How does an appointment with a psychotherapist go, why should you not be afraid of him and how to behave?

Psychologist, psychiatrist and psychotherapist - what is the difference and what do these specialists have in common? What is the basic type of their formation and which one should be used in each specific case? Why do many not only patients, but also doctors do not understand the difference between a psychologist and a psychiatrist, and both together from a psychotherapist? To understand these issues, we turned for clarification to the Chief Medical Doctor, psychiatrist, psychiatrist-narcologist and psychotherapist Vladislav Sipovich.

Why has there been confusion between the concepts of psychology and psychiatry, psychoanalysis and psychotherapy?

It is necessary to look for the roots of the problem in the historical past of the development of these areas of knowledge. The birth of psychiatry is associated with the study by medicine of the 19th century of methods of treating various mental illnesses. Psychology, which arose as a branch of philosophy around the same time, was engaged in the study and explanation of such mental phenomena as thinking, memory, etc. with a normally functioning psyche.

That is why it is still believed that the destiny of psychiatry is to treat any mental disorders, and psychology is to give advice, explain and model behavioral reactions as a variant of the norm. Historically, these two fields of knowledge moved in parallel, but with different goals. The uniting factor was the object of study - the human psyche, and the separating factor - goal settings. For psychology, these were theoretical studies in the field of explaining mental processes, and for psychiatry, these were the practical goal of curing mental illnesses.

Subsequently, thanks to Freud's research, a rapprochement between psychology and psychiatry occurred, which laid the foundation for the development of psychoanalysis as a treatment technique and, at the same time, a branch of science for the study of human mental activity.

This synthesis became possible due to the fact that Freud, as a psychiatrist, allowed his patients, both with and without mental illness, to “speak.” At the same time, he was interested not only in symptoms, but also in the subjective feelings and ideas of patients, as well as manifestations of the normal human psyche in the form of accidental slips of the tongue, unexpected forgetting of intentions (for example, why did I come to this room), dreams, etc. All this allowed the scientist to conclude that the laws of mental activity are the same for both healthy and sick psyches.

As for psychotherapy, its emergence also dates back to the first half of the 19th century. and is associated with the study of the phenomenon of hypnosis as a method of scientific psychotherapy. At the present stage, psychotherapy is a treatment process using certain psychotherapeutic techniques in compliance with certain rules. As a rule, it is realized through the interaction between the psychotherapist and the patient, aimed at identifying and ridding the latter of painful and psychologically destructive experiences.

To summarize, I can say that the main areas of study and correction of a person’s mental state are: • Psychology – a scientific direction for studying the patterns of mental activity of an individual and various social groups. Uses a humanitarian and natural science approach. A psychologist, in fact, is not a profession, but an education. • Psychiatry is a field of medicine that studies methods of diagnosing, preventing and treating mental disorders. • Psychotherapy is a therapeutic effect on the psyche and through the psyche on a person. Does not exclude the use of drug therapy as an adjuvant. Includes three main areas - psychoanalysis, cognitive behavioral therapy (CBT) and Gestalt therapy. • Psychoanalysis is one of the areas of psychotherapy that developed thanks to the work of Freud and actually gave impetus to the formation of other psychotherapeutic methodologies. Psychoanalysis involves the patient voicing his fantasies, associations, and dreams in order to identify hidden, deep-seated and unconscious conflicts that cause the patient’s mental problems.

In fact, this is a real “digging” into the patient’s soul to identify and resolve cause-and-effect relationships that negatively affect the character and behavior of the individual.

A comparative description of specialists in each profile, based on information about education, practical experience, areas of tasks to be solved, areas of activity and questions with which people can turn to them, will make it possible to illuminate the field of activity of these scientific disciplines in more detail.

Who is a psychiatrist

A psychiatrist is a specialist in the field of psychiatry who works with severe mental pathologies. Unlike an expert in the field of psychology, he has a specialized medical education and conducts drug therapy. The problems of his patients are so serious that he cannot limit himself to providing consultations.

Features of work

If a psychologist or psychotherapist uses more psychological techniques in their work, then the main tool of a psychiatrist, which distinguishes him from these professions, is medications. The difference is that, theoretically, it can influence the patient’s soul with compassion or warmth, but its main treatment is based on the prescription of psychotropic drugs, often powerful and prescribed.

You can understand how a psychiatrist differs from a psychotherapist and psychologist by looking at the list of diseases that he treats:

• bipolar disorder;
• affective insanity;
• hallucinations, delusions;
• epilepsy;
• schizophrenia;
• psychopathy;
• Alzheimer's and Parkinson's diseases;
• memory or consciousness disorder;
• functional psychosis.

To fully understand the difference, it should be noted that the work of a psychiatrist is regulated by the law on psychiatry. In some cases, a specialist has the right to compulsorily hospitalize a person - when the disease threatens the life (health) of the patient himself or those around him.

What exactly does a psychologist do and where can one get the appropriate education?

Psychology, like any scientific discipline, has its own object and subject of study. The object of psychology is a person, which is indisputable. But there are different opinions about the subject, varying historically and depending on the directions of psychological research.

At first it was the soul, then consciousness, adaptability, mental activity, behavior, the unconscious in the psyche, personal and practical experience, receipt and analysis of information, as well as other aspects. All this led to the emergence of a huge number of directions and branches in psychological science. Among the main ones we can highlight such as fundamental general psychology and many applied branches of practical importance: • clinical (medical); • gender; • children's room; • military; • criminal; • judicial; • legal; • engineering; • economic; • oncopsychology.

This includes the psychology of sports, work, parenting and many other areas. In short, they are legion. But the main thing that is important for a psychologist is the practical application of acquired knowledge, the ability to help a person solve problems that arise in the family, at work, in creativity, science, study or business. The task of a psychologist is not so much to give practical advice as to help a person himself understand the current specific situation and make a choice of the correct model of behavior and attitude towards it. This approach will allow the patient to more consciously and objectively assess negative situations in the future and try to resolve any problem without entering a stressful state and making enemies. A psychologist must teach a person to resist the challenges of the modern, extremely urbanized surrounding reality, to make his psyche stable and at the same time flexible, not breaking under the influence of constant stress, but capable of finding a way out of any difficult situation with minimal losses.

In fact, an experienced psychologist can become the best assistant in solving problems of finding one’s place in life, interaction with society and spiritual comfort.

A psychologist can act in different roles, specializing in psychodiagnostics or as a consultant, trainer, coach, or psychotherapist. But the main thing is to obtain a fundamental psychological education on the basis of state universities - Moscow State University, the Russian University for the Humanities, the Higher School of Economics Research Institute; in clinical medical psychology you can get an education at medical universities named after Sechenov and Pirogov. In St. Petersburg, psychologists are trained by St. Petersburg State University, State Pedagogical University named after. Herzen. Knowledge in clinical psychology can be obtained through program training at the St. Petersburg State Pediatric Medical University, St. Petersburg State Medical University named after. Pavlova.

In addition, a psychologist's education can be obtained at regional humanitarian universities. By the way, education is one of the key points that distinguishes a psychologist from a psychiatrist. Psychiatry is a branch of medicine that requires compulsory medical education, which allows a psychiatrist to prescribe treatment and write prescriptions for medications.

The psychologist is deprived of this right and solves the problems of the patient’s interaction with the outside world using purely psychological methods.

Who is a psychologist?

The task of a specialist is to help a person who finds himself in a difficult life situation. His clients are absolutely healthy people who do not have mental disorders, but are in dire need of psychological help.

Features of work

The main difference between a psychologist and a psychotherapist is that he does not have a medical education, that is, he cannot make diagnoses and prescribe medication. His work is based on providing consultations, testing and training that help people get out of a crisis period, increase self-esteem, and improve relationships with others.

There is a wide range of specializations in psychology, including:

• Educational psychologist - works in educational institutions, helping children in their developmental activities, solving behavioral problems, and improving academic performance.
• Family affairs specialist – provides advice to families on resolving conflicts, improving relationships between spouses or with older relatives.
• A specialist in legal psychology, she works with difficult teenagers who are registered with the juvenile affairs department.
• Clinical psychologist – helps people who suffer from severe physiological illnesses or are experiencing stress due to upcoming surgery.

When choosing between visiting a psychologist or psychotherapist, it is important to be aware of the differences between these professions - a specialist in the psychological field is a humanitarian who does not heal, but only helps restore mental balance.

Ethical aspect

There are generally established and legalized rules that a psychotherapist must support in his work.

The main one is, of course, confidentiality. The therapist has no right to take anything said by the client outside the office. The exceptions are cases of confession of committing murder or the existence of a threat to someone's life. If confidentiality was violated without reason, the client has the right to go to court.

By the way: an experienced specialist, if you meet him in a public place, will never greet you first. And your appearance will not show in any way that you know each other. He will only respond to you if you contact him first.

Other rules of conduct for a psychotherapist include respect for the person of the ward and his rights, and an unbiased attitude to the process. Here are the principles of competence, that is, increasing your professionalism and using exclusively scientifically based methods, honesty and responsibility in your work.

When do you need a child psychotherapist?

Unstable mental health in children is considered a separate area in psychotherapy. Mental disorders can occur at any age. Moreover, neurosis is treated by a neurologist. A referral to a psychotherapist is given to a child aged three years or older. If he has anorexia, drowsiness, does not study well, has inappropriate behavior, does not want to communicate with peers.

If you need the help of a psychotherapist, contact our EL Clinic in Northern Butovo. Highly qualified specialists work here who will help you get rid of unwanted mental health conditions.

What does a psychotherapist do?

This employee works with violations of not only will and attention, but also mental functions such as emotions and thinking .

Most often, all this activity is combined into one name “minor psychiatry” (psychiatry of borderline states). What does it mean?

In simple terms, this includes disorders such as obsessive thoughts, obsessive actions, and pathological fears.

A striking example is obsessive-compulsive disorder (we have already written about how to cope with this). For example, constant hand washing.

Here you can see both obsessive thoughts (“I might get infected with an incurable disease, I need to urgently wash my hands with soap”) and obsessive actions (“I washed my hands once, but what if they weren’t clean enough”). Then there is a temporary calm. But the condition remains in the person and continues to poison his life.

What does a psychotherapist treat?

As a rule, these are neuroses. For clarity, let's combine them into groups:

• anxious-phobic (fears of closed spaces, society, flying, obsessive thoughts),
• obsessive-compulsive (obsessive states),
• asthenic (high fatigue),
• hysterical (attracting attention to oneself through incoordination, convulsions and other manifestations in the body),
• depressive (chronically low mood, sleep problems),
• somatoform (when there are complaints of pain in the organs, but they are not confirmed by medical examinations).

A psychotherapist is really a doctor. He makes diagnoses and helps with diseases that can be cured without resorting to pharmacology (pills).

All these disorders, for the most part, are also characteristic of relatively healthy people. For example, obsessive-compulsive disorder (example with hand washing) can affect anyone.

In such cases, a person is always aware of his violation and strives to get rid of it. In more severe cases, criticism of one’s condition is not expressed; the person does not understand his violations.

What does a psychotherapist do?

Work with the client (here not yet with the patient) proceeds in the form of a dialogue.

• the specialist listens to the caller,
• clarifies its purpose
• identifies the reasons
• assesses mental state and readiness to work,
• outlines a precise plan,
• and helps in its implementation.

Why you shouldn't be afraid

Fear of visiting a psychotherapist can hardly be called justified. The specialist’s only goal will be to help his client and will try to solve all difficulties as efficiently and quickly as possible. Everyone who decides to take this step understands that there is definitely no need to be afraid of going to the doctor.

Why you shouldn’t be afraid of a psychotherapist:

1. There is always a result of meetings with a psychotherapist. A specialist will help you understand even very difficult cases and will do everything to help the patient.
2. The psychotherapist always treats his clients with understanding. You shouldn’t think that he will misunderstand something or be biased towards the words.
3. A visit to a specialist of such a profile will not be a stigma. All meetings remain confidential, and their content does not go beyond the communication between the doctor and the patient.

The situation is approximately the same with other unreasonable fears that people have before their first visit to a psychotherapist. Therefore, there is no need to be afraid of anything; instead, it is better to go into the session with confidence.

Principle of further therapy

The first appointment with a psychotherapist usually ends with setting a date for the next visit.
Otherwise, treatment does not continue. A one-time visit is basically impossible. A person needs support throughout the treatment process and even after it. There must be monitoring by a specialist over the emotional and mental state of the patient. When prescribing medications, their effects must be monitored. Psychotherapy is carried out only after successful stabilization of the nervous system with the help of medications. In this case, it is recommended to visit the hospital every 3 days for ten days. Such actions are mandatory to monitor the effectiveness and possible adjustment of the prescription.

What methods does the doctor use to treat?

If you are wondering what a psychotherapist treats , then the method of treatment is as follows. First he communicates with the patient. This method has a strong effect on the consciousness and subconscious of the patient. Treatment by such a specialist is performed voluntarily, and the patient can choose the type of treatment:

• communication,
• hypnosis,
• encoding,
• psychoanalysis,
• bioenergy therapy.

The main goals of psychotherapy are understanding, eliminating stressful situations, emotional release and coincidence with oneself.

When should you make an appointment to see a psychotherapist?

A psychotherapist deals with diseases associated with nerves and mental dysfunction of a particular type. Any adult is exposed to stress, so there are some conditions that require going to the doctor. Such conditions are generally considered to include the following:

• lethargy,
• disinterest in life,
• complete indifference to people and circumstances,
• dependence on alcohol and other substances that allow you to achieve another state,
• hysterics,
• panic attacks,
• irritability,
• excitement,
• depression.

How to behave

Some people going to see a psychotherapist are very worried about how to behave correctly. You just need to be yourself as much as possible. This is the only way to achieve quick results from sessions and solve your problems. The main advantage of meetings with a specialist is complete mutual understanding and trust.

Important Tips:

1. You need to remain frank in conversation. You should not hide facts from your doctor that may be important, even if unpleasant.
2. There is no need to worry or worry in vain. The specialist will not harm his client either physically or psychologically. There is no need to waste your nerves and worry.
3. The specialist should be completely trusted. It is recommended to use all the advice that the psychotherapist gives. The same applies to treatment methods.

Treatment with a psychotherapist is not as simple a task as it might seem. To achieve a noticeable result, you will need not only a good specialist, but also a lot of work on the part of the patient. Therefore, you should not complicate the situation with mistrust or excessive anxiety.

There is nothing wrong with turning to a psychotherapist to overcome personal difficulties. All sessions are conducted with an emphasis on complete trust between the patient and the specialist. Therefore, they very quickly give a positive effect, which the doctor will help to consolidate and even improve.

Who should I go to for treatment?

The modern rhythm of life is accompanied by regular stress, nervous tension, and our psyche is subjected to powerful stress. Someone is able to cope with this by relaxing in time, giving the body rest. But sometimes your internal resources run out, and you realize that something incomprehensible is happening to you, something that you are not able to cope with on your own. And this means that it is time to seek help from a specialist.

To whom exactly? Let's try to figure it out. A psychologist, psychotherapist and psychiatrist have one goal - to help the patient restore his damaged psyche. But they do it in different ways.

How is the appointment going?

After setting the exact appointment time, the person only has to come to the session. The first meeting is considered the most exciting, because it is then that you have to step over yourself, overcoming fears and barriers. However, nothing extraordinary happens during the conversation that would make it worth postponing the visit.

The first step is always getting to know each other. At this time, the client adapts to the general environment, tells the psychotherapist about himself, and shares what worries him. After this, the conversation moves to the next stage - studying the problem. The task of the psychotherapist at the new stage is to determine what exactly caused the complaints and how the situation can be corrected.

In most cases, a specialist can draw the main conclusions already in the first session. However, this does not mean that everything will be resolved immediately. Additional meetings are often required to better understand the problem and overcome it more effectively. This is especially true when it comes to severe depression and a host of internal problems.

Having made final conclusions, the specialist can prescribe medication and psychotherapy. In the first case, the patient will need to take the prescribed medications, which should not pose any difficulties. In the second, he will need to work with the doctor, coming to additional appointments. There, the psychotherapist will help the patient better understand himself and overcome the difficulties that have arisen.