Art therapy in psychology - methods and techniques. Therapy with creative self-expression vigorously List of used literature

Method of creative self-expression ( FOOTNOTE: The method was tested on the basis of the well-known psychological techniques of M. E. Burno. See: Burno M.E. Therapy with creative self-expression. – M., 1989.–S. 304) includes a number of techniques united by a common methodology and construction technology. The point of this method is to bring every teenager into contact with his own creativity, to give him the opportunity to feel an existential involvement in the world, to help him find a foothold in his uniqueness. To be able to find reserves in one’s own individuality is the most valuable skill necessary for an individual in predicting and further shaping one’s destiny in life (M. E. Burno).

The method is based on the idea that subjective creativity and positive experiences will help convince a person of their importance and find the meaning of life.

The method of self-expression through literary creativity, as through other types of creativity, is carried out in the form practical classes. Lessons of this type are structured in a certain way, like any lesson, in accordance with the learning objectives. Techniques are selected randomly by the teacher. There are no particular difficulties in conducting classes of this type, so we will limit our description of the method to instructions and a sample lesson plan.

Instructions:

“You need to create a picture from words, filled with sensations (taste, smell, touch, sounds, visual images). The story must be very sincere, even if it is under the guise of another person. If the author describes some experiences that are not typical for him, then it is necessary to express his attitude to what is happening in the story.”

Each student can choose their own topic for the story, or all students write a story on the same topic. It is advisable to offer several options. We consider it appropriate to work with the following topics:

1. Describe a childhood event, trip, or experience.

2. Try to make a direct description of nature. To do this, go into the bosom of nature and write down everything that you feel, see, remember, think.

The name “art therapy” is translated from Latin as “treatment with art.” This area of ​​psychotherapy is relatively young, but rapidly developing due to the effect that is achieved during treatment. It has many species and subspecies, opening up wide opportunities for getting rid of.

What is art therapy?

Initially, we were talking about drawing therapy, that is, treatment fine arts, but later other types of creativity appeared - singing, dancing, acting, modeling and others, which help a person not only relax and escape from pressing matters, but also to better understand himself, his inner "I", thus getting rid of his complexes and contradictions, improving mood, harmonizing state of mind. Art therapy has no undesirable side effects and does not cause resistance in a person, because in this matter the process itself is important, not the result.

What is art therapy in psychology?

This concept was introduced by the British doctor and artist Adrian Hill, who worked with tuberculosis patients and noticed that drawing helped them fight the disease. Art therapy in psychology was also used during the Second World War in relation to children released from concentration camps. Today it is carried out both in the form of individual and group classes. You can practice art therapy without even leaving your home by purchasing an anti-stress coloring book created by Joanna Basford.

Goals of art therapy

While undergoing a course of art treatment, the client carries out self-knowledge, self-expression and self-analysis, which allows him to harmonize it. Creative therapy aims to improve the psychological and emotional background, relieve tension, get rid of fears and phobias, aggression, anxiety, apathy, depression, increase vitality and mood.

In addition to harmonization mental state Psychologist’s sessions with elements of art therapy have the following objectives:

1. Reveal a person, his talents and abilities.
2. Accelerate recovery for many diseases.
3. Establish contact between the therapist and the client, establish a trusting relationship between them.
4. Help the patient concentrate on internal experiences and learn to control their emotions.
5. Help a person adapt socially.
6. Give impetus to the expression of feelings and thoughts that a person cannot or does not want to express in the usual way.

What are the benefits of art therapy?

Art therapy has a gentle, unobtrusive effect on the psyche, because the treatment process itself is similar to engaging in a hobby. Often the patient is depressed and it is difficult to establish communication, but the possibilities of art therapy allow you to express your “I” through visual art. The technique of such treatment is based on the principle that the contents of the patient’s inner “I” are reflected in visual images at the moment when he sculpts, draws, dances or sings, as a result of which the state of the psyche is harmonized.

This treatment does not cause rejection or rejection in the client, which is very important for people under stress. It is always voluntary and safe. In the process of projecting inner experiences onto his creation, a person does not realize that they are unconsciously coming out. If we consider the process from the point of view of psychoanalysis, then its main mechanism is sublimation. Through artistic visual images and objects, the unconscious interacts with the conscious, and the therapist helps the patient understand what his “unconscious” wants to tell him.

Types of art therapy

This technique is attracting increasing interest, which creates the preconditions for expanding its boundaries and the emergence of new “tools” of the healing art. Art therapy methods include:

• isotherapy – painting and drawing;
• color therapy - a person is exposed to light of various colors;
• music therapy, which involves listening to various compositions;
• sand therapy – sand painting;
• video therapy - means watching a video in which the hero has the same problem;
• game therapy - during the game the necessary mental functions are formed;
• bibliotherapy - this method uses literature to treat with words;
• fairy tale therapy - writing fairy tales, analyzing existing works;
• mask therapy - a three-dimensional image of the patient’s face is used, which allows him to direct his emotions and experiences in the right direction;
• dramatherapy, that is, dramatization, acting out a plot;
• phototherapy – photographing, creating collages;
• dance therapy – dancing class;
• art synthesis therapy - it combines painting, poetry, cartoon, color, mask, phototherapy, etc.

Art therapy for women

At the modern pace of life, when people are regularly exposed to stress, art therapy helps to understand oneself, one’s place in life and find ways to fulfill one’s desires. Art therapy for adults provides an opportunity to strengthen your own energy, gain self-confidence and calmness. Through artistic visual images, a picture of one’s own life is created - the way a person wants to see it.

Art therapy for older people

The direction of treatment is always chosen by a specialist, taking into account the complexity of each type of creativity. And if playing in amateur theater or dancing is more suitable for teenagers, then art therapy for the elderly involves choosing calmer and simpler techniques that are easy to handle and do not require special skills to perform. When working with older people, it is very important to encourage a person to start and not strive to achieve a specific result. This is the most difficult stage, because many people at this age no longer believe in their abilities, and also believe that this requires a special talent.

Art therapy - exercises

There are many techniques that allow you to solve your internal problems. Here are some of them:

1. When working with a child, ask him to draw his fear. For something scary to turn around, it needs to be made funny and amusing. For example, draw a bow on a crocodile, and angry dog pink wings.
2. Art therapy techniques include an exercise called “Scribbles.” The patient is asked to draw a nonsense, and then carefully examine it and identify a meaningful image, circle it, complete the drawing, and then describe the drawing.
3. Art therapy techniques include the “collage” technique. In the context of a given topic, glue, sculpt and draw anything on paper. The analysis is carried out taking into account the size and position of elements, color, plot, harmony, etc.

Books on art therapy

Creative expression therapy is covered in the following works:

1. “Techniques of body-oriented art therapy” by A.I. Kopytina. Practical guide, helping in working with various injuries and addictions.
2. “The practice of art therapy: approaches, diagnostics, training systems” L.D. Lebedeva. The author in simple and accessible form leads detailed description art treatment technician, lists everything necessary for this, describes diagnostic techniques.
3. “Creative self-expression therapy” M.E. Stormy. The book covers the entire spectrum therapeutic techniques, based on art and creativity.

This complex clinical psychotherapeutic method has been developed by me for more than thirty years and is described in detail in 4 books (Burno M., 1990, 1999, 2000).

There is already extensive literature on creativity therapy in the world. However, it was not possible to find thorough works outlining the practice of this serious treatment in accordance with the characteristics of the clinic and personal background. Basically, these are psychoanalytic, psychodynamic, generally psychological (in a broad sense), but non-clinically oriented messages, books about self-disclosure therapy in creativity (Naumburg M., 1966; Franzke E., 1977; Gibson G, 1978; Zwerling I., 1979 ; Kratochvil S., 1981; Biniek E., 1982; Burkovsky G. and Khaikin P., 1982; Günter M., 1989). It is generally accepted that it is possible to speak about therapy with creativity and art only in psychoanalytic language. Thus, the relatively recent remark of Cologne professor P. Rech that “non-psychoanalytically oriented art therapy makes little sense” is characteristic (Rech R., 1991, p. 158). V. Kretschmer (1958, 1963, 1982) builds his “synthetic psychotherapy” on clinical principles father (E. Kretschmer) and V. Stern’s ideas about personal consciousness, thoroughly including culture as a therapeutic agent in psychotherapy (“Treatment with positive experiences and creativity”). V. Kretschmer, however, fundamentally limits himself here to general theoretical expressive provisions, without offering the doctor and psychologist any practical developments or recommendations.

Therapy through creative self-expression (with awareness of one’s social benefit, with the emergence on this basis of a stable bright worldview) grew up in the field of the concept of emotional-stress (“uplifting”, addressed to the spirituality of a person) psychotherapy by V. Rozhnov (1985). This method is very effective in treating patients with defensive disorders. “Defensiveness” (from défēnsio - defense, defense (lat.)) is understood in clinical psychiatry as the opposite of “aggressiveness”, authoritarianism. The essence of defensiveness is the experience of one’s inferiority, a conflict between the feeling of inferiority (the feeling of inferiority is revealed by timidity, self-doubt, shyness, anxious suspiciousness, etc.) with vulnerable pride. Defensiveness is characteristic of psychasthenics, asthenics, many cycloids, schizoids, patients with neurosis-like schizophrenia; defensiveness occurs in many depressive disorders.

The main healing “mechanism” of creativity

In anxious tension, in general, with almost any serious mood disorder, a person experiences a painful feeling of uncertainty, instability, amorphism of his “I” - up to painful depersonalization disorders. This loss of oneself, it seems, is the main, deepest node of painful, pathological mental tension (in comparison with the personal, permeated with one’s own “I” experience-purification). Creativity, as the performance of any moral deed in one’s own way, in accordance with one’s spiritual individuality, helps to return to oneself, to feel more clearly and distinctly oneself, to soften mentally, to brighten, to see one’s path more clearly, and to find the meaning of life. A meaningful meeting with oneself in creativity, the crystallization of individuality is revealed by spiritual uplift (creative inspiration), and in this sense, Creativity and Love (in the broadest sense - at least as sincere goodwill towards people) are always together. But a creative person is directed towards people, serving them also by the fact that with his lively individuality he interests, “infects” them, and encourages them to their own creativity. After all, only spiritual individuality makes art art, inspiration inspiration, and only it is eternal. This is true both in the spiritual-idealistic and in the spiritual-materialistic (clinical) understanding.

The essence of the method

However, it is often not easy to revive and “warm up” healing creative movements in a suffering soul. This is greatly facilitated, in our experience, by a feasible clinical study of one’s chronic depression, one’s spiritual individuality (personality), the study of other personal options (characters) and how exactly this or that mentality (character), this or that depression in a variety of creativity. In order to walk consciously and confidently enough his, on a special socially useful path, feeling like yourself, with a creative healing light in the soul, you need to study at least the elements of characterological radicals - syntonic, autistic, psychasthenic, etc., having learned and felt that there are no “good” and “bad” radical characters, just as there are no “good” and “bad” nationalities. It is important to feel and study in yourself and others - both weaknesses and strengths, value (constitutionally closely related to these weaknesses) - in order to realize that for each their own(if only this yours was moral). To truly deeply understand oneself and others, one’s purpose in life, is possible, as I am convinced, only through the process of diverse creative self-expression.

Patients in individual meetings with a psychotherapist, in group sessions (in open creative expression group- 8-12 people, 2 times a month for 2 hours) in the liberating, soul-softening atmosphere of a “psychotherapeutic living room” necessary for defensive people (tea, slides, music, candles) (ill. 1) and homework - they get to know and study their own mental characteristics, the characteristics of each other, the characteristics of famous artists, writers, philosophers (based on the doctrine of character, on memories of famous people). They learn to express themselves creatively in every possible way, studying the characteristics of their creative personality among the world’s spiritual culture.

Here are specific methods of creativity therapy, intertwined in our work, reinforcing each other: therapy 1) creating creative works; 2) creative communication with nature; 3) creative communication with literature, art, science; 4) creative collecting; 5) soulful and creative immersion in the past; 6) keeping a diary and notebooks; 7) home (at home address) correspondence with a doctor; 8) creative travel; 9) a creative search for spirituality in the everyday.

Gradually, over the course of 2-5 years of such outpatient work, patients acquire a more or less stable inspired and creative style, a bright meaning of life, in which they are freed from their hopeless mental tension and amorphism.

Short-term, concentrated treatment using this method in an outpatient clinic or in a hospital with daily group classes is also possible - for at least two weeks. Then the groups become closed. In such cases, we count on at least an increase and brightening of the quality of mental life for the future.

With a full, long-term course of treatment, compensation or remission is usually hardly reversible - in the sense that there is no longer a complete return to the previous difficult days, and it is now easier for the patient to resist his disorders. However, if he stops creative activities and loses his creative form (style), deterioration often occurs.

In Creative Self-Expression Therapy, as well as in humanistic psychology-psychotherapy, a person grows personally, becomes enriched, self-actualized, finds the meaning of life, but, unlike the approaches of Maslow, Rogers, Fromm, which bypass personality types (character) and the clinical picture, Frankl, who carry within themselves the conviction of the originality of the Spirit, the spiritual - here the psychotherapist helps to grow spiritually, to find oneself as an autistic or syntonic person, or psychasthenic, etc. warehouse, to find a creative style characteristic of their warehouse, the meaning of life. This is based on theoretical position E. Kretschmer (Kretschmer E., 1934) about psychotherapeutic searches together with the patient for his characteristic style of behavior, life field - in accordance with his constitutional foundations. I am, of course, aware that such a materialistic commitment to the constitution, the clinical picture, looks more mundane, less spiritual in the psychological-autistic understanding than humanistic, existential, psychoanalytic, religious and other spiritual-idealistic approaches, but this clinicalism, this The natural scientific approach to the human soul is the essence of my psychotherapeutic method, which seriously helps Russians and continues (as I am convinced) the domestic clinical psychotherapeutic tradition. The clinical nature of the method fills it with a subtle, complex clinic, especially the study of personal soil, without which this method is impossible. Patients, acquiring elements of clinical knowledge, become, to a certain extent, clinician-psychotherapists for themselves.

Therapy with creative self-expression, which is spiritually and materialistically based not on the eternal Spirit, but on eternal Nature (features of the constitution, clinical picture) allows the patient to feel uniquely himself (syntonic, autistic, etc.) in spiritual culture, in life (including through one’s spiritual consonance with famous artists, writers, philosophers). Thus, emphasizing in its own way personal freedom, the pricelessness of everything moral and human, it can lead the patient to my philosophical-idealistic, religious personal path.

Several practical examples and tips

1. Ask the patient to read aloud in the group a story-memory, for example, about childhood in the village. Let him show the slides he has now made of the herbs and flowers that grew in that village as a child. Let him show his, albeit inept, but sincere drawings-memories of village landscapes from memory, a drawing of the house in which he lived. So he turns on a tape with the singing of birds that he heard there, crowing, bleating of a sheep, etc. Patients, together with the psychotherapist, try to penetrate all this, but not in order to evaluate literary or artistic-photographic skills (not here literary circle, not an art studio!), but in order to kindly feel in the creative self-expression of a comrade his spiritual, characterological peculiarity, compare with his own peculiarity, tell and show in response yours on this topic and suggest to each other possible, characteristic ways of creative (and therefore healing) self-expression.

2. On the screen in comparison are slides: the ancient Greek Kore and the ancient Egyptian Nefertiti. Patients try to “try on” their vision of the world to the syntonic vision of the world of the ancient Greek artist and the autistic one of the ancient Egyptian. Where is there more harmony with the artist? Not - what do you like more, but - where is more of me, my character, my attitude? Look and talk about how these two worldviews continue in the paintings of famous artists of all times, in poetry, prose, in music, in cinematography, in the work of bandmates. What are the strengths and weaknesses of each of these worldviews? In what ways do various syntontic and autistic people usually find themselves happy in life? How do psychasthenic people differ from them in all this? Etc.

3. If at first it is difficult for the “new guy” to express himself creatively, you can ask him to bring to the group several postcards with images of artists’ paintings that resonate with him or with images of his favorite animals and plants. Or we ask you to read aloud a poem by your favorite poet in the group, to include a piece of music that you like (i.e., as if about him, as if he himself would have written it if he could).

4. The psychotherapist participates in the group through his own creativity, revealing his personality (character) to patients. For example, he shows on a slide how he himself involuntarily philosophically “clings” to thunderclouds with his camera, symbolically and autistically expressing his experience. Or, if he is syntonal, he shows with his slide of nature how he naturally dissolves with his whole being in the surrounding reality, without opposing himself to the fullness of life. Or, talking about creative communication with nature, the psychotherapist shows how he himself feels and understands his own peculiarity, communicating with a flower that is in tune with him (“my flower”). How exactly is this communication with a flower (including photographing it, drawing it, describing it in notebook) emphasizes to the psychotherapist his own peculiarity.

5. These insecure patients should not be “overloaded” with an intimidating “encyclopedic” abundance of information. Minimum information, maximum creativity.

6. In the process of creative self-expression, it is necessary to help patients learn to respect their defensiveness. It is not only a weakness (excessive anxiety, impracticality, clumsiness, etc.), but also a wonderful strength, which is expressed primarily by the anxious moral reflections and experiences that are urgent in our era. This “power of weakness”, which, by the way, is also filled with Durer’s Melancholy, depressed by doubts, is important to usefully apply in life. The patient should be helped to become as socially useful as possible - without breaking himself, without trying to turn himself through artificial training into his “brave”, “impudent” opposite (which is what many defensive sufferers so strive for at first).

So, for example, in the group of creative self-expression, with common, heartfelt efforts, we show the modern Hamlet that behind his everyday impracticality and indecisiveness there is an invaluable moral scrupulousness, the ability to philosophically and wittily comprehend reality and tell many people about themselves and the wondrous dialectics of life - as they themselves they would not be able to see it, to understand it. Having realized that bravely aggressive, practical affairs are not his destiny, that, perhaps, Darwin, Tolstoy, Chekhov would have suffered from defensive experiences in the appropriate situation, let the defensive patient learn to respect this Darwinian, Tolstoy, Chekhovian thing. Confirmed in his true value, he will sooner learn to do the necessary practical work more decisively. But only necessary practical things.

I tell in groups how a long time ago my school friend V., gifted in mathematics, but timid, absent-minded, physically fragile, awkward, literally tortured himself in physical education lessons with difficult exercises, despising his “weakness” and impracticality to tears. Already as a student, he continued to “break” himself with mountaineering and soon died in an abyss. Apparently, thanks to Creative Self-Expression Therapy, V. could feel and realize that it is even possible to respect his bodily fragility and awkwardness as an integral part of his mental-physical constitution, without which his mathematical gift would not exist. This is what distinguishes clinical psychotherapy, which individualizes each case, from psychologically oriented psychotherapy, which might require the group’s opinion to transform Hamlet into a self-confident, unreasoning brave man (even if artificial), forcing him to shout loudly: “Me! I!! I!!!".

Creative expression therapy is contraindicated in many cases of psychotic depression. Here the experience of melancholy hopelessness and separation from people can even deepen - in a bright environment of inspired creativity.

Conclusion

Thus, Creative Expression Therapy as a method of clinical psychotherapy is not simply a treatment of joyful, creative experiences. This is an attempt, with the help of special spiritually creative activities, to help a defensive patient become imbued with a conscious sense of spiritual, socially useful originality. Specifically, in life, this is expressed, for example, in the fact that on an excursion in an ancient city a person no longer sees just white gray walls, onion-shaped churches, but feels and realizes in them and in himself the characterological features of his ancestors - harsh softness, syntonous, cheerful flourish in the spirit of “Moscow Baroque”, shy closeness to living nature (onion). In the greenery near the temple he now distinguishes salsify, forest geranium, yarrow and with inspiration knows yours attitude to a specific flower, to a specific architectural image (“how close this is, how much all this emphasizes me, my own way in life"). This everyday creative self-expression is somewhat reminiscent of “being” (as opposed to “having”) in the way Fromm thinks about it. Unlike Fromm, I understand the essence of being, creative being, spiritually and materialistically: a person does not “choose” to absolute (essentially divine) freedom from his “I”, but freely, morally, socially and actively lives his own “I”, studying it concretely and realistically.

1. 1. 2. Therapy (prevention) with creative self-expression

In these recommendations, the author of the psychotherapeutic (psychoprophylactic) method indicated in the title briefly describes the practical essence of the matter in relation to the circumstances in which a doctor and psychologist work with patients and healthy people.

This method is especially effective in the treatment of patients with various defensive non-acute psychotic disorders and as a prevention nervous pathology in healthy people experiencing defensive mood disorders within the normal range. The term “defensiveness” is closely related to such concepts as asthenicity, psychasthenicity, asthenicity, psychasthenicity, inhibition, melancholicity. It is clear that depression usually carries with it a certain defensiveness. Defensiveness (experience of one's inferiority) is found as a leading disorder in many patients with low-progressive neurosis-like schizophrenia, in psychasthenic and asthenic psychopaths, in defensive schizoids, cycloids, epileptoids, defensive hysterical psychopaths, in alcoholics and drug addicts of a defensive (inhibited) type. Mood disorders of a defensive nature are not uncommon in healthy people, especially in accentuated individuals. This technique helps all these people to soften mentally, to be imbued with more or less persistent healing and creative inspiration, to learn to overcome difficulties in moral self-expression, without turning (to alleviate mental tension and “lift the spirit”) to psychotropic drugs, alcohol, and drugs.

Creative Expression Therapy (CET) departs in detail from the clinical picture, from the features of the natural mental and physical self-defense hidden in it, as well as clinical hypnotherapy, clinical rational conversations, clinical techniques mental self-regulation and other clinically refracted methods that make up the arsenal of a psychotherapist-clinician. Creativity (in a broad sense) is understood as the performance of any socially useful task in accordance with its unique spiritual characteristics. Therefore (in contrast to simply “self-expression”) creativity cannot be reactionary, immoral, it is always a creation that carries within itself the individuality of the author. By their dissimilarity from each other, by their moral characteristics, people unite into teams in which, ideally, everyone spiritually, in their own way (and not mechanically, not mechanically) implements a socially useful task that unites the collective. Since the main instrument of any creativity is a living spiritual individuality, sick and healthy people study mental disorders and characters in TTS, recognize their individuality in creativity, become, as it were, more themselves and, thus gaining inspiration, are freed from the painful uncertainty that is always present in mood disorders , in any mental tension, depression. In the process of treatment (prevention), a person finds or refines his own creative, socially useful and at the same time healing, inspirational path in his profession, in communicating with people, in his family, and in his leisure time. This is, in a very brief summary, the clinical-psychotherapeutic, scientific essence of Creative Self-Expression Therapy as a complex clinical-psychotherapeutic effect.

The goals of the method Of course, it’s not about teaching those we help to create works of art, science, or giving them some kind of “hobby” that distracts them from mental difficulties. The goals are as follows.

Medicinal purposes

1. To help defensive patients get out of painful mood disorders, to significantly soften their pathological experience of their inferiority, various psychopathic and neurosis-like manifestations: obsessive, asthenic-hypochondriacal, senestopathic-hypochondriacal, depersonalization, etc. Thus preventing the possible destructive “self-help” of drinking and drug addiction.

2. At the same time, in the process of therapy, to liberate and activate hidden reserves of social and moral activity, often “hidden” in these patients who are not confident in themselves without such special treatment. To help them creatively, more usefully for society and more healingly for themselves, “fit in”, “get involved” in life precisely with their own, including chronic pathological, characteristics.

Prevention goals

1. Help healthy people with defensive difficulties get rid of tension that interferes with life and work, fraught with addiction to alcohol and drugs.

2. Through special classes, help a healthy person with characterological difficulties find his creative, most socially useful and therefore inspirational and healing path in life.

Objectives of the method(as a tactical one, implementing the strategy of goals)

Treatment objectives

1. To help patients, in the process of individual conversations, medical-educational, psychological-typological influences in a group, if possible, to know and study their painfully persistent, “difficult” characterological characteristics, chronic pathological disorders - primarily in order to find out how it is possible to apply their most socially useful, which is the peculiar life force this chronic pathology.

2. To help in the process of personal psychotherapeutic contact with a doctor, psychologist, in the process of Therapy through creative self-expression, in accordance with one’s own characteristics, to realize one’s place among people and for people, having thought through and felt one’s own serious non-randomness in the country, in humanity.

3. Do not just encourage patients to be creative (write, draw, photograph, etc.), but unobtrusively, in a cozy creative environment, lead them to this, “infect” them with it, arouse the interest of group members in each other’s creativity, pushing them to self-expression and own (doctor, psychologist, paramedic, nurse) creativity.

4. To ensure that patients, thanks to their individuality now strengthened by creativity, firmly and productively enter life groups - work, education, household, etc.

Preventive tasks

1. In the process of psychological and characterological studies, help healthy people with mental difficulties to study as much as possible the elements of character typology, their own characterological radicals, abilities in order to consciously try to become personally more socially active and, therefore, healingly spiritual.

2. “Immerse” healthy people with defensive experiences in the work of a group of creative self-expression, so that in a kaleidoscope of special activities they become spiritually enriched, find themselves, realize and feel in creativity their personal characteristics that are useful for society, their serious place among people and nature.

The practical essence of this method is uniform in treatment and prevention and is as follows. Patients and healthy people (with mental difficulties) - in individual conversations with a doctor, a psychologist, in group classes (creative self-expression group) in the liberating, softening atmosphere of the “psychotherapeutic living room” (tea, slides, music, dim light) and in home exercises learn in every possible way express yourself creatively. Any, even seemingly completely useless, but clarifying, personality-strengthening creative activity in leisure time can help strengthen professional creativity, since a person in any moral self-expression generally becomes more of a personality. Such a person becomes more protected in relation to mood disorders (which, for example, are associated with a breakdown in an alcoholic).

Stage I- self-knowledge (study of one’s character, one’s painful disorders) + knowledge of other characters (study of elements of the doctrine of character: “to each his own”, learn to respect this “mine” of another, in any case, treat this “mine” of another kindly, if it is, of course, not immoral); duration from 1-3 months (in case of leisurely outpatient work for 2-5 years) to several days (in case of short-time work - hospital, sanatorium, rest home).

Stage II- continued knowledge of oneself and others in creative self-expression (with awareness of one’s social usefulness, with the formation of an optimistic attitude towards life) - with the help of specific methods of creativity therapy; duration from several years (for leisurely outpatient work - a dispensary, clinic, sobriety club) to 2 weeks (in the case of a short course of treatment (prevention)).

Forms of therapy (prevention) with creative self-expression:

1) individual conversations (from 3 times a week to 1 time every 2 months);

2) postal correspondence (from several letters per month to several per year);

3) groups (open or closed) for creative self-expression (8-12 people each) in a “psychotherapeutic living room” with reading aloud their stories, discussing each other’s slides (how the author’s peculiarities are manifested in all this and how socially useful it is possible to apply them ) etc.; group meetings from once a day to twice a month (in accordance with working conditions) - parallel to individual conversations.

Along with all this, if necessary, hypnotic sessions, training psychotherapy, medications (mainly sedatives, tranquilizers).

Of course, a labor-intensive course of treatment over several years is quite long. But many years of experience in creative self-expression therapy for patients with defensive-low-progressive schizophrenia, defensive psychopaths and alcoholics with a defensive disposition confirms that only with such long-term, unhurried treatment is it possible in most cases to achieve high And average degree of therapeutic effectiveness.

High the degree of therapeutic effectiveness here is found in fairly stable compensations and remissions, containing a psychotherapeutically educated creative, inspired uplift of spirit and the ability to resist, thanks to this, internal and external difficulties, an almost reliable ability to soften, enlighten oneself in the hours and days of deterioration with certain creativity, noticeable the rise of the social curve of life with a clear, conscious sense of one’s useful inclusion in the life of society and the conviction that, basically, these changes are due precisely to this long-term Therapy of creative self-expression. There is also a desire to help “sufferers” like themselves with creativity in the same way that they themselves were helped.

Average the degree of effectiveness is expressed in a more or less stable improvement, in which the patient is able to significantly mitigate his disorders using developed methods of creative self-expression against the background of a noticeable (in general) rise in the social curve of life. Experiencing at times a bright feeling of his social usefulness, the patient is convinced that all these beneficial changes in his condition are due to the new, creative style of his life.

Small the degree of effectiveness is an unstable improvement, during which the patient gets the impression that the painful thing is able to recede precisely in the process of creative self-expression, and the hope that everything will get better becomes stronger. Now clearly feeling at least the “crumbs” of his social usefulness, the patient is drawn to creativity.

The effectiveness of Creative Expression Therapy is assessed primarily clinically. Attempts to “measure” effectiveness using our accepted psychological methods here (especially in cases of schizophrenia and psychopathy) are unreliable. For example, with a clear and long-term improvement established clinically and socially, the MMPI profile often remains the same.

In cases chronic alcoholism the effectiveness of treatment is assessed in a generally accepted way or (with long-term outpatient management of patients in an anti-alcohol club) total number“sober” working months, days of the year.

As an aid to assessing the effectiveness of Creative Expression Therapy, this questionnaire is provided in which patients are asked to highlight what they believe to be true.

1. In the process of our treatment, thanks to it, you have specific creative activities with which you can:

Reliably get out of difficult mood disorders

Significantly alleviate your frustrations

Improve your condition at least a little

2. You experience undeniable improvement overall:

In the last 3 months

In the last six months

During the last year

In recent years (2, 3, 4, 5, 6, 7, 8, 9, 10)

3. You attribute this improvement to our individual and group meetings:

Fully

Mostly

Only partly

4. Your improvement is mainly due to favorable life circumstances that do not depend on treatment:

5. You are convinced that, thanks to treatment, your condition has generally improved, although the circumstances of your life have become more difficult:

6. Due to the fact that during the course of this treatment your condition has significantly improved, you want to help people with experiences and disorders similar to yours in a similar way (or are already trying to do this):

7. Specific, official facts indicate that, thanks to our treatment, you are increasingly bringing social benefit:

8. You experience, thanks to our treatment (or, regardless of it, in your opinion), a creative upsurge, a desire to work spiritually:

Almost permanent

From time to time

Only occasionally

9. Thanks to our treatment, it has become much easier for you to cope with your mental and life difficulties:

10. You are confident that you have become more socially useful yourself, although this is not expressed in official data (position, salary, etc.):

11. During the treatment process, the hope arose and strengthened that you will get better and better:

12. Thanks to the treatment, a clear impression arose that mental difficulties were receding and weakening in creativity:

The data from this questionnaire should be interpreted carefully and clinically (especially in cases of schizophrenia), comparing them with the actual condition of the patient, his objective successes in life, information from relatives, etc.

Therapy through creative self-expression with all the kaleidoscopic multicoloredness of its means (studying characters, writing stories, poems, painting, communicating, for example, with stinging nettles and stinging nettles, with antiquities, books, toys of one’s childhood, the starry sky, soulful slow reading, for example, by Nekrasov , collecting coins, searching for beauty even in an earthworm, and an endless variety of other similar activities) - must remain in all its details clinical, i.e. constantly adapt to the clinical, personal soil, so as not to turn into psychological attempts at forcible “reconstruction” of the personality or into entertaining entertainment that can even cause harm. In groups of creative self-expression, patients with schizophrenia are treated together with psychopaths, often becoming friends with each other, thanks to the defensiveness that unites them. However, this defensiveness is clinically different and treatment remains clinically differentiated (in accordance with the nosological affiliation), even in a group. So, if a psychasthenic in the process of treatment needs detailed scientific and therapeutic information and all sorts of sensory revitalization, then an asthenic needs to be given more psychotherapeutic care that affirms him in life, a healing artistic emotion that elevates the soul. The defensive cycloid should be humorously encouraged, relying on his tendency to believe in the authority of the doctor, leading him through creativity, first of all, to his characteristic living practical activity (professional and social). The defensive schizoid should be helped to use his autism in symbolic-philosophical art, philosophy, physics, mathematics, etc. for social benefit, thus gently leading him away from a possible painful immersion in mysticism. Let the defensive epileptoid use his dysphoric tension and authoritarianism in the name of good, for example, in the fight against hooligans, and let the defensive-hysterical patient find a useful use of his beautiful demonstrativeness, anancast - his scrupulousness. We cannot significantly help a patient with schizophrenia without a special kind of emotional contact (Burno M.E., 1985). We try to revive patients with alcoholism spiritually, to encourage creativity - also in accordance with their premorbid personality, in accordance with what remains of the personality in the process of alcoholic coarsening and decline. At the same time, we constantly strengthen their teetotal attitude - including through “artistic and psychotherapeutic” methods (writing stories, poems, drawing - on the bitter themes of their former drunken life, analyzing an anti-alcohol play, in which, perhaps, the patients themselves play roles, and etc. ). Depending on personal characteristics, we work preventively with healthy people in “risk groups”, in sobriety clubs.

Each patient and healthy person with mental difficulties over time, with the help of a psychotherapist, his assistants and his comrades in the group, will feel and realize his own characteristics, for example, in his own stories, slides on the screen, etc. - in order to internalize your strengths, your path in life.

Creative self-expression therapy involves personal contact with a doctor, psychologist, paramedic, or nurse. This means a keen interest in the personality of a patient or a healthy person, interest in his work and everyday affairs, seemingly unrelated to mood disorders, symptoms, the ability to sincerely sympathize, worry, i.e. everything that excludes the feeling of a “guinea pig” that often arises in a person who finds himself in a therapeutic or preventive formal setting. At the same time, for the success of the business, there should not be, in the full, vital sense, friendly (or, even more so, loving) relationships; there must exist here (without any falsehood!) that subtle, invisible distance at which psychotherapeutic (psychoprophylactic) art is maintained, those. that beneficial “artificiality” that distinguishes art (including psychotherapeutic art) from life itself.

This personal contact has its own characteristics in accordance with the clinical or healthy characterological properties.

Creative Expression Therapy psychotherapeutic and psychoprophylactic method aimed at helping people suffering from the painful experience of their inferiority. This technique was developed by a Russian scientist M.E. Burno(Professor of the Department of Psychotherapy, Medical Psychology and Sexology of the Russian medical academy postgraduate education).

Creative self-expression therapy can be mastered and used in their practice not only by professional psychotherapists, but also by psychologists, coaches, etc. In recent years, this method is increasingly used as an element of various trainings, mild remedy revealing a person’s creative potential, its reflection in the works created by the patient.

Initially, the method was focused primarily on helping the sick those suffering from indecision, vulnerability, shyness, anxiety, fears, obsessions, painful doubts, suspiciousness, super values, hypochondria, etc. Often such manifestations lead to various chronic diseases, as well as to combat their symptoms through alcohol consumption, potent drugs. It's clear that this dead end path, which only makes the problem worse.

Dignity creative expression therapy is about extreme softness approach. For example, unlike some Western similar methods, Burno therapy is based on the fact that a person’s character cannot be changed, you can only reconcile a person with yourself, direct him on the path of self-knowledge, so that he sees his advantages and can use them.

One of the main concepts method is an emotional-stressful impact, which means not " harmful stress", and elation, inspiration, which have a tonic and healing effect on all aspects of human life, including health.

The essence method lies in the accessible teaching patients basics clinical psychiatry, characterology, psychotherapy, natural science in the process of various creativity patients. As a result, a person turns from a sufferer into a creative one, comprehends his own characteristics, recognizes himself through artistic self-expression, discovers his own path and accepts it. Studying plays a major role in this process experience talented, brilliant creators, for many of whom art was a means of self-medication.

Similar treatment methods have been known and practiced since ancient times - treatment with music, theatrical performances in ancient times, etc. Already in the 19th century, medical studies showed that patients with mental pathologies recover much faster if they have an interesting, favorite activity to which they can devote their time.

Creative Expression Therapy sees your ideal in achieving a healing and creative lifestyle, a constant feeling of creative inspiration. This result can be achieved after several years of training, but occasional procedures also have a very beneficial effect.

Methodology includes individual conversations with a psychotherapist, homework, participation in a creative self-expression group in a cozy psychotherapeutic living room (warm home furnishings, drinking tea, pleasant relaxing music), playing roles in a psychotherapeutic theater (as a special group of creative self-expression through performing arts).

Main stages of treatment

• Self-knowledge and knowledge of others. First of all, we are talking about studying human characters and types of mental disorders.
• Knowing yourself and others through creative self-expression. Includes therapy:
  • creation of creative works;
  • creative communication with nature;
  • creative communication with literature, art, science;
  • creative collecting;
  • soulful and creative immersion in the past;
  • keeping a diary and notebooks;
  • home correspondence with a doctor;
  • creative travel;
  • a creative search for spirituality in the everyday.

It should be noted that the method of creative self-expression therapy requires a great deal from the psychotherapist. experience And dedication. Here, each treatment case is individual and often the right solution can only be obtained intuitively.

In the practice of creative self-expression therapy, two are acceptable: forms work - individual meetings and work with open groups at the outpatient clinic. Individual the form allows the doctor to enter the patient’s world, learn about his intimate experiences, and clarify with him the question of his well-being and mood. Group the form allows the patient to clearly see himself, his character, his spiritual values, his creativity in comparison with all this from his group mates. The patient can be convinced of the sincerity of interest and respect for him on the part of his comrades, understand and accept others images of experience and behavior, which in itself are therapeutically valuable.

One of the most common types of creativity in creative expression therapy is drawing. The patient can only master the basics of this artistic method, but this is quite enough - after all, the goal is not to create a work of art, but to self-knowledge. Drawing available almost always, which allows the patient to quickly relieve emotional tension on his own - this is akin to the effect of keeping a diary. Creating drawings in group work - a unique opportunity in a short time (literally in a few minutes) to more clearly recognize the characters of the participants and their characteristics.

Among contraindications for therapy it is necessary to note: deep psychotic depression with suicidal motives; defensive low-progressive schizophrenic cases, when patients persistently report that they become more and more "in the process of treatment" fragile"For the vulnerable, treatment awakens joyful hopes - and it only makes it all the more painful" the blows of life"; delusional and overvalued mood of patients with a tendency to delusional interpretation of the doctrine of character typology to the detriment of the patient and the people around him.

Positiveeffect of therapy creative self-expression is based on the fact that a person finds his own individual core, which saves him from emotional tension, fears, and uncertainty about the future. In the creative process, a person finds and discovers himself - finds new values and brings into his confused and amorphous soul certainty, answers the questions - who am I, what am I worth, what can I do, what is my calling, etc. A creative person is more emotional protected, since he can perceive life’s adversities, grief and other negativity as creative material on the basis of which a work of art is created.

Russian clinical-psychotherapeutic method-school - in contrast to therapy with creative self-expression, creativity therapy (Creative therapy) in the broad, Western sense (as an auxiliary therapy, "mainly within the framework of the general treatment plan, taking into account psychoanalytic concept", I. Bonstedt-Wilke, U. R?ger, 1997). T. T. S. B. brings specific activities of healing creativity, spiritual culture into the natural science traditional Russian clinical psychotherapy of A. I. Yarotsky (1866-1944) and S. I. Konstorum (1890-1950).In contrast to art therapeutic, existential-humanistic and religious approaches, T. T. S. B. assumes a natural, bodily basis in the most complex movements of the soul and is not sent in its psychotherapeutic effects from Spirit, but from Nature (Burno M. E. Creative Self-Expression Therapy, 1999; Burno M. E. Clinical Psychotherapy, 2006; Burno M. E., Dobrolyubova E. A. (eds.). A practical guide to Creative Self-Expression Therapy , 2003). The psychotherapist examines the protective-adaptive work of nature, more or less understandable to the clinician in a language outlined in the clinical picture, in personal soil, in order to help spontaneous natural forces better protect against harmful external and internal influences. For example, depersonalization suffering is understood as a protective-adaptive unnaturalness of feeling, experiencing (“I feel, I experience not in my own way, for example, I am numb in my soul”), softening heartbreaking melancholy. This spontaneous imperfection of natural defense is corrected, if possible, by psychotherapeutic creativity, helping the patient to feel like himself and to brighten up in creative inspiration. Theoretical basis method - P. B. Gannushkin’s position (1933) on “vital compensation for psychopaths” and “mild schizophrenics and epileptics” (detection or non-detection of this pathology depending “on external influences, from their amount, from their content") and similar, consonant with Gannushkin, reflections of E. Kretschmer (1934) with the subsequent conclusion that “here lie psychotherapeutic tasks.” We are talking about Kretschmer’s psychotherapeutic concept - “the creation of personality according to its constitutional basic laws and activities" (E. Kretschmer, 1975). T. T. S. B. came out of psychiatry and is indicated for a variety of patients with a painful experience of inferiority with a feeling of guilt, failure (pathological defensiveness (passive defensiveness) - as opposed to aggressiveness However, especially in recent years, the method began to be used to treat mentally healthy somatic, neurological patients with defensive character traits, to help healthy defensive children (at school, in kindergarten) etc. The essence of the method. A patient or healthy people with defensive difficulties, under the guidance of a psychotherapist, study elements of clinical psychiatry, characterology (including the characters of artists, scientists), elements of psychotherapy, natural science in a variety of creative self-expression in order to find their own healing, meaningful creative inspiration that lifts them out of the “mess” of experiences . Find yourself as a unique, but still, in accordance with your nature, autistic, psychasthenic, syntonic, polyphonic-schizotypal, etc. personality. Natural characters and symptoms of illness are understood here not as “tags”, but as important natural landmarks (like, for example, male or female, youthful or old people’s natural mental characteristics), helping to find the path to one’s creative autistic, psychasthenic, etc. uniqueness , your Love and your Meaning. Just as a conservatory student, on the advice of a teacher, performs some favorite piece of music the way a musician who is spiritually in tune with him performs it, comes from imitation to his own, in the words of Ravel, “unconscious inaccuracy.” Practice the method. Individual psychotherapeutic meetings, creative homework, creative self-expression group in the intimate setting of a psychotherapeutic living room, realistic psychotherapeutic theater. Specific methods of creativity therapy, intertwined with each other: 1) therapy by creating creative works; 2) therapy through creative communication with nature; 3) therapy through creative communication with literature, art, science; 4) therapy through creative collecting; 5) therapy with insightful and creative immersion into the past; 6) therapy by keeping diaries and notebooks; 7) correspondence therapy with a psychotherapist; 8) creative travel therapy; 9) therapy with a creative search for spirituality in the everyday. “Creative” here means everywhere the knowledge and search of oneself, autistic, psychasthenic, etc., in communication with art, nature, etc., in order to find one’s inspired and creative unique path in life. Long-term T. t.s. B. lasts 2-5 years, short-term versions of the method - from a week to 4 months. The ideal of therapeutic effectiveness is the formation of a creative lifestyle: the ability to bring oneself into a state of creative inspiration in acquired ways, the ability to live for a long time in a state of inspiration. T.t.s. B. develops endlessly along with clinical psychiatry, characterology, art, all areas of spiritual life, from which the method selects the material it needs, refracting it clinically and psychotherapeutically. Just as surgery refracts clinically in its own way more and more new technical discoveries.

THERAPY WITH CREATIVE SELF-EXPRESSION

Developed by M.E. Burno (1989, 1990) and intended mainly for patients with defensive disorders without acute psychotic disorders (i.e., with a painful experience of their inferiority). This is a rather complex, long-term (2-5 years or more) method. M.E. Burno (1993) also proposed a technique short-term therapy creative drawing.

Name T. t.s. B. points out the connection of this method with creativity therapy (creative therapy, arts therapy), but at the same time the author notes its originality: 1) imbued with subtle clinicalism, i.e. consistent with clinical picture and the patient’s protective forces manifested in it; 2) aimed at teaching the patient methods of healing creative self-expression with awareness of the social usefulness of his work and his life in general. The purpose of the method is to help the patient reveal his creative possibilities in general, and above all in his profession. The method is a practical expression of Rozhnov’s concept of emotional stress psychotherapy, which elevates, spiritualizes the personality, and addresses its spiritual components.

T.t.s. B. arose on the basis of the author’s many years of work with patients suffering from psychopathy and low-progressive schizophrenia with defensive manifestations (passive-defensive reaction, anxious feelings of inferiority). There is also experience of its use in alcoholism and family conflicts, both for therapeutic and psychohygienic and psychoprophylactic purposes.

Basic techniques of T. t.s. B.: 1) creation of creative works (writing stories, drawing, photography, embroidery, etc.) at the level of the patient’s capabilities in order to express the characteristics of his personality; 2) creative communication with nature, during which the patient should try to feel and realize what exactly from the environment (landscape, plants, birds, etc.) is especially close to him and what he is indifferent to; 3) creative communication with literature, art, science (we are talking about a conscious search among various works of culture for something close to the patient); 4) collecting objects that correspond or, on the contrary, do not correspond to the patient’s individuality, in order to understand his characteristics self; 5) immersion in the past by communicating with objects of one’s childhood, looking at photographs of parents, ancestors, studying the history of one’s people or humanity as a whole for a deeper understanding of one’s own individuality, one’s “roots” and one’s “non-randomness” in the world; 6) keeping a diary or other kind of records including elements of creative analysis of certain events, works of art and science; 7) correspondence with a doctor whose letters are of a psychotherapeutic nature; 8) training in “creative travel” (including walks along the streets or out of town) in order to identify the patient’s attitude to the environment and develop his ability to analyze this attitude based on knowledge of his own personality; 9) training in the creative search for the spiritual in the everyday, the unusual in the ordinary.

During the treatment process, the listed methods are often intertwined in the corresponding individual and group explanatory and educational work of the psychotherapist. They are implemented in a psychotherapeutic setting - in a special living room, which is lit with dim light, where music plays quietly, tea is served and there is an opportunity to show slides and demonstrate the work of patients.

T.t.s. B. is carried out in 2 stages. Stage 1 - self-knowledge, during which the patient studies the characteristics of his own personality and painful disorders (based on feasible research of other human characters, etc.). The duration of this stage is 1-3 months. Stage 2 - knowing yourself and others using the above methods: its duration is 2-5 years.

Burno recommends the following forms of work: 1) individual conversations (the first 1-2 years from 2 times a week to 1 time in 2 months, and then even less often); correspondence between the doctor and the patient (from several letters per month to several per year, in which issues related to the patient’s creativity and his painful experiences are discussed); 2) home activities for patients (studying artistic and scientific literature), creation of creative works, etc.); 3) evenings, meetings of the psychotherapeutic group (8-12 people each) in the psychotherapeutic living room with reading aloud works written by patients, showing slides, discussing the works of patients (2 times a month for 2 hours). At the same stage of treatment, various psychotherapeutic techniques can be combined. B. with other types of psychotherapy and medications.

Emphasizing the clinical orientation of his method, the author gives recommendations regarding its leading focus in various types psychopathy and low-progressive schizophrenia with defensive manifestations. Thus, psychasthenic psychopaths, in accordance with their characteristics, usually need fairly detailed scientific and therapeutic information, asthenic psychopaths - in the manifestation of sincere medical care, cycloid personalities - in encouraging, humorous and revitalizing influences, in faith in their doctor. Schizoid individuals should be helped to use their inherent autism in various useful activities (mathematics, philosophical and symbolic artistic creativity, etc.). When treating patients with epileptoid psychopathy Special attention should be addressed to the moral realization of dysphoric tension; while approving the honesty and uncompromising nature of such patients, it is necessary to friendlyly suggest to them that they will achieve much more in life if they try to be more lenient towards the human weaknesses of others. Patients with a hysterical personality should be helped to find recognition from other people in conditions where they are given the opportunity to read aloud, participate in amateur performances, create works of art, but at the same time it is important to bring them to an understanding of the need to differentiate this activity from behavior in everyday life (to teach them to at least “play” modesty). In psychotherapeutic work with patients with low-progressive schizophrenia with defensive manifestations, it is necessary to gently activate their capabilities, encourage creativity both during individual work and in groups (based on the established emotional contact of the patient with the doctor).

Particularly noteworthy are the author's instructions that it is not enough, and sometimes even harmful, to simply encourage patients to draw, photograph or write. It is important to gradually lead them to these activities, motivating them by their own example, the example of other patients, using the mutual interest of the members of the psychotherapeutic group in each other’s work, and also discussing the issue of the consonance of their experiences with the content of the works they create or the works of famous painters and writers.

Some practical tips:

1. Ask the patient to read aloud to the group a story-memory, for example about childhood in the village; let him show the slides he has now made of the herbs and flowers that grew in his village in childhood; let him show his, although inept, but touching with sincerity, drawings-memories of village landscapes, the house in which he lived; let him turn on a tape recording of the singing of the birds that he heard there, etc. The patients, together with the psychotherapist, try to get into all this, but not in order to evaluate literary or artistic-photographic skills (this is not a literary circle, not an art studio!), but in order to feel in the patient’s creative self-expression his spiritual, characterological originality, compare with his own characteristics, tell and show in response something of his own on the same topic, suggest to each other possible ways of creative (and therefore healing) inherent to each self-expression.

2. On the screen in comparison are slides: the ancient Greek Kore and the ancient Egyptian Nefertiti. Patients try to “try on” their vision of the world to the syntonic vision of the world of the ancient Greek artist and the autistic one of the ancient Egyptian. Where is there more harmony with the artist? Not just - what you like best, but where there is more of me, my character, my attitude. Look and talk about how these two worldviews continue in the paintings of famous artists of all times, in poetry, prose, music, cinematography, and the work of group members; what are the strengths and weaknesses of each of these worldviews; in what, in what activities do various syntontic and artistic people usually find themselves happily in life; how do psychasthenic patients differ from them in all this, etc.

3. If a first-time patient initially finds it difficult to express himself creatively, you can ask him to bring to the group several postcards depicting paintings by artists or favorite animals and plants that resonate with him; You can offer to read aloud a poem by your favorite poet in the group, or include a piece of music that you like (i.e., as if about him, as if he himself would have written it if he could).

4. The psychotherapist participates in the group through his own creativity, revealing his personality (character) to patients. For example, he shows on a slide how he himself involuntarily “clings” to ominous clouds with his camera, symbolically and autistically expressing his experiences; or, if he is syntonous, shows slides depicting nature, then how naturally he dissolves in the surrounding reality, without opposing himself to the fullness of life; or, talking about creative communication with nature, he shows how he himself feels, understands his own peculiarity, spiritually communicating with a flower in tune with him (“my flower”), how exactly this communication with a flower is (including photographing it, drawing it, describing it in notebook) emphasizes its originality.

5. You should not overwhelm insecure patients with an intimidating encyclopedic abundance of information - a minimum of information, a maximum of creativity.

6. In the process of creative self-expression, it is necessary to help patients learn to respect their defensiveness. It is not only a weakness (excessive anxiety, impracticality, clumsiness, etc.), but also a strength, expressed primarily in the anxious moral reflections and experiences that are so necessary in our time. This “power of weakness,” with which Dürer’s melancholy is filled and depressed by doubts, is important and useful to apply in life. The patient should be helped to become more useful to society without breaking himself, without trying to artificially transform himself into his “brave”, “impudent” opposite (which is what many defensive patients so strive for at first).

So, for example, in the creative self-expression group, we jointly show the “modern Hamlet” that behind his everyday impracticality and indecisiveness there is an invaluable moral scrupulousness, the ability to philosophically, wittily comprehend reality and tell many people about themselves and the wondrous dialectics of life as they themselves we couldn't. Having realized that bravely aggressive, practical affairs are not his destiny, that, perhaps, Darwin, Tolstoy, and Chekhov would have suffered from defensive experiences in the appropriate situation, the defensive patient will begin to respect this “Darwinian, Tolstoyan, Chekhovian” of his. Confirmed in his true value, he will sooner learn to more decisively engage in necessary practical work.

One can give an example of how a patient, a gifted mathematician, but timid, absent-minded, physically fragile, awkward, literally tortured himself in physical education lessons with complex exercises, despising his weakness and impracticality to the point of tears. As a student, he continued to “break” himself by climbing, and soon died, falling into the abyss. Apparently, with the help of T. t.s. B. he could feel and realize that his bodily fragility, awkwardness can even be respected as an integral part of the mental-physical constitution, without which his mathematical gift would not exist. The author of the method, M.E. Burno, emphasizes that in this he sees the difference between truly clinical psychotherapy, which individualizes each case, and psychologically-oriented one, in which a situation could arise that turns Hamlet into an unreasoning brave man (at least in the opinion of the group).

T.t.s. B. can be used both in a hospital and on an outpatient basis, in a clinic, as well as a dispensary, in sobriety clubs, in aesthetic therapy rooms (in sanatoriums), when working with risk groups (those suffering from alcoholism). In addition, this method can occupy a significant place in the rehabilitation system for mentally ill patients. T.t.s. B. is contraindicated in persons with severe depression and suicidal thoughts. In this case, in an atmosphere of inspired creativity, the feeling of melancholy hopelessness and distance from people may even deepen.