and world psychology has increasingly begun to arise, which required a revision of such concepts as medical and clinical psychology.

The change in the name of medical psychology to clinical psychology is due to the fact that in recent decades it has been integrating into world psychology.

Clinical psychology as an organization of researchers and practitioners has been represented by the American Association of Clinical Psychology since 1917, and in German-speaking countries since the middle of the XNUMXth century.

The international guide to clinical psychology, edited by M. Perret and W. Baumann, provides the following definition: "Clinical psychology is a private psychological discipline, the subject of which is mental disorders and mental aspects of somatic disorders (diseases). It includes the following sections: etiology ( analysis of the conditions for the occurrence of disorders), classification, diagnosis, epidemiology, intervention (prevention, psychotherapy, rehabilitation), health care, evaluation of results. In English-speaking countries, in addition to the term "clinical psychology", the term "pathological psychology" - Abnormal Psychology - is used as a synonym. In addition to clinical psychology, many universities, mostly Western ones, also teach medical psychology. The content of this discipline may be different. It includes:

1) the application of the achievements of psychology in medical practice (first of all, this concerns solving the problem of interaction between a doctor and a patient);

2) disease prevention (prophylaxis) and health protection;

3) mental aspects of somatic disorders, etc. In accordance with the state educational

The standard of clinical psychology is a wide-profile specialty aimed at solving a set of problems in the healthcare and education system. It is also noted that clinical psychology is intersectoral in nature.

Experts give different definitions of clinical psychology. But they all agree on one thing: clinical psychology considers the area that borders between medicine and psychology. This is a science that studies the problems of medicine from the point of view of psychology.

The leading Soviet psychiatrist A.V. Snezhnevsky believes that medical psychology is a branch of general psychology that studies the state and role of the psyche in the occurrence of human diseases, the features of their manifestations, course, as well as outcome and recovery. In its research, medical psychology uses descriptive and experimental methods accepted in psychology.

2. Subject and object of research in clinical psychology

According to the direction, psychological research is divided into general (aimed at identifying general patterns) and private (aimed at studying the characteristics of a particular patient). In accordance with this, one can distinguish between general and particular clinical psychology.

The subject of general clinical psychology are:

1) the main patterns of the psychology of the patient, the psychology of a medical worker, the psychological characteristics of communication between the patient and the doctor, as well as the influence of the psychological atmosphere of medical institutions on the human condition;

2) psychosomatic and somatopsychic mutual influences;

3) individuality (personality, character and temperament), human evolution, the passage of successive stages of development in the process of ontogenesis (childhood, adolescence, youth, maturity and late age), as well as emotional and volitional processes;

4) issues of medical duty, ethics, medical secrecy;

5) mental hygiene (psychology of medical consultations, family), including mental hygiene of persons in crisis periods of their lives (puberty, menopause), psychology of sexual life;

6) general psychotherapy.

Private clinical psychology studies a specific patient, namely:

1) features of mental processes in mental patients;

2) the psyche of patients during the period of preparation for surgical interventions and in the postoperative period;

3) features of the psyche of patients suffering from various diseases (cardiovascular, infectious, oncological, gynecological, skin, etc.);

4) the psyche of patients with defects in the organs of hearing, vision, etc.;

5) features of the psyche of patients during labor, military and forensic examinations;

6) the psyche of patients with alcoholism and drug addiction;

7) private psychotherapy.

B. D. Karvasarsky, as a subject of clinical psychology, highlighted the features of the patient’s mental activity in their significance for the pathogenetic and differential diagnosis of the disease, optimization of its treatment, as well as prevention and promotion of health.

What is the object of clinical psychology? B.D. Karvasarsky believes that the object of clinical psychology is a person with difficulties of adaptation and self-realization that are associated with his physical, social and spiritual state.

3. Goals and structure of clinical psychology. Main sections and areas of their research

Clinical psychology as an independent science faces certain goals. In the 60s-70s. XX century the specific goals of clinical psychology were formulated as follows (M. S. Lebedinsky, V. N. Myasishchev, 1966; M. M. Kabanov, B. D. Karvasarsky, 1978):

1) the study of mental factors affecting the development of diseases, their prevention and treatment;

2) study of the influence of certain diseases on the psyche;

3) the study of mental manifestations of various diseases in their dynamics;

4) the study of developmental disorders of the psyche; study of the nature of the relationship of a sick person with medical personnel and the surrounding microenvironment;

5) development of principles and methods of psychological research in the clinic;

6) creation and study of psychological methods of influencing the human psyche for therapeutic and prophylactic purposes.

Such a formulation of the goals of clinical psychology corresponded to the growing tendency to use the ideas and methods of this science to improve the quality of the diagnostic and treatment process in various fields of medicine, with all the difficulties inevitable at this stage due to the unequal degree of development of one or another of its sections.

It is possible to single out specific sections of medical psychology that find practical application of knowledge in the relevant clinics: in a psychiatric clinic - pathopsychology; in neurological - neuropsychology; in somatic - psychosomatics.

According to B. V. Zeigarnik, pathopsychology studies disorders of mental activity, patterns of disintegration of the psyche in comparison with the norm. She notes that pathopsychology operates with the concepts of general and clinical psychology and uses psychological methods. Pathopsychology works both on the problems of general clinical psychology (when changes in the personality of mental patients and patterns of mental decay are studied), and private (when mental disorders of a particular patient are studied to clarify the diagnosis, conduct a labor, judicial or military examination).

The object of study of neuropsychology is diseases of the central nervous system (CNS), mainly local focal lesions of the brain.

Psychosomatics studies how changes in the psyche affect the occurrence of somatic diseases.

Pathopsychology should be distinguished from psychopathology (which will be discussed later). Now it is only worth noting that pathopsychology is a part of psychiatry and studies the symptoms of mental illness by clinical methods, using medical concepts: diagnosis, etiology, pathogenesis, symptom, syndrome, etc. The main method of psychopathology is clinical and descriptive.

4. The relationship of clinical psychology with other sciences

The basic sciences for clinical psychology are general psychology and psychiatry. The development of clinical psychology is also greatly influenced by neurology and neurosurgery.

Psychiatry is a medical science, but it is closely related to clinical psychology. These sciences have a common subject of scientific research - mental disorders. But besides this, clinical psychology deals with such disorders, which in their significance are not equivalent to diseases (for example, problems of matrimony), as well as the mental aspects of somatic disorders. However, psychiatry, as a private field of medicine, takes more into account the somatic plane of mental disorders. Clinical psychology focuses on psychological aspects.

Clinical psychology is related to psychopharmacology: both study psychopathological disorders and methods of treating them. In addition, the use of drugs always has a positive or negative psychological effect on the patient.

Medical pedagogy is successfully developing - an area adjacent to medicine, psychology and pedagogy, whose tasks include teaching, educating and treating sick children.

Psychotherapy as an independent medical specialty is closely related to clinical psychology. Theoretical and practical problems of psychotherapy are developed based on the achievements of medical psychology.

In the West, psychotherapy is considered to be a special area of clinical psychology, and thus emphasizes the special affinity between psychology and psychotherapy.

However, the position on the special proximity of psychotherapy and clinical psychology is often disputed. Many scientists believe that from a scientific point of view, psychotherapy is closer to medicine. This gives the following arguments:

1) the treatment of patients is the task of medicine;

2) psychotherapy is the treatment of patients. It follows that psychotherapy is the task of medicine. This provision is based on the fact that in many countries only physicians are eligible to practice it.

Clinical psychology is also close to a number of other psychological and pedagogical sciences - experimental psychology, occupational therapy, oligophrenic pedagogy, tiflopsychology, deaf psychology, etc.

Thus, it is obvious that in the process of work, a clinical psychologist needs to apply an integrated approach.

5. The origin and development of clinical psychology

The formation of clinical psychology as one of the main applied branches of psychological science is associated with the development of both psychology itself and medicine, biology, physiology, and anthropology.

The origin of clinical psychology dates back to ancient times, when psychological knowledge was born in the depths of philosophy and natural science.

The emergence of the first scientific ideas about the psyche, the identification of the science of the soul, the formation of empirical knowledge about mental processes and their disorders is associated with the development of ancient philosophy and the achievements of ancient doctors. Thus, Alkemon of Croton (VI century BC) for the first time in history put forward the position of the localization of thoughts in the brain. Hippocrates also attached great importance to the study of the brain as an organ of the psyche. He developed the doctrine of temperament and the first classification of human types. The Alexandrian doctors Herophilus and Erasistratus described the brain in detail; they paid attention to the cortex with its convolutions, which distinguished humans from animals in mental abilities.

The next stage in the development of clinical psychology was the Middle Ages. It was a rather long period, riddled with unbridled mysticism and religious dogmatism, persecution of natural scientists and the fires of the Inquisition. Initially, education was built on the basis of ancient philosophy and the natural science achievements of Hippocrates, Galen, Aristotle. Then knowledge declines, alchemy flourishes, and until the XNUMXth century. the dark years continue. Psychology in the Middle Ages is based on philosophy

Thomas Aquinas. The development of ideas about the psyche at this stage slowed down sharply. An important role in the development of domestic clinical psychology was played by A.F. Lazursky, the organizer of his own psychological school.

Thanks to A.F. Lazursky, the natural experiment was introduced into clinical practice, although he had originally developed it for educational psychology.

Most developed in the 60s. XNUMXth century were the following sections of clinical psychology:

1) pathopsychology, which arose at the intersection of psychology, psychopathology and psychiatry (B. V. Zeigarnik, Yu. F. Polyakov, etc.);

2) neuropsychology, formed at the border of psychology, neurology and neurosurgery {A. R. Luria, E. D. Chomskaya, etc.).

There is an independent field of psychological knowledge, which has its own subject, its own research methods, its own theoretical and practical tasks - clinical psychology.

Currently, clinical psychology is one of the most popular applied branches of psychology and has great prospects for development both abroad and in Russia.

6. Practical tasks and functions of a clinical psychologist

A clinical psychologist in healthcare institutions is a specialist whose responsibilities include both participation in psychodiagnostic and psychocorrectional activities, and in the treatment process as a whole. Medical assistance is provided by a team of specialists. This “team” model of medical care initially arose in psychotherapeutic and psychiatric services. The center of the team is the attending physician, working together with a psychotherapist, clinical psychologist and social work specialist. Each of them carries out their own diagnostic, treatment and rehabilitation plan under the guidance of the attending physician and in close cooperation with other specialists. But such a “team” model in healthcare is not yet widespread enough, and the speed of its spread depends on the availability of psychological personnel. But so far, unfortunately, the domestic healthcare system is not ready for this.

The activities of a psychologist in a medical institution are aimed at:

1) increasing the mental resources and adaptive capabilities of a person;

2) harmonization of mental development;

3) health protection;

4) prevention and psychological rehabilitation. The subject of the activity of a clinical psychologist

we can consider mental processes and states, individual and interpersonal characteristics, socio-psychological phenomena that manifest themselves in various areas of human activity.

Therefore, it is important to emphasize that a clinical psychologist is a specialist who can work not only in clinics, but also in institutions of a different profile: education, social protection, etc. These are institutions that require an in-depth study of a person’s personality and the provision of psychological assistance to him.

In the above areas, a clinical psychologist performs the following activities:

1) diagnostic;

2) expert;

3) correctional;

4) preventive;

5) rehabilitation;

6) advisory;

7) research, etc.

7. Features and objectives of pathopsychological research

The main areas of work of the pathopsychologist are as follows.

1. Solving problems of differential diagnostics.

Most often, such tasks arise when it is necessary to distinguish the initial manifestations of sluggish forms of schizophrenia from neurosis, psychopathy, and organic diseases of the brain. Also, the need for a pathopsychological study may arise when recognizing erased or "masked" depressions, dissimulating delusional experiences and some forms of pathology of late age.

2. Assessment of the structure and degree of neuropsychiatric disorders.

With the help of a pathopsychological study, a psychologist can determine the severity and nature of violations of individual mental processes, the possibility of compensating for these violations, taking into account the psychological characteristics of a particular activity.

3. Diagnostics of mental development and the choice of ways of training and retraining.

In children's institutions, the pathopsychologist plays a large role in solving diagnostic problems. An important task here is to determine anomalies of mental development, to identify the degree and structure of various forms of mental development disorders. Pathopsychological research contributes to a better understanding of the nature of mental development anomalies, and also serves as the basis for the development of psychocorrectional programs for further work with the child.

4. Study of the personality and social environment of the patient.

In this case, the psychological experiment is based on the principle of modeling a certain objective activity. At the same time, the features of the psyche of patients, mental processes and personality traits that play an important role in social and professional adaptation are revealed. The pathopsychologist must determine which functions are affected and which are preserved, and determine the ways of compensation in various activities.

5. Assessment of the dynamics of mental disorders. Psychological methods are effective

to identify changes in the system of relations and in the social position of the patient in connection with the ongoing psycho-correctional work. It is important to note that when assessing the dynamics of the patient's condition, a repeated psychological examination is always carried out.

6. Expert work.

Pathopsychological research is an important element of medical-labor, military-medical, medical-pedagogical and forensic-psychiatric examinations. In addition, in judicial practice, psychological examination can act as independent evidence. The tasks of the study are determined by the type of examination, as well as the questions that the psychologist must answer during the experiment.

8. Methods of pathopsychological research

The methods used for pathopsychological research can be divided into standardized and non-standardized.

Non-standardized methods are aimed at determining specific disorders of mental activity and are compiled individually for each patient.

Non-standardized methods of pathopsychological research include:

1) the method of "artificial concept formation" by L. S. Vygotsky, which is used to identify the features of conceptual thinking in various mental illnesses, primarily in schizophrenia and some organic brain lesions;

2) the method of "classification of objects" by Goldstein, which is used to analyze various violations of the processes of abstraction and generalization;

3) methods "classification", "subject pictures", "exclusion of objects", "exclusion of concepts", "interpretation of proverbs" and other methods of studying thinking;

4) the method of “proofreading tests” by Anfimov-Bourdon and the method of “black-red digital tables” by Schulte-Gorbov (for studying attention and memory), as well as methods of typing syllables and words, the methods of Kraepelin and Ebbinghaus are used to study short-term memory;

5) the method of "unfinished sentences";

6) the method of "paired profiles";

7) thematic apperception test (TAT) and other methods for the study of personality.

The main principle when using non-standardized research methods is the principle of modeling certain situations in which certain types of mental activity of the patient are manifested. The conclusion of the pathopsychologist is based on an assessment of the end result of the patient's activity, as well as on an analysis of the characteristics of the process of performing tasks, which allows not only to identify violations, but also to compare the disturbed and intact aspects of mental activity.

Standardized methods are widely used in diagnostic work. In this case, specially selected tasks are presented in the same form to each subject. Thus, it becomes possible to compare the methods and levels of task performance by the subjects and other persons.

Almost all non-standardized methods can be standardized. It should be noted that for a qualitative analysis of the characteristics of mental activity, most of the subtests included in the standardized methods can be used in a non-standardized version.

B. V. Zeigarnik believes that the pathopsychological experiment is aimed at:

1) to study the real activity of a person;

2) a qualitative analysis of various forms of the disintegration of the psyche;

3) to reveal the mechanisms of disturbed activity and the possibility of its restoration.

9. The procedure for conducting a pathopsychological study

Pathopsychological research includes the following stages.

1. Studying the medical history, talking with a doctor and setting the task of a pathopsychological study.

The attending physician must inform the pathopsychologist of the main clinical data about the patient and set the tasks of pathopsychological research for the psychologist. The psychologist specifies for himself the task of the study, selects the necessary methods and establishes the order of their presentation to the patient. The doctor must explain to the patient the goals of the pathopsychological study and thereby contribute to the development of positive motivation in him.

2. Carrying out a pathopsychological study.

First of all, the psychologist needs to establish contact with the patient. The reliability of the results obtained in the course of the pathopsychological study largely depends on the success of establishing psychological contact between the pathopsychologist and the subject. Before proceeding with the experiment, it is necessary to make sure that contact with patients is established and the patient understands the purpose of the study. The instruction should be formulated clearly and accessible to the patient.

M. M. Kostereva identifies several types of patient's relationship to pathopsychological research:

1) active (patients join the experiment with interest, adequately respond to both success and failure, are interested in the results of the study);

2) wary (at first, patients treat the study with suspicion, irony, or even fear it, but during the experiment, uncertainty disappears, the patient begins to show accuracy and diligence; with this type of attitude, a "delayed form of response" should be noted, when discrepancies between subjective experiences are observed the subject and the external expressive component of behavior);

3) formally responsible (patients fulfill the requirements of a psychologist without personal interest, are not interested in the results of the study);

4) passive (the patient needs additional motivation; there is no installation for the examination or is extremely unstable);

5) negative or inadequate (patients refuse to participate in the study, perform tasks inconsistently, do not follow instructions).

In drawing conclusions, the pathopsychologist must take into account all factors, including the education of the patient, his attitude to the study, as well as his condition during the study.

3. Description of the results, drawing up a conclusion on the results of the study - the limits of the psychologist's competence.

But on the basis of the results of the study, a conclusion is drawn up, in which the conclusions are consistently stated.

10. Violation of mediation and hierarchy of motives

One of the types of personality development disorders are changes in the motivational sphere. A. N. Leontiev argued that the analysis of activity should be carried out through the analysis of changes in motives. Psychological analysis of changes in motives is one of the ways to study the personality of a sick person, including the characteristics of his activity. In addition, as noted by B. V. Zeigarnik, "in some cases, pathological material makes it possible not only to analyze changes in motives and needs, but also to trace the process of formation of these changes."

The main characteristics of motives include:

1) indirect nature of motives;

2) the hierarchy of the construction of motives.

In children, the hierarchical construction of motives and their mediation begins to emerge even before school. Then, throughout life, the complication of motives occurs. Some motives are subordinate to others: any one general motive (for example, to master a certain profession) includes a number of private motives (to acquire the necessary knowledge, acquire certain skills, etc.). Thus, human activity is always motivated by several motives and responds not to one, but to several needs. But in a specific activity, one can always single out one leading motive, which gives a certain meaning to all human behavior. Additional motives are necessary because they directly stimulate human behavior. The content of any activity loses its personal meaning if there are no leading motives that make it possible to mediate motives in their hierarchical structure.

B. S. Bratus points out that changes occur primarily in the motivational sphere (as an example, the narrowing of the circle of interests). In the course of a pathopsychological study, gross changes in cognitive processes are not detected, but when performing certain tasks (especially those that require prolonged concentration of attention, quick orientation in new material), the patient does not always notice the mistakes he has made (non-criticality), does not respond to the comments of the experimenter and no further guidance from them. The patient also has high self-esteem.

So, we see how, under the influence of alcoholism in this patient, the former hierarchy of motives is destroyed. Sometimes he has some desires (for example, to get a job), and the patient performs some actions, guided by the previous hierarchy of motives. However, these incentives are not sustainable. The main (sense-forming) motive that controls the activity of the patient, as a result, is the satisfaction of the need for alcohol.

So, based on the analysis of changes in mediation and the hierarchy of motives, we can draw the following conclusions:

1) these changes are not derived directly from brain disorders;

2) they go through a complex and long way of formation;

3) in the formation of changes, mechanisms similar to the mechanisms of the normal development of motives operate.

11. Violation of the meaning-forming and incentive functions of the motive

Now consider the pathology of the meaning-forming and motivating functions of motives.

Only by merging these two functions of motive can we speak of consciously regulated activity. Due to the weakening and distortion of these functions, a serious disruption of activity occurs.

These disorders were examined by M. M. Kochenov using the example of patients with schizophrenia. He conducted a study, which consisted of the following: the subject must complete three tasks of his own choice out of nine proposed to him by the experimenter, spending no more than 7 minutes on this. The tasks were:

1) draw a hundred crosses;

2) perform twelve lines of the proof test (according to Bourdon);

3) complete eight lines of the account (according to Kraepelin);

4) fold one of the ornaments of the Kos technique;

5) build a "well" from matches;

6) make a chain out of paper clips;

7) Solve three different puzzles.

Thus, the patient had to choose those actions that are most appropriate to achieve the main goal (perform a certain number of tasks in a certain time).

Conducting this study on healthy subjects, M. M. Kochenov came to the conclusion that in order to achieve the goal, an indicative stage (active orientation in the material) is necessary, which was present in all representatives of this group of subjects.

All subjects were guided by the degree of difficulty of the tasks and chose those that would take less time to complete, as they tried to meet the seven minutes allotted to them.

Thus, in healthy subjects in this situation, individual actions are structured into purposeful behavior.

When conducting an experiment among patients with schizophrenia, other results were obtained:

1) patients did not have an indicative stage;

2) they did not choose easy tasks and often took on those tasks that are clearly impossible to complete in the allotted time;

3) sometimes patients performed tasks with great interest and with special care, not noticing that the time had already expired.

Note that all patients also knew that they had to meet the allotted time, but this did not become a regulator of their behavior. During the experiment, they were able to spontaneously repeat "I have to do it in 7 minutes" without changing the way they completed the task.

So, the studies of M. M. Kochenov showed that the disruption in the activity of patients with schizophrenia was due to a change in the motivation of the sphere. Their motive turned into simply "knowledge" and thus lost its functions - meaning-forming and motivating.

It was the shift in the meaning-forming function of motives that caused the disturbance in the activity of patients, changes in their behavior and degradation of the personality.

12. Violation of controllability and criticality of behavior

Failure to control behavior is one of the images of personality disorders. It is expressed in the patient's incorrect assessment of his actions, in the absence of criticality to his painful experiences. Investigating violations of criticism in mental patients, I. I. Kozhukhovskaya showed that uncriticality in any form indicates a violation of activity in general. Criticality, according to Kozhukhovskaya, is "the pinnacle of a person's personal qualities."

As an example of such a violation, consider extracts from the medical history given by B. V. Zeigarnik:

sick M.

Year of birth - 1890.

Diagnosis: progressive paralysis.

Disease history. In childhood, he developed normally. He graduated from the Faculty of Medicine, worked as a surgeon.

At the age of 47, the first signs of mental illness appeared. During the operation, he made a gross mistake, which led to the death of the patient.

Mental state: correctly oriented, verbose. Knows about his disease, but treats it with great ease. Remembering his surgical mistake, he says with a smile that "everyone has accidents." At the moment, he considers himself healthy, "like a bull." I am convinced that I can work as a surgeon and chief physician of the hospital.

When performing even simple tasks, the patient makes many gross mistakes.

Without listening to the instructions, he tries to approach the task of classifying objects, like a game of dominoes, and asks: "How do you know who won?" When the instruction is read to him a second time, he performs the task correctly.

Performing the task "establishing a sequence of events", trying to simply explain each picture. But when the experimenter interrupts his reasoning and suggests putting the pictures in the right order, the patient performs the task correctly.

When performing the task "correlation of phrases with proverbs", the patient correctly explains the sayings "Measure seven times - cut once" and "Not all that glitters is gold." But he incorrectly refers to them the phrase "Gold is heavier than iron."

Using the pictogram technique, the following results were obtained: the patient forms connections of a rather generalized order (to memorize the phrase "jolly holiday" draws a flag, "dark night" - shades a square). The patient is often distracted from the task.

When checking, it turns out that the patient remembered only 5 words out of 14. When the experimenter told him that this was very little, the patient replied with a smile that next time he would remember more.

Thus, we see that patients do not have a motive for the sake of which they perform this or that activity, perform this or that task.

Their actions are absolutely unmotivated, patients are not aware of their actions, their statements.

The loss of the opportunity to adequately evaluate one's own behavior and the behavior of others led to the destruction of the activity of these patients and a deep personality disorder.

13. Violation of the operational side of thinking. Methods of its research

Violation of the operational side of thinking occurs in two categories:

1) lowering the level of generalization;

2) distortion of the generalization process.

Generalization refers to the main mental operations.

There are four levels of the generalization process:

1) categorical - this is belonging to a group based on essential features;

2) functional - belonging to a group based on functional characteristics;

3) specific - belonging to a group based on specific characteristics;

4) zero - enumeration of objects or their functions, no attempts to generalize objects.

Before proceeding to consider the types of violations of the operational side of thinking, we list the main methods that are used to diagnose the pathology of mental activity.

1. Method "Classification of objects" The task of the subject is to attribute

objects to a particular group (for example, "people", "animals", "clothing", etc.). Then the subject is asked to expand the groups formed by him (for example, "living" and "non-living"). If at the last stage a person identifies two or three groups, we can say that he has a high level of generalization.

2. Method "Exclusion of superfluous" Four cards are presented to the subject. Three of them depict objects that have something in common; the fourth subject should be excluded.

The selection of too generalized features, the inability to exclude an extra subject indicates a distortion of the generalization process.

3. Method "Formation of analogies" The subject is presented with pairs of words, between which there are certain semantic relationships. The subject's task is to highlight a couple of words by analogy.

4. Methodology "Comparison and definition of concepts"

Stimulus material is a homogeneous and heterogeneous concepts. This technique is used to investigate the distortion of the generalization process.

5. Interpretation of the figurative meaning of proverbs and metaphors

There are two versions of this technique. In the first case, the subject is asked to simply explain the figurative meaning of proverbs and metaphors. The second option is that for each proverb you need to find a phrase that corresponds in meaning.

6. Pictogram technique

The test subject's task is to remember 15 words and phrases. To do this, he needs to draw a light picture in order to remember all the phrases or words. Then the nature of the drawings performed is analyzed. Attention is drawn to the presence of connections between the stimulus word and the subject’s drawing.

14. Reducing the level of generalization

With a decrease in the level of generalization in patients, direct ideas about objects and phenomena prevail, i.e., instead of highlighting common features, patients establish specific situational connections between objects and phenomena. They are difficult to abstract from specific details.

B.V. Zeigarnik gives examples of performing the task “classification of objects” by patients with a reduced level of generalization: “... one of the patients described refuses to combine a goat and a wolf into one group, “because they are at enmity”; another patient does not combine a cat and a beetle , because “the cat lives in the house, and the beetle flies.” The particular signs “lives in the forest”, “flies” determine the judgments of patients more than the general sign “animals.” With a pronounced decrease in the level of generalization, the classification task is generally inaccessible to patients; for the subjects, the objects turn out to be so different in their specific properties that they cannot be combined. Even a table and a chair cannot be classified as one group, since “they sit on the chair, and work and eat on the table...”.

Let us give examples of the responses of patients with a reduced level of generalization in the "object exclusion" experiment. Patients are presented with pictures "kerosene lamp", "candle", "electric light bulb", "sun" and asked what needs to be removed. The experimenter receives the following responses.

1. "We must remove the candle. It is not needed, there is a light bulb."

2. "You don't need a candle, it burns out quickly, it is unprofitable, and then you can fall asleep, it can catch fire."

3. "We don't need a kerosene lamp, now there is electricity everywhere."

4. "If during the day, then you need to remove the sun - and without it it is light." Pictures "scales", "watches", "thermometer", "glasses" are presented:

1) the patient removes the thermometer, explaining that "it is only needed in the hospital";

2) the patient removes the scales, because "they are needed in the store when it is necessary to hang";

3) the patient cannot exclude anything: he says that the watch is needed "for time", and the thermometer - "to measure the temperature"; he cannot remove his glasses, because “if a person is short-sighted, then he needs them,” and scales “are not always needed, but are also useful in the household.”

So, we see that often patients approach the presented objects from the point of view of their suitability for life. They do not understand the conventions that are hidden in the task assigned to them.

15. Distortion of the generalization process. Violation of the dynamics of thinking

Patients with a distortion of the generalization process, as a rule, are guided by overly generalized signs. In such patients, random associations predominate.

For example: the patient puts shoes and a pencil in the same group because "they leave marks."

Distortion of the generalization process occurs in patients with schizophrenia.

The main difference between the distortion of the generalization process and the decrease in its level was most clearly described by B. V. Zeigarnik. She noted that if for patients with a reduced level of generalization, the compilation of pictograms is difficult due to the fact that they are not able to distract from any specific meanings of the word, then patients with a distortion of the generalization process easily perform this task, since they can form any association unrelated to their task.

For example: a patient draws two circles and two triangles, respectively, to memorize the phrases "merry holiday" and "warm wind", and a bow to memorize the word "separation".

Let's consider how a patient with a distortion of the generalization process (in schizophrenia) performs the "classification of objects" task:

1) combines a cupboard and a saucepan into one group, since "both objects have a hole";

2) identifies a group of objects "pig, goat, butterfly" because "they are hairy";

3) a car, a spoon and a cart are assigned to one group "according to the principle of movement (the spoon is also moved to the mouth)";

4) combines a clock and a bicycle into one group, because "clocks measure time, and when riding a bicycle, space is measured";

5) the shovel and the beetle belong to the same group, since "they dig the ground with a shovel, the beetle also digs in the ground";

6) combines a flower, a shovel and a spoon into one group, because "these are objects elongated in length."

Violation of the dynamics of thinking is quite common.

There are several types of violation of the dynamics of thinking.

1. Inconsistency of judgments.

2. Lability of thinking.

3. Inertia of thinking.

The study of the dynamics of thinking is carried out using the techniques used to study violations of the operational side of thinking. But with this type of violation, it is necessary first of all to pay attention to:

1) features of switching the subject from one type of activity to another;

2) excessive thoroughness of judgments;

3) a tendency to detail;

4) inability to maintain purposefulness of judgments.

16. Inconsistency of judgments

A characteristic feature of patients with inconsistent judgments is the instability of the way the task is performed. The level of generalization in such patients is usually reduced. They quite successfully perform tasks for generalization and comparison. However, the correct decisions in such patients alternate with a specific situational association of objects into a group and with decisions based on random connections.

Let us consider the actions of patients with inconsistent judgments when performing the "classification of objects" task. Such patients correctly assimilate the instructions, use an adequate method when performing a task, choose pictures according to a generalized feature. However, after some time, patients change the correct path of decision to the path of incorrect random associations. In this case, several features are noted:

1) alternation of generalized (correct) and specific situational combinations;

2) logical connections are replaced by random combinations (for example, patients assign objects to the same group because the cards are next to each other);

3) the formation of groups of the same name (for example, the patient identifies a group of people "child, doctor, cleaning lady" and the second group of the same name "sailor, skier").

This violation of the dynamics of thinking is characterized by the alternation of adequate and inadequate solutions. Lability does not lead to gross violations of the structure of thinking, but only for some time distorts the correct course of the patients' judgments. It is a violation of the mental performance of patients.

Sometimes the lability of thinking is persistent. Such a constant, persistent lability occurs in patients with TIR in the manic phase.

Often a word evokes a chain of associations in such patients, and they begin to give examples from their lives. For example, explaining the meaning of the proverb “All that glitters is not gold,” a patient in the manic phase of MDP says: “Gold is a beautiful gold watch my brother gave me, it’s very good. My brother loved the theater very much...”, etc. d.

In addition, in patients with manifestations of lability of thinking, "responsiveness" is observed: they begin to weave any random stimulus from the external environment into their reasoning. If this happens during the performance of the task, patients are distracted, violate the instructions, lose their focus on actions.

17. Inertia of thinking

The inertia of thinking is characterized by a pronounced difficulty in switching from one type of activity to another. This violation of thinking is the antipode of the lability of mental activity. In this case, patients cannot change the course of their judgments. Such switching difficulties are usually accompanied by a decrease in the level of generalization and distraction. The stiffness of thinking leads to the fact that the subjects cannot cope even with simple tasks that require switching (with tasks for mediation).

Inertia of thinking occurs in patients with:

1) epilepsy (most common);

2) with brain injuries;

3) with mental retardation.

To illustrate the inertia of thinking, we give an example: “Patient B-n (epilepsy). Wardrobe. “This is an object in which something is stored... But in the buffet they also store dishes, food, and in the closet - a dress, although in the closet often store food. If the room is small and a buffet does not fit in it, or if there is simply no buffet, then dishes are stored in the closet. Here we have a closet; on the right there is a large empty space, and on the left there are 4 shelves; there are dishes and food. This, of course, is uncivilized; bread often smells of mothballs - this is moth powder. Again, there are bookcases, they are not so deep. There are already shelves of them, a lot of shelves. Now the cabinets are built into the walls, but it’s still a cabinet.”

The inertia of mental activity is also revealed in the associative experiment. The instructions say that the subject must answer the experimenter with a word of the opposite meaning.

The obtained data showed that the latent period in such patients averages 6,5 s, and in some patients it reaches 20-30 s.

In subjects with inertia of thinking, a large number of delayed responses were noted. In this case, patients respond to the previously presented word, and not to the one that is presented at the moment. Consider examples of such delayed responses:

1) the patient answers the word "silence" to the word "singing", and the next word "wheel" answers the word "silence";

2) having answered the word "faith" to the word "deceit", the patient answers the next word "voices" with the word "falsehood".

Delayed responses of patients are a significant deviation from the course of the associative process in the norm. They show that the trace stimulus for such patients has a much greater signal value than the actual one.

18. Violation of the motivational (personal) side of thinking. Diversity of thinking

Thinking is determined by the goal, the task. When a person loses the purposefulness of mental activity, thinking ceases to be the regulator of human actions.

Violations of the motivational component of thinking include:

1) diversity;

2) reasoning.

Diversity of thinking is characterized by the absence of logical connections between different thoughts. Judgments of patients about this or that phenomenon proceed, as it were, in different planes. They can accurately understand the instructions, generalize the proposed objects based on the essential properties of the objects. However, they cannot complete tasks in the right direction.

Performing the task "classification of objects", patients can combine objects either on the basis of the properties of the objects themselves, or on the basis of their own attitudes and tastes.

Let's look at a few examples of diversity of thinking.

1. The patient singles out the group of objects "wardrobe, table, bookcase, cleaning lady, shovel", as it is "a group of people who sweep the bad out of life", and adds that "the shovel is the emblem of labor, and labor is incompatible with cheating."

2. The patient identifies a group of objects "elephant, skier", as these are "objects for spectacles. People tend to desire bread and circuses, the ancient Romans knew about this."

3. The patient selects a group of objects "a flower, a bed, a saucepan, a cleaner, a saw, a cherry", because these are "objects painted in red and blue."

Here are examples of the execution of the task "exclusion of objects" by one of the patients with a diversity of thinking:

1) pictures "kerosene lamp", "sun", "electric light bulb", "candle" are presented; the patient excludes the sun, since "this is a natural luminary, the rest is artificial lighting";

2) pictures "scales", "watches", "thermometer", "glasses" are presented; the patient decides to remove the glasses: “I will separate the glasses, I don’t like glasses, I love pince-nez, why don’t they wear them. Chekhov did wear them”;

3) pictures "drum", "revolver", "military cap", "umbrella" are presented; the patient removes the umbrella: "An umbrella is not needed, now they wear raincoats."

As we can see, the patient can make a generalization: she excludes the sun, since it is a natural luminary. But then she allocates points based on personal taste (because "she doesn't like them", not because they are not a measuring device). On the same basis, she allocates an umbrella.

19. Reasoning. Classification of thinking disorders in form and content

Reasoning is a tendency to unproductive verbose reasoning, a tendency to so-called “sterile philosophizing.” The judgments of such patients are caused not so much by a violation of intellectual activity as by increased affectivity. They strive to bring any phenomenon (even absolutely insignificant) under some concept.

Affectivity is manifested in the very form of the statement (the patient speaks loudly, with inappropriate pathos). Sometimes one intonation of the patient indicates that the statement is "resonant".

In addition to the considered classification of thought disorders, there is another classification according to which thought disorders are divided into two groups:

1) in form;

2) by content.

Violations of thinking in form, in turn, are divided into:

1) tempo violations:

a) acceleration (a jump of ideas, which is usually observed in the manic phase with MDP; mentism, or mantism, is an influx of thoughts that occurs against the will of the patient with schizophrenia, with MDP);

b) slowing down - lethargy and poverty of associations, which usually occurs during the depressive phase in MDP;

2) violations of harmony:

a) fragmentation - a violation of the logical connections between the members of the sentence (while maintaining the grammatical component);

b) incoherence is a violation in the field of speech, its semantic and syntactic components;

c) verbigeration - stereotypical repetition in speech of individual words and phrases that are similar in consonance;

3) violations of purposefulness:

a) reasoning;

b) pathological thoroughness of thinking;

c) perseveration.

Content disorders are divided into:

1) obsessive states - various involuntary thoughts that a person cannot get rid of, while maintaining a critical attitude towards them;

2) overvalued ideas - emotionally rich and plausible beliefs and ideas;

3) crazy ideas - false judgments and conclusions:

a) paranoid delusion - a systematized and plausible delirium that proceeds without disturbance of sensations and perception;

b) paranoid delirium, usually not having a sufficiently coherent system, occurring most often with impaired sensations and perception;

c) paraphrenic delirium - systematized delirium with violations of the associative process, occurring against the background of increased mood.

20. Methods that are used to study memory

The following methods are used to study memory.

1. Ten words

The subject is read ten simple words, after which he must repeat them in any order 5 times. The experimenter enters the results in the table. After 20-30 minutes, the subject is again asked to reproduce these words. The results are also entered into a table.

Example: water, forest, table, mountain, clock, cat, mushroom, book, brother, window.

2. Pictogram method

The subject is presented with 15 words to memorize. To facilitate this task, he should make sketches with a pencil. No writing or lettering is allowed. The subject is asked to repeat the words after the end of the work, and then again after 20-30 minutes. When analyzing the features of memorization, attention is paid to how many words are reproduced accurately, close in meaning, incorrectly, and how many are not reproduced at all. A modification of this method can be the test of A. N. Leontiev. This method involves not drawing, but choosing an object from the proposed ready-made pictures. The technique has several series, different in degree of complexity. The test of A. N. Leontiev can be used to study memory in children, as well as in persons with a low level of intelligence.

3. Reproduction of stories The subject is read a story (sometimes the story is given for independent reading). Then he must reproduce the story orally or in writing. When analyzing the results, the experimenter must take into account whether all semantic links have been reproduced by the subject, and whether he has observed confabulations (filling in gaps in memory with non-existent events).

Examples of stories for memorization: "Jackdaw and Doves", "Eternal King", "Logic", "Ant and Dove", etc.

4. Study of visual memory (A. L. Benton test).

For this test, five series of drawings are used. At the same time, in three series, 10 cards of the same complexity are offered, in two - 15 cards each. The subject is shown a card for 10 seconds, and then he must reproduce the seen figures on paper. The analysis of the obtained data is carried out using special Benton tables. This test allows you to obtain additional data on the presence of organic diseases of the brain.

When conducting a pathopsychological experiment aimed at studying memory disorders, the features of direct and indirect memory are usually revealed.

21. Violations of immediate memory

Immediate memory is the ability to recall information immediately after the action of a particular stimulus.

Some of the most common types of memory impairments are:

1) Korsakov's syndrome;

2) progressive amnesia.

Korsakov's syndrome is a violation of memory for current events with a relative preservation of memory for past events. This syndrome was described by the Russian psychiatrist S. S. Korsakov.

Korsakov's syndrome can manifest itself in insufficiently accurate reproduction of what is seen or heard, as well as in inaccurate orientation. Often, patients themselves notice defects in their memory and try to fill in the gaps with fictitious versions of events. Real events are either clearly reflected in the mind of the patient, or intricately intertwined with events that never existed. The inability to remember current events leads to the impossibility of organizing the future.

With progressive amnesia, memory impairment extends to both current events and past events. Patients confuse the past with the present, distort the sequence of events. With progressive amnesia, the following symptoms are noted:

1. Interfering effect - the imposition of past events on the events of the present, and vice versa.

2. Disorientation in space and time. Example: the patient seems to be living at the beginning of the XNUMXth century; she thinks that the October Revolution has recently begun.

Such memory impairments are often noted in mental illness of late age. First, patients have a reduced ability to remember current events, then the events of recent years are erased from memory. At the same time, the events from the distant past preserved in the memory acquire special relevance in the mind of the patient. The patient does not live in the present, but in fragments of situations and actions that took place in the distant past.

To illustrate such memory impairments, we give examples taken from the results of an experimental study of one of the patients:

1) explaining the meaning of the proverb “Don’t get into your sleigh,” he says: “Don’t be so impudent, impolite, a hooligan. Don’t go where you don’t need to”;

2) the meaning of the proverb "Strike while the iron is hot" explains as follows: "Work, be hardworking, cultured, polite. Do everything quickly, well. Love a person. Do everything for him."

Thus, understanding the figurative meaning of the proverb, the patient cannot remember it and is distracted. The patient's judgments are characterized by instability, correct judgments alternate with incorrect ones.

22. Violation of mediated memory

Indirect is memorization using an intermediate (mediating) link in order to improve reproduction.

Violation of mediated memory in various groups of patients was investigated by S. V. Loginova and G. V. Birenbaum. In the works of A. N. Leontiev it is shown that the introduction of the factor of mediation improves the reproduction of words. But despite the fact that the mediating factor normally improves memorization, it turned out that in some patients the introduction of a mediating link often does not improve, but even worsens the possibility of reproduction.

Patients with impaired mediated memory remember words worse when they try to use a mediating link. Mediation does not help those patients who are trying to establish too formal connections (for example, for the word "doubt" the patient drew a catfish fish, because the first syllable coincided, and for the word "friendship" - two triangles).

When analyzing memory disorders, one should take into account the personality-motivational component.

To study the violation of the motivational component of mnestic activity, experimental studies were carried out. The subject was presented with about twenty tasks that he had to complete. This new motive acted as a sense-forming and motivating motive (the subject set himself a specific goal - to reproduce as many actions as possible).

The fact that mnestic activity is motivated can also be seen in the example of pathology.

The same experiments were carried out in patients with various forms of disturbances in the motivational sphere. It turned out that:

1) in patients with schizophrenia, there was no effect of better reproduction of incomplete tasks compared to completed ones;

2) patients with rigidity of emotional attitudes (for example, in epilepsy) reproduced incomplete actions much more often than completed ones.

Summing up, let's compare the results obtained in the study of healthy subjects and subjects with various mental illnesses.

1. In healthy subjects, VL/VZ = 1,9.

2. In patients with schizophrenia (simple form) VL/VZ = 1,1.

3. In patients with epilepsy VL/VZ = 1,8.

4. In patients with asthenic syndrome VL/VZ = 1,2.

Thus, a comparison of the results of reproducing unfinished actions in patients with various disorders of the motivational sphere indicates the important role of the motivational component in mnestic activity.

23. Methods used to study attention

There are the following methods that are used in the study of attention.

1. Correction test. It is used to study the stability of attention, the ability to concentrate. Forms are used with the image of rows of letters that are arranged randomly. The subject must cross out one or two letters of the experimenter's choice. A stopwatch is required for the study. Sometimes every 30-60 s mark the position of the subject's pencil. The experimenter pays attention to the number of mistakes made, the pace at which the patient completes the task, as well as the distribution of errors during the experiment and their nature (crossing out other letters, omissions of individual letters or lines, etc.).

2. Account according to Kraepelin. This technique was proposed by E. Krepelin in 1895. It is used to study the features of switching attention, to study performance. The subject is presented with forms with columns of numbers located on them. You need to add or subtract these numbers in your mind, and write down the results on the form.

After completing the task, the experimenter makes a conclusion about performance (exhaustion, workability) and notes the presence or absence of attention disorders.

3. Finding numbers on Schulte tables. For the study, special tables are used, where numbers are arranged in random order (from 1 to 25). The test subject must use a pointer to show the numbers in order and name them. The experimenter takes into account the time it takes to complete the task. Research using Schulte tables helps to identify features of attention switching, exhaustion, workability, as well as concentration or distraction.

4. Modified Schulte table. To study attention switching, a modified red-black Schulte table is often used, which contains 49 numbers (of which 25 are black and 24 are red). The subject must show the numbers in turn: black - in ascending order, red - in descending order. This table is used to study the dynamics of mental activity and the ability to quickly switch attention from one object to another.

5. Countdown. The subject must count from a hundred a certain number (one and the same). At the same time, the experimenter notes pauses. When processing the results, examine:

1) the nature of the errors;

2) following the instructions;

3) switching;

4) concentration;

5) exhaustion of attention.

24. Feelings. Their classification

Sensation is the simplest mental process, consisting in the reflection of individual properties, objects and phenomena of the external world, as well as the internal states of the body with the direct impact of stimuli on the corresponding receptors.

The main properties of sensations are:

1) modality and quality;

2) intensity;

3) time characteristic (duration);

4) spatial characteristics.

Feelings can be both conscious and unconscious.

An important characteristic of sensations is the threshold of sensation - the magnitude of the stimulus that can cause sensation.

Consider some classifications of sensations.

V. M. Wundt proposed to divide sensations into three groups (depending on what characteristics of the external environment are reflected):

1) spatial;

2) temporary;

3) space-time.

A. A. Ukhtomsky suggested dividing all sensations into 2 groups:

1. Higher (those types of sensations that give the most subtle diverse differentiated analysis, for example, visual and auditory).

2. Lower (those types of sensations that are characterized by less differentiated sensitivity, such as pain and tactile).

Currently, the generally accepted and most common classification is Sherrington, who proposed to divide sensations into three groups depending on the location of the receptor and the location of the source of irritation:

1) exteroreceptors - receptors of the external environment (vision, hearing, smell, taste, tactile, temperature, pain sensations);

2) proprioceptors - receptors that reflect the movement and position of the body in space (muscular-articular, or kinesthetic, vibrational, vestibular);

3) interoreceptors - receptors located in the internal organs (they, in turn, are divided into chemoreceptors, thermoreceptors, pain receptors and mechanoreceptors, reflecting changes in pressure in the internal organs and bloodstream).

25. Methods for the study of sensations and perception. Major sensory disturbances

The study of perception is carried out:

1) clinical methods;

2) experimental psychological methods. The clinical method is usually used in the following cases:

1) studies of tactile and pain sensitivity;

2) study of temperature sensitivity;

3) study of disorders of the organs of hearing and vision.

4) study of the thresholds of auditory sensitivity, speech perception.

Experimental psychological methods are usually used to study more complex auditory and visual functions. So, E.F. Bazhin proposed a set of techniques, which includes:

1) methods for studying the simple aspects of the activity of analyzers;

2) methods for the study of more complex complex activities.

The following methods are also used:

1) the technique "Classification of objects" - to identify visual agnosia;

2) Poppelreuter tables, which are images superimposed on each other, and which are needed to detect visual agnosia;

3) Raven tables - for the study of visual perception;

4) tables proposed by M. F. Lukyanova (moving squares, wavy background) - for the study of sensory excitability (with organic disorders of the brain);

5) tachistoscopy method (identification of listened to tape recordings with various sounds: the sound of glass, the murmur of water, whisper, whistle, etc.) - for the study of auditory perception.

1. Anesthesia, or loss of sensation, can capture both individual types of sensitivity (partial anesthesia) and all types of sensitivity (total anesthesia).

2. The so-called hysterical anesthesia is quite common - the disappearance of sensitivity in patients with hysterical neurotic disorders (for example, hysterical deafness).

3. Hyperesthesia usually captures all spheres (the most common are visual and acoustic). For example, such patients cannot tolerate the sound of normal volume or not very bright light.

4. With hypoesthesia, the patient, as it were, does not clearly perceive the world around him (for example, with visual hypoesthesia, objects for him are devoid of colors, look shapeless and blurry).

5. With paresthesia, patients experience anxiety and fussiness, as well as increased sensitivity to skin contact with bed linen, clothing, etc.

A type of paresthesia is senestopathy - the appearance of rather ridiculous unpleasant sensations in various parts of the body (for example, a feeling of “transfusion” inside organs). Such disorders usually occur in schizophrenia.

26. Definition and types of perception

Now consider the main violations of perception. But first, let's define how perception differs from sensations. Perception is based on sensations, arises from them, but has certain characteristics.

What is common to sensations and perceptions is that they begin to function only with the direct action of irritation on the sense organs.

Perception is not reduced to the sum of individual sensations, but is a qualitatively new level of cognition.

The main principles of perception of objects are the following.

1. The principle of proximity (the closer to each other in the visual field are the elements, the more likely they are combined into a single image).

2. The principle of similarity (similar elements tend to unite).

3. The principle of "natural continuation" (elements that appear as parts of familiar figures, contours and forms are more likely to be combined into these figures, contours and forms).

4. The principle of isolation (the elements of the visual field tend to create a closed integral image).

The above principles determine the main properties of perception:

1) objectivity - the ability to perceive the world in the form of separate objects with certain properties;

2) integrity - the ability to mentally complete the perceived object to a holistic form, if it is represented by an incomplete set of elements;

3) constancy - the ability to perceive objects as constant in shape, color, consistency and size, regardless of the conditions of perception;

4) categorical - the ability to generalize and attribute the perceived object to a particular class.

The main types of perception are distinguished depending on the sense organ (as well as sensations):

1) visual;

2) auditory;

3) taste;

4) tactile;

5) olfactory.

One of the most significant types of perception in clinical psychology is a person's perception of time (it can change significantly under the influence of various diseases). Great importance is also attached to violations of the perception of one's own body and its parts.

27. Major Perceptual Disorders

The main cognitive impairments include:

1. Illusions are a distorted perception of a real object. For example, illusions can be auditory, visual, olfactory, etc.

There are three types of illusions according to the nature of their occurrence:

1) physical;

2) physiological;

3) mental.

2. Hallucinations - disturbances of perception that occur without the presence of a real object and are accompanied by confidence that this object really exists at a given time and in a given place.

Visual and auditory hallucinations are usually divided into two groups:

1. Simple. These include:

a) photopsia - perception of bright flashes of light, circles, stars;

b) acoasma - perception of sounds, noise, cod, whistle, crying.

2. Complex. These include, for example, auditory hallucinations, which have the form of articulate phrasal speech and are, as a rule, commanding or threatening.

3. Eidetism - a disorder of perception, in which the trace of the excitation that has just ended in any analyzer remains in the form of a clear and vivid image.

4. Depersonalization is a distorted perception of both one's own personality as a whole and individual qualities and parts of the body. Based on this, there are two types of depersonalization:

1) partial (impaired perception of individual parts of the body);

2) total (impaired perception of the whole body).

5. Derealization is a distorted perception of the surrounding world. An example of derealization is the symptom of "already seen" (de ja vu).

6. Agnosia is a violation of the recognition of objects, as well as parts of one's own body, but at the same time consciousness and self-consciousness are preserved.

There are the following types of agnosia:

1. Visual agnosia - disorders of recognition of objects and their images while maintaining sufficient visual acuity. Are divided into:

a) subject agnosia;

b) agnosia for colors and fonts;

c) optical-spatial agnosia (patients cannot convey in the drawing the spatial features of the object: further - closer, more - less, higher - lower, etc.).

2. Auditory agnosia - impaired ability to distinguish speech sounds in the absence of hearing impairment;

3. Tactile agnosia - disorders characterized by unrecognition of objects by touching them while maintaining tactile sensitivity.

28. Stress. A crisis

The concept of stress was introduced by the Canadian pathophysiologist and endocrinologist G. Selye. Stress is the body's standard response to any factor that affects it from the outside. It is characterized by affects - expressed emotional experiences.

Stress can be of a different nature:

1) distress is negative;

2) eustress is positive and mobilizing.

Some authors believe that stress is often the cause of various mental illnesses.

G. Selye identified two reactions to the harmful effects of the external environment:

1. Specific - a specific disease with specific symptoms.

2. Nonspecific (manifested in the general adaptation syndrome).

The nonspecific reaction consists of three phases:

1) anxiety reaction (under the influence of a stressful situation, the body changes its characteristics; if the stressor is very strong, stress can occur at this stage as well);

2) resistance reaction (if the action of the stressor is compatible with the body's capabilities, the body resists; anxiety almost disappears, the level of body resistance increases significantly);

3) exhaustion reaction (if the stressor acts for a long time, the body's forces are gradually depleted; anxiety reappears, but now irreversible; the stage of distress sets in).

The concept of crises originated and developed in the United States. According to this concept, "the risk of mental disorders reaches its highest point and materializes in a certain crisis situation."

"A crisis is a state that occurs when a person encounters an obstacle to vital goals, which for some time is insurmountable by the usual methods of problem solving. There is a period of disorganization, frustration, during which many different abortive attempts are made. Eventually some form of adaptation is achieved which may or may not best serve the interests of the person and those close to him.

There are the following types of crises:

1) developmental crises (for example, when a child enters kindergarten, school, marriage, retirement, etc.);

2) random crises (for example, unemployment, natural disaster, etc.);

3) typical crises (for example, the death of a loved one, the appearance of a child in the family, etc.).

29. Frustration. Fear

“Frustration (English frustration - “upset, disruption of plans, collapse”) is a specific emotional state that arises in cases where an obstacle and resistance arises on the way to achieving a goal, which are either really insurmountable or are perceived as such.”

Frustration is characterized by the following symptoms:

1) the presence of a motive;

2) the presence of a need;

3) the presence of a goal;

4) the existence of an initial plan of action;

5) the presence of resistance to an obstacle that is frustrating (resistance can be passive and active, external and internal).

In situations of frustration, a person behaves either as an infantile or as a mature person. An infantile personality in the case of frustration is characterized by non-constructive behavior, which expresses itself in aggression or avoiding resolving a difficult situation.

A mature personality, on the contrary, is characterized by constructive behavior, which manifests itself in the fact that a person increases motivation, increases the level of activity to achieve a goal, while maintaining the goal itself.

The most common symptom of emotional disturbance is fear. However, fears can be an adequate mobilizing response to a real threat. Many people are not even aware that they have some kind of fear until they are faced with a corresponding situation.

The following parameters are used to assess the degree of pathological fears.

1. Adequacy (validity) - the correspondence of the intensity of fear to the degree of real danger that comes from a given situation or from people around.

2. Intensity - the degree of disorganization of the activity and well-being of a person seized by a sense of fear.

3. Duration - duration of fear in time.

4. The degree of controllability of a feeling of fear by a person - the ability to overcome one's own feeling of fear.

A phobia is a fear that is experienced frequently, is obsessive, poorly controlled, and to a large extent disrupts the activity and well-being of a person.

The most common types of phobias are:

1) agoraphobia - fear of open spaces;

2) claustrophobia - fear of enclosed spaces. A fairly common phenomenon is social phobias - obsessive fears that are associated with the fear of condemning a person from others for any actions.

30. Violations of the volitional sphere

The concept of will is inextricably linked with the concept of motivation. Motivation is a process of purposeful organized sustainable activity (the main goal is the satisfaction of needs).

Motives and needs are expressed in desires and intentions. Interest, which plays the most important role in the acquisition of new knowledge, can also be a stimulus for human cognitive activity.

Motivation and activity are closely related to motor processes, therefore the volitional sphere is sometimes referred to as motor-volitional.

Volitional disorders include:

1) violation of the structure of the hierarchy of motives - deviation of the formation of the hierarchy of motives from the natural and age characteristics of a person;

2) parabulia - the formation of pathological needs and motives;

3) hyperbulia - a violation of behavior in the form of motor disinhibition (excitation);

4) hypobulia - a violation of behavior in the form of motor inhibition (stupor).

One of the most striking clinical syndromes of the motor-volitional sphere is catatonic syndrome, which includes the following symptoms:

1) stereotypy - frequent rhythmic repetition of the same movements;

2) impulsive actions - sudden, senseless and ridiculous motor acts without sufficient critical evaluation;

3) negativism - an unreasonable negative attitude towards any external influences in the form of resistance and refusal;

4) echolalia and echopraxia - the patient’s repetition of individual words or actions that he hears or sees at the moment;

5) catalepsy (symptom of “waxy flexibility”) - the patient freezes in one position and maintains this position for a long time.

The following pathological symptoms are special types of disorders of the will:

1) a symptom of autism;

2) a symptom of automatisms.

A symptom of autism is manifested in the fact that patients lose the need to communicate with others. They develop pathological isolation, unsociableness and isolation.

Automatisms are the spontaneous and uncontrolled implementation of a number of functions, regardless of the presence of stimulating impulses from the outside. The following types of automatisms are distinguished.

1. Outpatient (occurs in patients with epilepsy and consists in the fact that the patient performs outwardly ordered and purposeful actions, which he completely forgets about after an epileptic seizure).

2. Somnambulistic (the patient is either in a hypnotic trance, or in a state between sleep and wakefulness).

3. Associative.

4. Senestopathic.

5. Kinesthetic.

The last three varieties of automatisms are observed in the syndrome of mental automatism of Kandinsky-Clerambault.

31. Violations of consciousness and self-consciousness

Before proceeding to the consideration of violations, let's define consciousness.

"Consciousness is the highest form of reflection of reality, a way of relating to objective laws."

To determine violations of consciousness, it is important to consider that the presence of one of the above signs does not indicate clouding of consciousness, so it is necessary to establish the totality of all these signs.

Consciousness disorders are divided into two groups.

1. States of switched off consciousness:

2. States of upset consciousness:

a) delirium;

b) oneiroid;

c) twilight disorder of consciousness. The states of consciousness turned off are characterized by a sharp increase in the threshold for all external stimuli. In patients, movements slow down, they are indifferent to the environment.

Delirium is characterized by a violation of orientation in space and time (not just disorientation occurs, but false orientation) with complete preservation of orientation in one’s own personality. In this case, scene-like hallucinations arise, usually of a frightening nature. As a rule, the delirious state occurs in the evening and intensifies at night.

Oneiroid is characterized by disorientation (or false orientation) in space, in time, and partially in one's own personality. In this case, patients have hallucinations of a fantastic nature.

After leaving the oneiroid state, patients usually cannot remember what really happened in that situation, but only remember the content of their dreams.

The twilight state of consciousness is characterized by disorientation in space, in time and in one's own personality. This state begins suddenly and ends just as suddenly. A characteristic feature of the twilight state of consciousness is the subsequent amnesia - the absence of memories of the period of obscuration. Often in a twilight state of consciousness, patients have hallucinations and delusions.

One of the types of twilight state is "ambulatory automatism" (it proceeds without delirium and hallucinations). Such patients, having left the house for a specific purpose, unexpectedly find themselves at the other end of the city (or even in another city). At the same time, they mechanically cross the streets, ride in transport, etc.

32. Aphasia

Aphasias are called systemic speech disorders that appear with global injuries of the cortex of the left hemisphere (in right-handed people). The term "aphasia" was proposed in 1864 by A. Trousseau.

Consider the classification of speech disorders proposed by A. R. Luria. He identified seven forms of aphasia.

1. Sensory aphasia is characterized by impaired phonemic hearing. At the same time, patients either do not understand the speech addressed to them at all, or (in less severe cases) do not understand speech in complicated conditions (for example, too fast speech), they have a sharp difficulty in writing from dictation, repeating the words they hear, and also reading (from -for the inability to monitor the correctness of their speech).

2. Acoustic-mnestic aphasia (violation of auditory-speech memory) is expressed in the fact that the patient understands spoken speech, but is not able to remember even small speech material (while phonemic hearing remains preserved). Such a violation of auditory-verbal memory leads to a misunderstanding of long phrases and oral speech in general.

3. Optical-mnestic aphasia is expressed in the fact that patients cannot correctly name the object, but try to describe the object and its functional purpose. Patients cannot draw even elementary objects, although their graphic movements remain preserved.

4. Afferent motor aphasia is associated with a violation of the flow of sensations from the articulatory apparatus to the cerebral cortex during speech. Patients have speech disorders.

5. Semantic aphasia is characterized by impaired understanding of prepositions, words and phrases that reflect spatial relationships. In patients with semantic aphasia, there are violations of visual-figurative thinking.

6. Motor efferent aphasia is expressed in the fact that the patient cannot pronounce a single word (only inarticulate sounds) or one word remains in the patient's oral speech, which is used as a substitute for all other words. At the same time, the patient retains the ability to understand the speech addressed to him (to some extent).

7. Dynamic aphasia is manifested in the poverty of speech statements, the absence of independent statements and monosyllabic answers to questions (patients are not able to compose even the simplest phrase, they cannot answer even elementary questions in detail).

Note that of the above types of speech disorders, the first five are interconnected with the loss of auditory, visual, kinesthetic links of speech, which are otherwise called afferent links. The remaining two types of aphasia are associated with the loss of the efferent link.

33. Poverty of the vocabulary of speech

The poverty of the vocabulary is usually observed in oligophrenia, as well as in atherosclerosis of the brain. Let us consider the types of mental pathology that can be considered both as derivatives of speech disorders and as a result of disorders of the gnostic brain apparatus.

1. Dyslexia (alexia) - reading disorder.

In children, dyslexia manifests itself in the inability to master the skill of reading (with a normal level of intellectual and speech development, in optimal learning conditions, in the absence of hearing and vision impairments).

2. Agraphia (dysgraphia) - a violation of the ability to write correctly in form and meaning.

3. Akalkulia - a violation that is characterized by a violation of counting operations.

Let us dwell on the definition of other speech disorders encountered in clinical practice.

Verbal paraphasia - the use instead of some words of others that are not related to the meaning of the speech statement.

Literal paraphasia is when some sounds are replaced by others that are not present in a given word, or certain syllables and sounds are rearranged in a word.

Verbigeration is the repeated repetition of individual words or syllables.

Bradyphasia is slow speech.

Dysarthria - blurred, as if "stumbling" speech.

Dyslalia (tongue-tied speech) is a speech disorder characterized by the incorrect pronunciation of individual sounds (for example, skipping sounds or replacing one sound with another).

Stuttering is a violation of the fluency of speech, which manifests itself in the form of a convulsive disorder of speech coordination, the repetition of individual syllables with obvious difficulties in pronouncing them.

Logoclonia is a spasmodic repetition of certain syllables of a spoken word.

Increasing the volume of speech (up to a scream) is a violation that manifests itself in the fact that, as a result of overstrain, the voice of such patients becomes hoarse or completely disappears (noted in patients in a manic state).

Change in the modulation of speech - pomposity, pathos or colorlessness and monotony of speech (loss of speech melody).

Incoherence is a meaningless set of words that are not combined into grammatically correct sentences.

Oligophasia - a significant decrease in the number of words used in speech, impoverishment of the vocabulary.

Schizophasia is a meaningless collection of single words that are combined into grammatically correct sentences.

Symbolic speech - giving words and expressions a special meaning (instead of the generally accepted one), understandable only to the patient himself.

Cryptolalia is the creation of one's own language or a special cipher called cryptography.

34. Violations of arbitrary movements and actions

There are two types of violations of voluntary movements and actions:

1. Violations of voluntary movements and actions that are associated with a violation of efferent (executive) mechanisms.

2. Violations of voluntary movements and actions that are associated with a violation of the afferent mechanisms of motor acts (more complex violations).

Efferent disorders.

1. Paresis - weakening of muscle movements (a person after a brain injury cannot actively act with the opposite limb; while the movements of other parts of the body can remain preserved).

2. Hemiplegia - paralysis (a person completely loses the ability to move; motor function can be restored during treatment).

There are two types of hemiplegia:

1) dynamic hemiplegia (there are no voluntary movements, but there are violent ones);

2) static hemiplegia (no voluntary movements and amimia).

afferent disturbances.

1. Apraxia are disturbances that are characterized by the fact that an action that needs afferent reinforcement and organization of a motor act is not performed, although the efferent sphere remains preserved.

2. Catatonic disorders.

In catatonic disorders, there is an objectless chaotic motor activity of the patient (up to causing injury to himself and others). Currently, this condition is removed pharmacologically. Catatonic disorders are expressed in aimless throwing of the patient.

One form of catatonic disorder is stupor (freezing). There are the following forms of stupor:

1) negativistic (resistance to movements);

2) with numbness (the patient cannot be moved).

3. Violent actions.

This disorder of voluntary movements and actions is manifested in the fact that patients, in addition to their own desire, perform various motor acts (for example, crying, laughing, swearing, etc.).

35. Impaired intelligence

Intelligence is the system of all cognitive abilities of an individual (in particular, the ability to learn and solve problems that determine the success of any activity).

For quantitative analysis of intelligence, the concept of IQ is used - the coefficient of mental development.

There are three types of intelligence:

1) verbal intelligence (vocabulary, erudition, ability to understand what is read);

2) the ability to solve problems;

3) practical intelligence (the ability to adapt to the environment).

The structure of practical intelligence includes:

1. Processes of adequate perception and understanding of ongoing events.

2. Adequate self-esteem.

3. The ability to act rationally in a new environment.

The intellectual sphere includes some cognitive processes, but the intellect is not only the sum of these cognitive processes. The prerequisites for intelligence are attention and memory, but the understanding of the essence of intellectual activity is not exhausted by them.

There are three forms of organization of the intellect, which reflect different ways of cognition of objective reality, in particular in the sphere of interpersonal contacts.

1. Common sense is the process of adequate reflection of reality, based on the analysis of the essential motives of the behavior of people around and using a rational way of thinking.

2. Reason - the process of cognition of reality and a way of activity based on the use of formalized knowledge, interpretations of the motives of the activity of communication participants.

3. Reason - the highest form of organization of intellectual activity, in which the thought process contributes to the formation of theoretical knowledge and the creative transformation of reality.

Intellectual cognition can use the following methods:

1) rational (requires the application of formal logic laws, hypotheses and their confirmation);

2) irrational (relies on unconscious factors, does not have a strictly defined sequence, does not require the use of logical laws to prove the truth).

The following concepts are closely related to the concept of intelligence:

1) anticipatory abilities - the ability to anticipate the course of events and plan their activities in such a way as to avoid undesirable consequences and experiences;

2) reflection - the creation of an idea of the true attitude towards the subject on the part of others.

36. The problem of brain localization of mental functions

The problem of localization of mental functions is one of the main researched problems of neuropsychology. Initially, this problem was literally: how various mental processes and morphological zones of the brain are interconnected. But clear matches were not found. There are two points of view on this issue:

1) localizationism;

2) anti-localizationism. Localizationism binds every mental

process with the work of a certain part of the brain. Narrow localizationism considers mental functions as indecomposable into component parts and realized through the work of narrowly localized areas of the cerebral cortex.

The following facts speak against the concept of narrow localizationism:

1) with the defeat of different areas of the brain, a violation of the same mental function occurs;

2) the result of damage to a certain area of the brain may be a violation of several different mental functions;

3) impaired mental functions can be restored after damage without morphological restoration of the injured area of the brain.

According to the concept of anti-localizationism:

1) the brain is a single whole, and its work contributes to the development of the functioning of all mental processes equally;

2) with damage to any part of the brain, a general decrease in mental functions is observed (in this case, the degree of decrease depends on the volume of the affected brain).

According to the concept of equipotentiality of brain regions, all brain regions are equally involved in the implementation of mental functions. Thus, in all cases it is possible to restore the mental process, if only the quantitative characteristics of the damage do not exceed some critical values. However, not always and not all functions can be restored (even if the amount of damage is small).

At present, the main direction in solving this problem is determined by the concept of systemic dynamic localization of mental processes and functions, which was developed by L. S. Vygotsky and A. R. Luria. According to this theory:

1) the mental functions of a person are systemic formations that are formed throughout life, are arbitrary and mediated by speech;

2) the physiological basis of mental functions are functional systems that are interconnected with specific brain structures and consist of afferent and efferent interchangeable links.

37. Functional blocks of the brain

A. R. Luria developed a general structural and functional model of the brain, according to which the entire brain can be divided into three main blocks. Each block has its own structure and plays a specific role in mental functioning.

1st block - a block for regulating the level of general and selective activation of the brain, an energy block, which includes:

1) reticular formation of the brain stem;

2) diencephalic departments;

3) nonspecific midbrain structures;

4) limbic system;

5) mediobasal sections of the cortex of the frontal and temporal lobes.

2nd block - the block for receiving, processing and storing exteroceptive information, includes the central parts of the main analyzer systems, the cortical zones of which are located in the occipital, parietal and temporal lobes of the brain.

The work of the second block is subject to three laws.

1. The law of hierarchical structure (primary zones are phylo- and ontogenetically earlier, from which two principles follow: the "bottom-up" principle - the underdevelopment of primary fields in a child leads to the loss of later functions; the "top-down" principle - in an adult with a completely the existing psychological system, the tertiary zones control the work of the secondary ones subordinate to them and, if the latter are damaged, they have a compensating effect on their work).

2. The law of decreasing specificity (primary zones are the most modally specific, and tertiary zones are generally supramodal).

3. The law of progressive lateralization (as you ascend from the primary to the tertiary zones, the differentiation of the functions of the left and right hemispheres increases).

3rd block - the block of programming, regulation and control over the course of mental activity), consists of the motor, premotor and prefrontal sections of the cerebral cortex. When this part of the brain is damaged, the functioning of the musculoskeletal system is disrupted.

38. Concepts of neuropsychological factor, symptom and syndrome

"The neuropsychological factor is the principle of the physiological activity of a certain brain structure. It is a connecting concept between mental functions and a working brain.

Syndrome analysis is a tool for identifying neuropsychological factors, which includes:

1) qualitative qualification of violations of mental functions with an explanation of the reasons for the changes that have occurred;

2) analysis and comparison of primary and secondary disorders, i.e., the establishment of causal relationships between the direct source of pathology and emerging disorders;

3) study of the composition of preserved higher mental functions.

We list the main neuropsychological factors:

1) modal-non-specific (energy) factor;

2) kinetic factor;

3) modal-specific factor;

4) kinesthetic factor (a special case of modal-specific factor);

5) factor of arbitrary-involuntary regulation of mental activity;

6) the factor of awareness-unconsciousness of mental functions and states;

7) the successive factor (consistency) of the organization of higher mental functions;

8) the factor of simultaneity (simultaneity) of the organization of higher mental functions;

9) factor of interhemispheric interaction;

10) general cerebral factor;

11) factor of the work of deep subcortical structures.

Neuropsychological symptom - a violation of mental functions as a result of local lesions of the brain.

A syndrome is a regular combination of symptoms based on a neuropsychological factor, that is, certain physiological patterns of the work of brain regions, the violation of which is the cause of neuropsychological symptoms.

Neuropsychological syndrome is a fusion of neuropsychological symptoms associated with the loss of one or more factors.

Syndromic analysis is the analysis of neuropsychological symptoms, the main goal of which is to find a common factor that fully explains the appearance of different neuropsychological symptoms. Syndromic analysis includes the following stages: first, the signs of pathology of various mental functions are determined, and then the symptoms are qualified.

39. Methods of neuropsychological research. Restoration of higher mental functions

One of the most common methods for assessing syndromes in neuropsychology is the system proposed by A. R. Luria. It includes:

1) a formal description of the patient, his medical history;

2) a general description of the patient's mental status (state of consciousness, ability to navigate in place and time, level of criticism, etc.);

3) studies of voluntary and involuntary attention;

4) studies of emotional reactions;

5) studies of visual gnosis (based on real objects, contour images, etc.);

6) studies of somatosensory gnosis (recognition of objects by touch, by touch);

7) studies of auditory gnosis (recognition of melodies, repetition of rhythms);

8) studies of movements and actions (evaluation of coordination, results of drawing, objective actions, etc.);

9) speech research;

10) study of writing (letters, words and phrases);

11) reading research;

12) memory research;

13) research of the counting system;

14) research of intellectual processes. One of the important sections of neuropsychology explores the mechanisms and ways of restoring higher mental functions that are impaired as a result of local pathologies of the brain. A position was put forward on the possibility of restoring the affected mental functions by restructuring the functional systems that determine the implementation of higher mental functions.

In the works of A. R. Luria and his students, the mechanisms for restoring higher mental functions were revealed:

1) transfer of the process to the highest conscious level;

2) replacement of the missing link of the functional system with a new one.

We list the principles of restorative education:

1) neuropsychological qualification of the defect;

2) reliance on preserved forms of activity;

3) external programming of the restored function.

The practice of treating the wounded during the Great Patriotic War proved the effectiveness of these ideas. In the future, neuropsychological methods began to be used in conjunction with medication.

The development of ideas about the functional asymmetry of the human brain in the history of neuropsychology is associated with the name of the French doctor M. Dax, who in 1836, speaking at a medical society, presented the results of observations of 40 patients. He observed patients with brain damage accompanied by a decrease or loss of speech, and came to the conclusion that the disorders were caused only by defects in the left hemisphere.

40. Schizophrenia

Schizophrenia (from the Greek shiso - "split", frenio - "soul") - "a mental illness that occurs with rapidly or slowly developing personality changes of a special type (reduced energy potential, progressive introversion, emotional impoverishment, distortion of mental processes)".

Often the result of this disease is a break in the patient's previous social relations and a significant maladjustment of patients in society.

Schizophrenia is considered to be practically the most famous mental illness.

There are several forms of schizophrenia:

1) continuously ongoing schizophrenia;

2) paroxysmal-progredient (fur-like);

3) recurrent (periodic flow).

According to the pace of the process, the following types of schizophrenia are distinguished:

1) low-progressive;

2) medium progredient;

3) malignant.

There are various forms of schizophrenia, for example:

1) schizophrenia with obsessions;

2) paranoid schizophrenia (delusions of persecution, jealousy, invention, etc. are noted);

3) schizophrenia with asthenohypochondriac manifestations (mental weakness with a painful fixation on the state of health);

4) simple;

5) hallucinatory-paranoid;

6) hebephrenic (foolish motor and speech excitement, elevated mood, fragmented thinking are noted);

7) catatonic (characterized by the predominance of movement disorders). For patients with schizophrenia, the following features are characteristic.

1. Severe disorders of perception, thinking, emotional-volitional sphere.

2. Decrease in emotionality.

3. Loss of differentiation of emotional reactions.

4. State of apathy.

5. Indifferent attitude towards family members.

6. Loss of interest in the environment.

7. Inadequacy in experiences.

8. Decreased volitional effort from insignificant to pronounced lack of will (aboulia).

41. Manic-depressive psychosis

Manic-depressive psychosis (MPD) is a disease characterized by the presence of depressive and manic phases. The phases are separated by periods with the complete disappearance of mental disorders - intermissions.

It should be noted that manic-depressive psychosis is much more common in women than in men.

As mentioned earlier, the disease proceeds in the form of phases - manic and depressive. At the same time, depressive phases are several times more common than manic phases.

The depressive phase is characterized by the following symptoms:

1) depressed mood (depressive affect);

2) intellectual inhibition (inhibition of thought processes);

3) psychomotor and speech inhibition.

The manic phase is characterized by the following symptoms.

1. Increased mood (manic affect).

2. Intellectual excitement (accelerated flow of thought processes).

3. Psychomotor and speech stimulation. Sometimes depression can only be identified

through psychological research.

The manifestations of manic-depressive psychosis can occur in childhood, adolescence and adolescence. At each age, with MDP, its own characteristics are noted.

In children under 10 years of age in the depressive phase, the following features are noted:

1) lethargy;

2) slowness;

3) reticence;

4) passivity;

5) confusion;

6) tired and unhealthy look;

7) complaints of weakness, pain in the head, abdomen, legs;

8) low academic performance;

9) difficulties in communication;

10) disorders of appetite and sleep.

Children in the manic phase experience:

1) ease in the appearance of laughter;

2) impudence in communication;

3) increased initiative;

4) no signs of fatigue;

5) mobility.

In adolescence and youth, a depressive state manifests itself in the following features: inhibition of motor skills and speech; decrease in initiative; passivity; loss of vivacity of reactions; feeling of melancholy, apathy, boredom, anxiety; forgetfulness; tendency to self-digging; heightened sensitivity to peers; suicidal thoughts and attempts.

42. Epilepsy

Epilepsy is characterized by the presence in the patient of frequent disturbances of consciousness and mood.

This disease gradually leads to personality changes.

It is believed that the hereditary factor, as well as exogenous factors (for example, intrauterine organic brain damage), play an important role in the origin of epilepsy. One of the characteristic signs of epilepsy is a convulsive seizure, which usually begins suddenly.

Sometimes a few days before the seizure, harbingers appear:

1) feeling unwell;

2) irritability;

3) headache.

The seizure usually lasts about three minutes. After it, the patient feels lethargy and drowsiness. Seizures can recur with varying frequency (from daily to several per year).

Patients have atypical seizures.

1. Small seizures (loss of consciousness for several minutes without falling).

2. Twilight state of consciousness.

3. Ambulatory automatisms, including somnambulism (sleepwalking).

Patients have the following symptoms:

1) stiffness, slowness of all mental processes;

2) thoroughness of thinking;

3) tendency to get stuck on details;

4) the inability to distinguish the main from the secondary;

5) dysphoria (a tendency to an angry-dreary mood). Characteristic features of patients with epilepsy are:

1) a combination of affective viscosity and explosiveness (explosiveness);

2) pedantry in relation to clothes, order in the house;

3) infantilism (immaturity of judgments);

4) sweetness, exaggerated courtesy;

5) a combination of hypersensitivity and vulnerability with malice.

The face of patients with epilepsy is inactive, inexpressive, restraint in gestures is noted.

During the study of patients with epilepsy, the psychologist studies primarily thinking, memory and attention.

The following methods are commonly used to study patients with epilepsy.

1. Schulte tables.

2. Exclusion of items.

3. Classification of objects.

4. "Ten words", etc.

43. Mental disorders of organic origin

In the work of a psychologist, the task of diagnosing between an organic brain disease and schizophrenia often arises.

In this case, you should investigate:

1) attention;

2) memory;

3) thinking;

4) signs of exhaustion.

The study of mental disorders of organic origin requires knowledge not only in the field of pathopsychology, but also in the field of neuropsychology.

In diseases of the brain, the following is noted.

1. Increased exhaustion.

2. Decreased memory.

3. Inertia of thinking.

4. Reducing the level of intellectual processes.

5. Passivity.

6. Narrowing the circle of interests, etc. Consider the most common diseases of organic origin.

1. Cerebral atherosclerosis. With this disease, there is an increased exhaustion of mental processes, which can be of two types:

1) hypersthenic type (change of fast rate by its decrease) - occurs in the initial stages of the disease;

2) hyposthenic type (decrease in the pace and quality of the task with the passage of time) - characteristic of the late stages of the disease.

In patients with cerebral atherosclerosis, the following is observed.

1. Memory disorders.

2. Inertia of mental activity.

3. Increased exhaustion.

4. Decrease in the level of generalization, memory impairment, increase in speech disorders.

2. Senile (senile) dementia. There are several forms of senile dementia:

1) simple;

2) confabulatory (characterized by fussiness, euphoria, the presence of confabulations);

3) delirious (characterized by clouding of consciousness).

3. Alzheimer's disease is an atypical form of senile dementia, as it begins at an earlier age (40-45 years). In this case, the atrophic process affects the parieto-occipital, temporal, frontal parts of the left hemisphere of the brain.

4. Pick's disease. The cause of this disease is atrophy of the frontal, temporal or parietal areas of the brain.

44. Neurosis

The concept of "neurosis" has been used since 1776. This made it possible to single out psychosomatic disorders from a number of somatic diseases and associate them with impaired nervous activity.

With all forms of neurosis, the patient retains a critical attitude towards the disease.

Neurosis is characterized by the following features:

1) pathological disorders are reversible regardless of duration;

2) psychogenic origin;

3) the presence of emotional-affective and somatovegetative disorders.

Different signs underlie the allocation of various forms of neuroses.

1. Etiological (guilt, frustration, aggression, etc.).

2. Situational and reactive.

3. Informational (lack or excess of information).

4. Constitutional and reactive in terms of the genetic factor.

5. According to the signs of the profession.

6. According to events in the life of society.

Currently, there are three main forms of neuroses:

1) neurasthenia;

2) hysteria;

3) obsessional neurosis. Neurasthenia (from the Greek asthenos - "weak") - weakness of the nerves.

There are three stages of this disease:

1) violation of active inhibition (manifested in the form of irritability and excitability);

2) lability of excitatory processes (irritable weakness);

3) the predominance of weakness, exhaustion, lethargy, apathy, low mood, drowsiness, etc.

Weakness in neurasthenia is expressed in a constant feeling of fatigue. In this case, the patient has a feeling as if he was doing physical work, there are complaints of headache, heart palpitations, abdominal pain, sexual disorders, etc.

It is believed that neurasthenia is more likely to affect people in leadership positions, as they are in constant tension at work.

The term "hysteria" comes from the Greek. hystera - "womb", since at the time of Plato it was believed that this disease was associated with the circulation of the uterus through the body of a woman (hysteria is much more common in women). However, the same symptoms were later found in men.

45. Health psychology

Mental health is a standard factor in the full functioning and development of a person. On the one hand, this is a condition for a person to fulfill his age and moral goals (child or adult, teacher or entrepreneur, Russian or American, etc.), and on the other hand, this gives a person the opportunity for continuous development throughout his life.

Mental health is closely related to physical health. In a person, the physical and mental are closely connected. Both are necessary for the full functioning of the body. This is emphasized in the very term "mental health".

Health psychology - "the science of the psychological causes of health, the methods and means of its preservation, strengthening and development" (V. A. Ananiev) - is an independent scientific direction, within which the influence of mental factors on the preservation of health and on the occurrence of disease is studied in detail.

Health is considered not as an end in itself, but as a condition for a person to fulfill his tasks and goals, his individual mission. Focusing on some factors of health psychology, one can imagine that psychological health is a prerequisite for physical health, i.e. a psychologically healthy person is most likely to be physically healthy as well. The continuous connection between the mental and the bodily originated in antiquity. Even Socrates said: "It is wrong to treat eyes without a head, a head without a body, just like a body without a soul." In modern times, there is a separate direction - psychosomatic medicine, which studies the mechanisms of the influence of the psyche on bodily functions, and also systematizes psychosomatic disorders, determines methods for their prevention and treatment. This industry is quite well developed and successfully functioning.

Despite the fact that mental health problems have been actively studied by domestic psychologists, health psychology as a separate field of knowledge is more common abroad, where it is more actively introduced into the practice of medical institutions.

Health Psychology can be defined narrowly and broadly.

In a narrow sense, health psychology is a private psychological discipline that deals with:

1) prevention and health protection;

2) disease prevention;

3) identifying behaviors that increase the risk of disease.

In a broad sense, health psychology deals with:

1) prevention and health protection;

2) prevention and treatment of diseases;

3) identifying behaviors that increase the risk of disease;

4) identifying the causes of diseases;

5) rehabilitation.

46. Behavioral medicine. public health

At the beginning of the XX century. the main causes of death were diseases such as influenza, pneumonia, tuberculosis and gastrointestinal infections. Since then, the annual mortality from these diseases has declined significantly. Currently, the most well-known causes of death are diseases in which behavior is important: myocardial infarction, cancer, accidents, injuries, murders and poisonings, etc. Thus, the main possible way to improve health is to change unhealthy behavior.

Behavioral Medicine is an interdisciplinary research and application field that focuses on the biopsychosocial model in its approach to health problems. Behavioral medicine integrates advances in the behavioral and biomedical sciences related to physical health. It combines sections of such sciences as:

1) psychology;

2) epidemiology;

3) sociology;

4) anthropology;

5) physiology;

6) pharmacology;

7) anatomy;

8) dietology, etc.

There are the following main types of unhealthy behavior.

1. Smoking (contributes to the development of cardiovascular diseases, cancer of the oral cavity, lungs and esophagus, bronchitis, etc.).

2. Alcohol abuse (can lead to cirrhosis of the liver, pancreatitis, cancer, as well as accidents, murders and fires).

3. Improper nutrition (for example, obesity increases the risk of developing hypertension, diabetes and cardiovascular disease, complicates surgical interventions, etc.).

Public health (Public Health), or population medicine, is an interdisciplinary field of research and practice that deals with improving the overall level of public health. Currently, another term is often used - "health science".

The tasks of population medicine are:

1) disease prevention (prophylaxis);

2) life extension;

3) improving well-being.

These tasks are carried out through public events and the impact on the health system as a whole.

Thus, we are talking about a systematic approach, based on the entire population Public Health is still a field of research and practice that is not identified with a separate profession.

47. Social and biological components of normal and abnormal human development

Both biological and social factors contribute significantly to human development. We list the biological factors of dysontogenesis:

1) genetic factors (hereditary diseases, chromosomal aberrations, gene mutations, endogenous diseases, etc.);

2) intrauterine disorders (toxicoses, infections, intoxications, etc.);

3) pathology of childbirth;

4) early diseases with damage to the central nervous system (progressive hydrocephalus, brain tumors, encephalitis, etc.).

The social factors of dysontogenesis include:

1) various types of emotional and social deprivation;

2) various kinds of social psychological stress. The problem of the influence of social and biological factors on the ontogenetic development of a person is also dealt with by clinical psychology, or rather, a special section of clinical psychology - developmental clinical psychology. The areas of interest in developmental clinical psychology include:

1) mental processes and states;

2) analysis of the course of age-related crises;

3) psychosomatic mutual influences at various stages of human development.

The formation of individual psychological qualities of a person is greatly influenced by both the biological and social components of development. Without the appropriate "material support" (the presence of a highly developed nervous system, brain), any attempts to achieve appropriate education and training were unsuccessful. The same applies to the social component: the loss of even the best "material" from society in early childhood leads to a complete suppression of the child's development (for example, "Mowgli children").

But a particular child is not in society in general, but interacts with specific people who have individual characters, have a certain culture, intellect, etc. In the process of development, by the beginning of each age period, certain relations are formed between the child and the social microenvironment surrounding him. These relationships are the essence of the social situation of the child's development. When analyzing the process of a child's development, it should be taken into account that each period is characterized by a new type of relationship between him and his surrounding social environment. The formation of the child's psyche is possible only with involvement in the world of social relationships.

Age-related psychological crises are special periods of ontogeny that do not last long and are characterized by dramatic psychological changes.

48. Types of disorders of mental development

There are various classifications of dysontogenesis. Let's consider some of them and give a description of the types of dysontogenesis.

G. E. Sukhareva distinguishes three types of dysontogenesis:

1) detained;

2) damaged;

3) distorted development.

Close to the considered one is another classification of disorders of mental development.

1. Irreversible underdevelopment (associated with oligophrenia).

2. Disharmonious development (associated with psychopathy).

3. Regressive development (associated with progressive degenerative diseases, malignant epilepsy).

4. Alternating development (observed in various somatic and mental pathologies).

5. Development, changed in quality and direction (with a schizophrenic process).

G. K. Ushakov and V. V. Kovalev proposed to distinguish the main clinical types of dysontogenesis:

1) retardation is retarded mental development or stable mental underdevelopment;

2) asynchrony - disharmonic mental development.

Clinical forms of dysontogenesis can be classified as follows:

1) mental retardation;

2) borderline and partial delays in mental development;

3) distortions of mental development;

4) autistic disorders;

5) acceleration;

6) infantilism;

7) somatopathy.

The most common is the following classification of dysontogenesis:

1) mental underdevelopment;

2) delayed development;

3) damaged mental development;

4) deficient mental development;

5) distorted mental development;

6) disharmonic mental development.

There are other differentiations of types of oligophrenia. For example, in pedagogical terms, the classification of M.S. Pevzner can be considered the most common. This author identifies five main types of oligophrenia.

1. Uncomplicated mental retardation.

2. Complicated oligophrenia with the presence of neurodynamic disorders.

3. Oligophrenia, characterized by a violation of various analyzers.

4. Mental retardation, which is characterized by psychopathic forms of behavior.

5. Oligophrenia with a pronounced frontal insufficiency.

49. Primary identification of children with developmental disabilities

There are several types of observation:

1. Standardized observation (assumes the presence of a pre-compiled observation plan, the goals and objectives of which are predetermined).

2. Free observation (does not provide for special training and observation plan).

3. Included observation (carried out in the process of joint activities with the child).

There are other types of observation:

1) group and individual;

2) short-term and long-term;

3) external and internal, etc.

In the process of observation, the psychologist should take into account the peculiarities of the manifestation of the child's activity, which forms the basis of his psychosocial development. First of all, you should pay attention to:

1) general and motor activity;

2) emotional and behavioral responses to new stimuli;

3) the intensity of the emotional expression of one's desires and relationships;

4) the mood of the child;

5) the ability to focus on emotional contact or manipulation with objects;

6) the ability to cope with difficulties, overcome obstacles.

If a child's behavior differs from other children, the psychologist organizes a more thorough observation of him.

When qualifying the observed features of the child's behavior as deviations, the psychologist is guided by the following criteria:

1) change in the child's behavior in general;

2) inconsistency of the child's behavior with the age norms of development;

3) the duration of the noted behavioral features;

4) frequency of observed symptoms;

5) features of the emergence of a particular trait in behavior, indicating the social nature of its occurrence;

6) a tendency to perform monotonous actions with objects;

7) lack of attachment to close adults, etc.

Having found out the causes of violations in the development of the child, the psychologist develops a long-term plan for its development and correction. He necessarily carries out special work with parents to explain the features of this period in the life of the child and the best methods of interaction with him.

Psychologists widely use gaming activities as a basic developmental and correctional method. If there is a pronounced lag and the absence of a positive pace in the development of play activity, a thorough examination of the child is carried out, taking into account the reasons for this lag. In this case, as a rule, other specialists are involved (teachers, doctors, etc.).

50. Basic principles of psychodiagnostics of children with mental developmental disorders

Before starting a psychodiagnostic examination, it is necessary to obtain some additional information, which include:

1) psychological history (various data on the previous stages of the child's development);

2) information received from parents, doctors and teachers about the characteristics of the child's behavior in various life situations;

3) information about the state of health of the child at the time of the examination.

Psychodiagnostic examination is carried out for the following purposes.

1. Identification of developmental disorders that most often cause mental illness, as well as learning difficulties, behavior, etc.

2. Control over the dynamics of mental development and the success of the application of therapeutic effects and means of psycho-correction.

3. Detection of the child's personality traits that hinder his social adaptation.

The nature of the examination depends on the age, gender, state of health, as well as the educational level and ethnicity of the patient.

Examination of a teenager or an adult can last about an hour, a junior schoolchild - 30-45 minutes.

In some cases, diagnosis can be carried out in the presence of parents and other persons. Sometimes there is a group study.

In the process of examining children with mental developmental disabilities who experience learning difficulties, programs should be used that will help in identifying not only the actual, but also the potential level.

Since children with developmental disabilities are characterized by rapid exhaustion, a small set of techniques should be used during a psychodiagnostic examination.

Depending on the results of the initial examination, there may be a need for additional diagnostics using psychophysiological, neuropsychological or other methods of examination.

When conducting a psychodiagnostic examination, it is impossible to provide assistance (if it is not provided for by the examination procedure), criticize or praise the child strenuously.

During the examination, the creation of comfortable conditions, the establishment of psychological contact with the child, goodwill, and the removal of anxiety are of no small importance. In the case of clinical diagnosis, these factors are of particular importance.

51. Psychological counseling

Psychological counseling focuses primarily on psychological impact, psychocorrection - on the processes of manipulation, control and formation, and within the framework of psychotherapy, each of the above methods of providing psychological assistance is used.

The main goal of counseling is the formation of a personal position, a specific worldview and the formation of a hierarchy of client values.

The task of psychological correction is to develop skills that are optimal for the individual and effective for maintaining health of mental activity that contributes to personal growth and adaptation of a person in society.

The main task of psychotherapy is the relief of psychopathological symptoms, through which internal and external harmonization of the personality is achieved.

Psychological counseling includes various processes:

1) a diagnostic process that contributes to the specific features of the development of the client (normal or abnormal), as well as the presence or absence of psychopathological symptoms;

2) the process of informing a person about the structure of his mental activity and individual psychological characteristics, favorable and unfavorable life situations;

3) the process of learning auto-training skills, methods of psychological protection, as well as methods for normalizing one's own emotional state.

Psychological counseling involves the joint work of a doctor, a clinical psychologist and a patient. The process of psychological counseling includes:

1) discussion of the problems that a person has and possible options for overcoming them;

2) informing the individual about his individual psychological qualities and methods of self-regulation.

The structure of psychological counseling includes diagnostics, which includes clinical interviewing, the use of psychodiagnostic methods to determine the features of the functioning of mental processes and personality parameters.

Psychological counseling is used in solving various problems of the client as the initial stage of therapy. Often counseling is used in combination with psychocorrectional and psychotherapeutic influence. The specific purpose of psychological counseling is psychological phenomena that are caused by identity crises and other worldview problems, as well as communication disorders. When solving such problems, the use of psychocorrection or psychotherapy is considered ineffective.

52. Logotherapy

Logotherapy is a humanistic direction of psychotherapy. The main goal of logotherapy is to return to a person the meaning of life lost due to some reasons. The mechanism of development of psychological problems in a person is seen in the "existential crisis". The task of logotherapy is the restoration or acquisition by a person of lost spirituality, freedom and responsibility. Viktor Frankl, the founder of logotherapy, believed that the lost meaning of a person can be restored using the method of persuasion. The basis of logotherapy is the healing of the soul by forming in a person a meaningful desire for meaning instead of the desire for pleasure or power.

Within the framework of the psychology of self-realization, much attention is paid to the development of a psychological strategy for maximizing the use of one's own personal potential in life, which includes:

1) the inner nature of a person in the form of basic needs, abilities and individual psychological characteristics;

2) potential opportunities, the realization of which depends on extrapsychic factors (family, immediate environment, education, etc.);

3) authenticity - the ability to know the true own needs and capabilities;

4) the ability to perceive oneself;

5) the need for love.

A. Maslow noted that an individual has values of being (B-values) and values that are formed according to the principle of eliminating scarcity (D-values). The values of life include the following:

1) integrity - unity, integration, interconnectedness;

2) perfection - necessity, naturalness, relevance;

3) completeness - finiteness;

4) justice - legality, obligation;

5) vitality - spontaneity, self-regulation;

6) completeness - differentiation, complexity;

7) simplicity - sincerity, essence;

8) beauty - correctness;

9) righteousness - rightness, desirability;

10) uniqueness - individuality, originality;

11) ease - lightness, absence of tension;

12) game - fun, joy, pleasure;

13) truth - honesty, reality;

14) self-sufficiency - independence, the ability to be oneself.

53. Psychological correction

Psychological correction is based on psychological counseling. Psychocorrection is a psychological impact on the client in order to normalize his mental state in cases of diagnosing any personality anomalies in him, as well as for mastering any activity. Psychocorrection in clinical psychology is aimed at active external intervention in the formation of an adequate mental state of a person, harmonization of his relationship with the social environment.

The purpose of psychocorrection is to correct and normalize any deviations from the optimal level of individual psychological characteristics and abilities of a person. Yu. S. Shevchenko distinguishes five types of psycho-correction strategies:

1) psychocorrection of individual mental functions (attention, memory, thinking, perception, cognitive activity, etc.) or personality correction;

2) directive or non-directive psychocorrection;

3) psycho-correction, focused on a specific person or focused on the family;

4) psychocorrection in the form of group sessions or individual psychocorrection;

5) psychocorrection as an element of clinical psychotherapy (used in the complex treatment of neuropsychiatric diseases) or as the main and leading method of psychological influence on a person with behavioral deviations and social adaptation.

In contrast to psychological counseling, the role of the client in psychocorrection is less active and even more often passive. Psychological correction implies the development of new adequate ways of behavior in the process of specially designed training programs.

Psychocorrection uses the following as the main methods:

1) manipulation;

2) formation;

3) management.

In clinical psychology, psychological correction is used if the client has psychological problems that arise in connection with personality anomalies, with neurotic psychosomatic disorders, etc.

The most famous trainings that are used in the process of psychological correction are the following.

1. Autotraining.

2. Neuro-Linguistic Programming (NLP).

3. Transactional analysis.

4. Behavioral (behavioral) therapy.

5. Psychodrama.

54. Autotraining (autogenic training)

Auto-training is a method by which an understanding of the skills of mental self-regulation occurs through relaxation methods.

Relaxation (relaxation) is a state of cheerful spirit, which is described by reduced psychophysiological activity.

In clinical psychology, the following types of auto-training are most often used:

1) proper autogenic training with neuromuscular relaxation;

2) biofeedback technique.

In the process of progressive muscle relaxation, a person is trained to control the state of the muscles and induce relaxation in certain muscle groups in order to relieve emotional stress. Auto-training is carried out in stages and consists in mastering exercises to relieve neuromuscular tension.

The biofeedback technique consists in the conditioned reflex fixing of the skill to change one's somatic state while controlling it with the help of various devices. A person independently controls the biological functioning of his body and learns to change it using various methods of self-regulation.

A. A. Alexandrov distinguishes the following types of biofeedback:

1) electromyographic biofeedback (learning the process of relaxation of a specific muscle or muscle groups, as well as general relaxation);

2) temperature biofeedback (allows you to acquire the skills of expanding and constricting blood vessels, resulting in a change in body temperature);

3) electrocutaneous biofeedback (allows you to learn how to control galvanic skin reactions by influencing sympathetic nervous activity);

4) electroencephalographic biofeedback

(formation of skills to change the bioelectric activity of the brain by changing the ratio of waves of different frequencies).

55. Neuro-Linguistic Programming (NLP)

NLP is one of the currently most popular areas of psychotherapy, which appeared in the early 70s. XX century Richard Bandler and John Grinder are considered the founders of neurolinguistic programming.

Taking into account NLP, any person has a leading modality - the main way of receiving information. For example, in one person the leading modality is visual perception, in another it is auditory, etc.

To clarify the leading modality and features of information reception in NLP, an analysis of the types of scanning eye movement is used.

To clarify the prevailing representative system, the method of content analysis of the words most frequently used by a person is used.

Thus, the predominance in the use of the corresponding type of words indicates the main representational system for a given person.

To establish the most clear interaction with the client, the psychotherapist should know which particular representational system prevails in this person, and use predominantly verbal or non-verbal (facial and gesture language) communication, i.e. he must speak with the client in his language.

After identifying the dominant modality of a person, a correction of his behavior is expected. It may or may not be realized by the patient (in the first case, we are talking about managing the individual, and in the second, manipulating him with the help of verbal and non-verbal methods).

The goal of NLP is to develop a specific behavioral strategy that is desirable for a particular person or environment.

The main task of NLP is considered to be a new formation of personality and giving it some new definite form. This process is called "reframing".

Reframing is based on the following provisions of neurolinguistic programming:

1) any reaction and behavior of a person is protective and therefore useful (they are considered harmful only if used in an inappropriate context);

2) each person has a certain model of the world that can be changed;

3) any person has hidden resources, with the help of which it is possible to change the subjective model of the world.

Reframing is carried out in six stages:

1) the symptom is determined;

2) the patient is invited to make a kind of splitting himself into parts (healthy and pathological) and come into contact with the part that is responsible for the formation and manifestation of the symptom, and understand the mechanism of its occurrence;

3) the symptom is separated from the original motive;

4) the discovery of a new part that is able to satisfy this motive in other ways with "setting the anchor" (an associative connection between events or thoughts);

5) the formation of the consent of the whole "I" to a new connection (fifth and sixth stages).

56. Transactional Analysis

American psychologist Eric Berne created an independent psychotherapeutic direction - transactional analysis. The term "transaction" literally means "interaction". Thus, transactional analysis implies the analysis of interaction, i.e., communication between people.

Transactional analysis proceeds from the fact that any forms of non-adaptive human behavior are based on certain patterns of relationships and interactions, which E. Berne calls games. In them, people, without realizing it, play all their lives.

Transactional analysis involves the separation of relationship models, playing out the three main roles of our "I" - "Parent", "Adult" and "Child". These roles can change in the same person depending on the life situation and how he perceives the image and behavior of the person with whom he communicates.

Parent. Each person has a certain image of their parents. And in certain life situations, a person begins to involuntarily imitate the behavior patterns of one of the parents, that is, he behaves like a parent. It is characterized by the presence of normative and evaluative stereotypes of behavior.

Adult. Each person (some more often, some less) perceives the situation and himself quite objectively and maturely. The state of such a perception of reality is called in transactional analysis the state of "adult". An adult manifests itself as signs of mature mental activity.

Child. Each person has retained in himself the perception of himself as a child and in specific situations feels like a boy or a girl, that is, a child from his past, regardless of his real age. The child manifests himself with infantile character traits and attitudes towards reality.

In transactional analysis, the process of communication between people is divided into conventional units - transactions. Transactions are divided into:

1) transactional incentives - all types of appeal to another person;

2) transactional reactions - all types of responses to certain appeals.

The main goal of transactional analysis is to make the individual understand the features of his interaction with others and to teach him normative and optimal behavior. The practice of transactional analysis shows that often the mere awareness of one's game with the help of the therapist's explanations can lead the client to a solution to an existing problem or to healing.

Author: Vedekhina S.A.

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