What is Creative Expression Therapy? The main stages of treatment. Therapy creative self-expression violently

If you take a sheet of paper, paints or pencils and draw everything that comes to your mind, then a good specialist will be able to determine your psychological state from this drawing, read your problems and fears. Complete this task and take a look at the drawing that you get. Empty middle or not? Is the entire sheet occupied or is it grouped somewhere in one place? What colors predominate red, black, brown or light? Or maybe the lines are correct, even, but dead and soulless? This can be seen not only by a specialist, but you yourself can determine that it is time to treat the soul. This is what Art Therapy studies - it is a method of healing through the creativity of human souls.

Everyone is capable of self-expression in various ways, through the selection of hairstyles and clothes, through movement, through drawings, through poetry and prose. For any creative personality- this is the only opportunity to express yourself, to talk about your feelings, experiences and thoughts. It is not correct to divide people into uncreative and creative. All people are capable of creating, only the need for this is different, someone is stronger, someone is weaker. It is Art Therapy that provides an opportunity for self-expression, to meet their needs. This is her main task.

Art therapy uses the creative possibilities of a person. You don't have to be an artist to express yourself through drawing. The inner world is more important than the correct execution of the drawing. Understanding the language of creativity, the ability to use it helps to discover new qualities in yourself and other people. Allows you to better understand your desires and needs, contradictions and resources. It is not so easy to master these qualities, but their possession gives new opportunities, opens up new horizons. The task that art therapy sets and solves is not to teach a person to draw, compose music and poetry, but to teach to create in the broadest sense of the word. Create your own destiny, your life, as this is what the person himself wants.

Today, alas, a creative approach to one's life is forgotten. Now most people are of the opinion that people's lives are predetermined from childhood, they are sure that society itself dictates its conditions to us. Today, people increasingly live in a constant struggle for survival, the main thing is resourcefulness, speed, assertiveness, strength. We are increasingly accustomed to looking at things from a practical point of view, from the point of view of personal gain. If there is a problem, there is and there is a solution. We need to do one thing, then another, we must. What and to whom do we owe?

Art therapy uses symbolic images, it is through them that we have access to these opportunities and abilities unknown to us, develop various ways thinking, perception changes, it becomes more complete. There is an opportunity to understand yourself better, to gain more confidence. This is an opportunity to clarify the meaning through the formation of an understanding of the uniqueness of one's personality.

We refer to creativity as various types of human activity in order to achieve a specific goal. Creativity is modeling, and drawing, and dancing, and composing poetry and music, and many other types of action.

Art therapy is a relatively new direction in psychiatry, although the basics go back to the same Z. Freud. This is not a drug treatment of a disease, but a method of unwinding the internal capabilities and abilities of a person, promoting creativity, inner harmony and human development. Art therapy relies on the ability of a person to reflect his inner state in visual images.

A person who feels grief or joy, pain, defeat or victory, can draw his state, express it in poetry and dance, can reflect this state in music. The techniques used by Art Therapy allow you to shoot psycho-emotional stress, open Creative skills, to change the attitude to the world, to close and surrounding people. You do not need to have professional training to work in this direction, you do not need to have any special abilities. The most important thing is to enjoy the process itself from what you are doing.

Pay attention to the paintings of various authors, because each of them carries its own emotions, this is a splash of emotion, somewhere positive, somewhere not. We can see a similar phenomenon in literature and music. Creativity allows you to look at your inner world from the outside.

Music for the liver!

No need to prove and explain that music has an amazing effect on us. Now you can find various music albums: "Liver", "Migraine", "Digestion". This music is very popular for the treatment of various body systems. The action takes place on a psychological level, the music causes shock, excitement. Try to find yours musical composition, which will reflect your emotional state at a given time, calm or invigorate. Music always evokes strong emotions in the soul, carries a charge of energy, and has a beneficial effect on a person.

Try to hear the "inner child"

Thoughts may arise, it is shameful and frivolous in adulthood to engage in modeling, drawing, but this is a big delusion. And in the soul of every very serious and very adult person there always lives an inner child who is just waiting for his master, having removed all the restrictions and stamps of "seriousness", again touches the light and beautiful world creativity and childhood.

What does science say about this?

Physical pain decreases from the contemplation of beauty - this is scientifically proven by neurologists from the University of Bari (Italy). The participants of the experiment chose from the hundreds of paintings provided to them 20 beautiful and 20 ugly paintings (according to the participants). Then, with the help of a laser pulse, painful tingling was caused in them and they were asked to look through selected pictures without stopping. When summing up the results of the experiment, they noticed that when the subjects looked at beautiful paintings, including Botticelli, their feelings were almost a third less than when viewing an “ugly picture” or an empty canvas in general.

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

What is art therapy?

Initially, it was about drawing therapy, that is, treatment with the fine arts, but later other types of creativity appeared - singing, dancing, acting, modeling and others that help a person not only relax and get distracted from pressing matters, but also get to know oneself more deeply. , your inner "I", thus getting rid of your complexes and contradictions, improving your mood, harmonizing your state of mind. Art therapy has no unwanted side effects and does not cause resistance in a person, because in this matter the process itself is important, and 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 helps 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 lessons. You can do art therapy without even leaving your home by buying an anti-stress coloring book invented by Joanna Basford.

Goals of art therapy

While undergoing art treatment, the client carries out self-knowledge, self-expression and introspection, which allows harmonizing 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 harmonizing the mental state, the psychologist's classes with elements of art therapy pursue the following tasks:

1. To reveal a person, his talents and abilities.
2. Accelerate recovery from many diseases.
3. To establish contact between the therapist and the client, to establish a trusting relationship between them.
4. Help the patient to concentrate on inner experiences and learn to control their emotions.
5. Help the person socialize.
6. To give impetus to the expression of their 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 affects the psyche gently, unobtrusively, because the process of treatment itself is like a hobby. Often the patient is in a depressed state and it is difficult to establish communication, and the possibilities of art therapy allow you to express your "I" through visual art. The method 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.

Such treatment does not cause rejection or rejection in the client, which is very important for people in a state of stress. It is always voluntary and safe. In the process of projecting internal experiences onto his creation, a person does not realize that they unconsciously come 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 interaction of the unconscious with consciousness takes place, and the therapist helps the patient understand what his "unconscious" wants to tell him.

Types of art therapy

This technique is of increasing interest, which creates the prerequisites for expanding its boundaries and the emergence of new "tools" of medical art. Art therapy methods include:

• isotherapy - painting and drawing;
• color therapy - a person is exposed to light of various colors;
• music therapy, which consists in listening to various compositions;
• sand therapy - sand painting;
• video therapy - it 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 a word;
• fairy tale therapy - writing fairy tales, analysis of existing works;
• mask therapy - a three-dimensional image of the patient's face is used, which allows directing his emotions and experiences in the right direction;
• drama therapy, that is, dramatization, playing out a plot;
• phototherapy - photographing, creating collages;
• dance therapy - dancing;
• art synthesis therapy - it combines painting, versification, cartoon, color, mask, phototherapy, etc.

Art therapy for women

In 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 one's 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 the elderly

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

Art Therapy - Exercises

There are many ways to solve your internal problems. Here are some of them:

1. When working with a child, ask him to draw his fear. For the frightening to turn around reverse side, it needs to be made funny and amusing. For example, add a bow to a crocodile, and pink wings to an angry dog.
2. Art therapy techniques include an exercise called “Kalyaki-Malyaki”. The patient is invited to draw nonsense, and then carefully consider it and highlight a meaningful image, circle it, draw it, 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 the elements, color, plot, harmony, etc.

Art Therapy Books

Creative self-expression therapy is covered in the following works:

1. "Techniques of body-oriented art therapy" A.I. Kopytin. A practical guide to help you deal with various traumas and addictions.
2. "The practice of art therapy: approaches, diagnostics, systems of classes" L.D. Lebedeva. The author in a simple and accessible form gives detailed description art treatment technician, lists everything necessary for this, describes diagnostic methods.
3. "Therapy with creative self-expression" M.E. Stormy. The book provides a full range of treatment techniques based on art and creativity.

Creative expression therapy psychotherapeutic and psychoprophylactic method, focused on 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 of 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. last years this method increasingly used as part of various trainings, soft release agent creativity of a person, his reflection in the works created by the patient.

Initially, the method was focused primarily on helping the sick suffering from indecision, vulnerability, shyness, anxiety, fears, obsessions, painful doubts, suspiciousness, supervalues, hypochondria, etc. Often, these manifestations lead to various chronic diseases, as well as to combat their symptoms through the use of alcohol, potent drugs. It is clear that this dead end road which only exacerbates the problem.

Dignity creative self-expression therapy lies in the extraordinary softness approach. For example, unlike some Western similar methods, Burno's therapy is based on the fact that a person's character cannot be changed, you can only reconcile a person with himself, direct him to 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 effect, which is understood not as " harmful stress", and spiritual uplift, inspiration which have a tonic and healing effect on all sides human life, including health.

essence method lies in the available teaching patients fundamentals clinical psychiatry, characterology, psychotherapy, natural science in the process of various creativity patients. As a result, a person turns from a suffering person into a creative one, comprehends his own characteristics, recognizes himself through artistic self-expression, opens his own path and accepts it. An important role in this process is played by the study experience talented, brilliant creators, for many of whom art was a means of self-healing.

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

Creative self-expression therapy sees its ideal in achieving a healing and creative lifestyle, a constant feeling of creative inspiration. Such a result can be achieved after several years of practice, but episodic procedures have a very beneficial effect.

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

The main stages of treatment

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

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

In the practice of creative self-expression therapy, two forms work — individual meetings and work with open groups in the outpatient clinic. Individual the form enables the doctor to enter the world of the patient, learn about his intimate experiences, clarify with him the question of his well-being and mood. group the form enables the patient to visually see himself, his character, his spiritual values, his creativity in comparison with all this in 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 other images of experience and behavior, which in itself is therapeutically valuable.

One of the most common types of creativity in creative self-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 independently quickly relieve emotional tension - this is akin to the effect of keeping a diary. Create drawings in group work - a unique opportunity for a short time(literally in a few minutes) to get to know the characters of the participants, their features more clearly.

Among contraindications to therapy it should be noted: deep psychotic depression with suicidal motives; defensive low-progressive schizophrenic cases, in which patients persistently report that they are becoming more and more " fragile", vulnerable, the treatment awakens joyful hopes - and it only hurts more from all this" blows of life"; delusional and overvalued mood of patients with a tendency to delusional interpretation of the doctrine of the typology of characters to the detriment of the patient and the people around him.

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

It is based on two ideas.

The first is that a person suffering from a psychopathological disorder can recognize and understand the peculiarity of his character, his disorders, his mood.

The second idea, which follows from the first, is that, having recognized the strengths and weaknesses of his character, the patient can creatively soften his condition, since any creativity releases a large amount of positive energy, any creativity is healing. The latter does not contradict Freud's position on sublimation, according to which people of art and science raise (sublimate) their illness into creativity.

However, the cardinal difference between the Bourno technique and Western psychotherapy is that creative self-expression therapy, developing the clinical approaches of Ernst Kretschmer and P. B. Gannushkin, is based on the position: each character is inherent in a person innately, and therefore it is useless and pointless to try to change him, with him fight.

Bourno's therapy is built taking into account the characteristics of each character, and not from the existential unity of the human personality.

In order for a person suffering from, say, chronic depression to understand the peculiarities of his depression, his character, he first listens to the stories of his comrades about artists, writers, composers, philosophers in group classes in the "psychotherapeutic living room", trying to gradually penetrate into the foundations of characterological typology, to distinguish one character from another, to try on each of the characters passing by him in a series of activities.

Most often, artists become the object of analysis, because verbal knowledge about them can be easily supported by live reproduction, thereby creating a stereoscopic image of the character.

Creative self-expression therapy classes are held in a relaxed atmosphere, by candlelight, over a cup of tea, under the conducive to relaxation. classical music. Gradually, patients draw closer, often becoming friends who are able to morally support each other.

As a methodological background at the beginning of the lesson, two opposite paintings are often shown, for example, the synthonic "Moscow Courtyard" by Polenov and the autistic painting masterpiece of N. K. Roerich, full of symbols going to infinity. The opposition of realistic, syntonic and autistic principles is present in every lesson.

Against this background, synthonic Mozart and Pushkin, autistic Beethoven and Shostakovich, epileptoids Rodin and Ernst Neizvestny, psychasthenics Claude Monet and Chekhov, polyphonic mosaic characters - Goya, Dali, Rozanov, Dostoevsky, Bulgakov pass before the patients.

At the heart of each lesson is a question, a riddle, therefore, each visit of the patient to the "psychotherapeutic living room" is already fanned with creativity: you need to determine the difficult character of this or that person, to understand which character is closer to yourself. At the heart of the problem is not necessarily a specific person, it can be an abstract problem - a crowd, fear, anti-Semitism, depersonalization - all this is considered from a characterological point of view.

The patient thinks about the fact that creativity healed a great man, helped him in his difficult life, and if therapy with creative self-expression is shown to the patient, he can begin to live of his own free will creative life, which manifests itself in a wide variety of forms - in correspondence with a doctor, in inventing stories, creating paintings, photographing, even collecting stamps.

When a person comprehends his own character, it is easier for him to understand the characters of those around him, he knows what can be expected or demanded from this or that person, and what cannot. He is included in social life, and the painful fractures of his own soul are gradually softened, up to a staunch opposition to the disease.

Therapy according to the Burno method has a philosophical and humanitarian-culturological bias. It not only contributes to the improvement of the individual, but also makes people more educated and more moral.

1. About the essence of medical creativity.
Creativity is "an activity that generates something qualitatively new and is distinguished by originality, originality and socio-historical uniqueness." Creativity expresses the personal: only the personal can be so uniquely original that it always represents something qualitatively new. In creativity (in the broadest sense of the word), a person feels himself truly himself in the name of moral ties with people. The special, high joy of meeting oneself in creativity is inspiration. Creativity reveals and strengthens the originality of the creator, paves the way for him to people.

Rapidly deals with the treatment of adult psychopaths (psychasthenics, asthenics, cycloids, schizoids, epileptoids) and low-progressive schizophrenic patients who themselves seek help from doctors about their mental difficulties and are opposite to asocial-aggressive psychopathic natures with their defensiveness.

Defensiveness is passive defensiveness, a tendency to defend in general, "inhibition". All defensive patients carry an asthenic conflict of feelings of inferiority with vulnerable self-esteem, timidity, self-doubt, fearfully inert indecision, pathological shyness, anxious suspiciousness, worldly impracticality, a feeling of uselessness and uselessness.

The problem of treating defensive psychopathy is very relevant, since this kind of pathology is currently widespread both among the adult population and among adolescents and young men, and there are no sufficiently effective methods of treatment developed.

The value of deep contact with people for a defensive patient cannot be overestimated. But the creative deepening into oneself also acts here, as a rule, therapeutically, displacing the feeling of uncertainty, "jellyfishness", helplessness, which supports painful tension. The most painful for many clinical patients is the feeling of uncertainty in mental tension, when you don’t know what you want, what to fear, what to love. When a defensive patient, finding himself in creativity, realizes himself among relatives, comrades, strangers, in his people, in humanity as a non-random, creative personality, imbued with spiritual light, he is no longer able to suffer as sharply as before. Therefore, in a creative work created by the patient, we should be interested not so much in whether this is a true work of art or science, but in how the patient managed to express his individuality in this work and how it helped him therapeutically.

2. general characteristics method.
Patients in an atmosphere of spiritual, human care for them by a doctor and a nurse, in individual conversations with a therapist, in group classes in a liberating "non-medical" comfort atmosphere of a psychotherapeutic office (tea, slides, music, candles, etc.), at home over the received task, within 2-5 years they learn to understand themselves and others, to express themselves creatively in accordance with their clinical characteristics. Specific methods of creativity therapy, which make up the content core of the technique, are intertwined, dissolved in each other in this method on the basis of explanatory and educational moral and creative knowledge of oneself and others, up to the study of known characterological radicals, pathological disorders, properties (painful doubts, anxieties, insecurity , reflection, depersonalization, hypochondria, depression, etc.), which it is also often possible to learn to apply in life in a therapeutic and creative way and for the benefit of people.

3. Separate methods of therapy with creativity are therapy:

1) creation of creative works,

2) creative communication with nature,

3) creative communication with literature, art, science,

4) creative collecting.

5) creative immersion in the past,

6) keeping a diary and notebooks,

7) home correspondence with the doctor,

8) creative travels,

9) creative search for spirituality in everyday life.

Its essence is in its own way, with the introduction of its own, individual into any business (official communication with people and home-made salad). It is this individual that is true spiritual path to other people. The term "creative" is appropriate in the name of each individual technique indicated, also because it is important for the patient to constantly be aware of his identity, for example, in art gallery, and when reading fiction, and in relation to everything that he gets acquainted with on a journey. Patients must be clearly aware of what is happening to them during this treatment.

Knowledge of other mental disorders and other human characters;

Continued knowledge of oneself and others in creative self-expression with awareness of one's social benefit, with the emergence on this basis of a stable bright worldview.

The essence of creative self-expression therapy is in the patient's conscious, purposeful elucidation in the process of therapy of his individuality, his place among people, in personal, creative self-affirmation.

The patient writes a story or draws a picture, not only and not so much in order to get carried away by the process of writing itself, but in order to develop and enrich the creative individuality, to live and act in constant search its most socially useful meaning in life.

From this follow the goals and objectives of such therapy.

1. To cause permanent, irreversible improvement in deficient patients, helping them to become "themselves", helping them find their meaning in life;

2. Open, put into action, liberate the hidden reserves of patients, which will help them to adapt much better to social and moral activities;

3. To help defensive patients, on the basis of a strengthened creative individuality, to steadfastly and productively enter teams - work, study, household, etc.

5. Individual and group forms of work according to the Bourno method.

In the practical application of creative self-expression therapy, Bourno distinguishes two acceptable forms of work - individual meetings and work with open groups in the outpatient clinic. The individual form allows the doctor to enter the world of the patient, learn about his intimate experiences, clarify with him the question of his well-being and mood.

The group form enables the patient to visually see himself, his character, his spiritual values, his creativity in comparison with all this in 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 other images of experience and behavior, which in itself is therapeutically valuable.

6. A little about creative therapy works of art.

While engaging in group therapy with inpatients and outpatients, Bourno most often used the following specific types of creativity therapy - writing stories and essays, creative photography, graphics and painting. As he points out, this is the minimum that a doctor must master in the sense of his own creativity. encouraging patients to work. It is important to remember that the doctor does not aim to become writers, photographers or painters. He only has to learn to reveal his spiritual individuality to his patients, to give them an example of communication through creativity. The less skill in the work of a doctor, the easier it is apparently for him to inspire patients with the courage to take the first step. Of course, a doctor is required to have a clinical and therapeutic understanding of all types of creativity for differentiated therapy of patients with different personal inclinations and abilities, that is, a doctor engaged in creative therapy must first of all be a good clinician. So, abstract painting, symbolism in prose and deep empathy with music are closer to schizophrenics. And psychasthenics, with their "withered" sensuality and innate solidity, are more understandable in the language of realism. For them, it is necessary to reveal the immediate joy of being, the bright colors and sounds of life. For defensive patients who are unsure of themselves and their abilities, it is often important to emphasize freedom, lack of limits, in order to stimulate the creative process.

Therapy with graphics and painting is possible without the help of the lessons of a specialist artist, because its goal is not to create true works art, and in an effort to find out, to emphasize their individuality with a brush, pencil, felt-tip pen and paints.

Stormy highlights such mechanisms of therapy with graphics and painting:

Drawing can be as accessible to the patient anywhere as writing in a book, and it often brings the same instantaneous symptomatic relief of emotional tension as keeping a diary;

The patient who constantly draws involuntarily, out of habit already, looks closely at the colors and lines around, and thus constantly finds out his spiritual individuality and "attaches" to the environment;

Writing with colors, mixing colors, drawing with fingers and palms on a large sheet sharpens, "ignites" the faded sensuality of defensive patients and contributes to an even greater "binding" them to life;

Therapeutic and creative drawing in a group on a given topic, for example, "The House of My Childhood", makes it possible immediately, after a few minutes of drawing, to see each member of the group in the drawings put together and, more clearly, oneself through comparison with others.

The doctor and the nurse must first of all show themselves in the group how easy it is to draw your own. This requires only an inspired desire to convey your experience, without thinking about how to do it. The meaning and refrain at the same time - we draw (write, photograph) in order to better see the world and ourselves in it. Stormy recommends doing all this with a condescendingly warm attitude towards the ineptness of draftsmen, briefly but seriously supporting timid patients drowned out by bashful cowardice ("Where am I!", "I have no imagination," etc.)

Topics for drawings and paintings, as well as topics for stories and essays, can be very diverse. The main thing is to express yourself. These can be "Landscapes of my childhood", "A flower that I like", "Animal that I like", "What I don't like", etc.

It is advisable to consider in a group of albums on ancient Greek, ancient Egyptian, ancient Roman art, so that patients can find out what is more consonant with them, where each of them is closer in their own characterological manner of drawing.

Often it is necessary to help patients get out of the formalistic "cages" in which they have previously locked their spiritual individuality. For example, defensive, unlike morally empty psychopaths, emasculated and mannered schizophrenics are filled with feelings of inferiority, moral concerns, they have something to say to people warmly, from the heart. However, fearing to be hurt, some of them go into spontaneous creativity in the aesthetically cold formality of the image, copying other people's paintings, and these mask fences not only hide their torment from people, but exacerbate mental tension, make it difficult to communicate with people. In such cases, it is necessary to help the patient work in his own way, sincerely, easier. more spiritually, telling exactly about their own innermost experiences.

Sometimes the patient needs to be "led" into drawing or writing out of his special, lively interests. So, for example, a patient, engulfed by ancient historical reflections, begins to draw mammoths in the midst of primitive nature.

Reading literature about the types and genres of fine art, about performance techniques and materials often helps to reach out for graphics or painting. That inquisitive, absent-minded, defensive patient, having learned that the pictures spiritually close to him were painted in pastel, having seen pastel crayons in the group for the first time, tries to draw with them and gets carried away.

Psychasthenics without musical ear and interest in music, it is shown to combine listening to music with drawing pictures, with viewing artistic slides that are consonant with this piece of music. After all, a psychasthenic tends to concretely imagine what is happening there, "in music". creative images, which at the same time arise, are not just interesting - they are healing. It also helps to understand music and empathize with it and reading memoirs about composers.

Defensive schizoids often perceive music without any ideas - this is how the soul itself sounds. For a schizoid, on the contrary, parallel classes will interfere with listening to music, distract and even annoy.

Based on his own experience, Bourno suggests the following systematics of musical consonance depending on the clinical groups of patients:

Defensive cycloids are usually consonant with Mozart, Glinka, Rossini, Strauss, Rimsky-Korsakov, Schubert, Kalman, Ravel, Stravinsky.

Defensive schizoids - Handel, Bach, Gluck, Haydn, Beethoven, Paganini, Liszt, Grieg, Chopin, Wagner, Tchaikovsky, Verdi, Shostakovich.

For psychasthenics - Vivaldi, Glinka, Saint-Saens.

Defensive epileptoids - Mussorgsky, Borodin, gypsy romances.

Patients who are more inclined towards music are usually more disposed towards poetry. However, Burno advises from time to time in any treatment group to listen to music while reading aloud poems specially selected for the melodies, thus trying to enhance the healing-musical experience with a poetic one.

7. About indications and contraindications for creative self-expression therapy.

This therapy is shown a wide range deficient patients.

An absolute contraindication is deep psychotic depression with suicidal motives. The stay of such patients in a group of people who express themselves creatively can exacerbate the feeling of depressive hopelessness, being turned off from life and pushing for suicide (including through preparation for leaving life thought out with the help of diary entries).

Defensive low-progressive schizophrenic cases are also considered a contraindication, when patients persistently report that they are becoming more and more “fragile”, vulnerable during the treatment, the treatment awakens joyful hopes - and only the “blows of life” are more painful from all this. The houses are so bad, so gray, coldly indifferent. "It would be better not to know this contrast!"

A contraindication (relative) is the delusional and overvalued mood of patients with a tendency to delusional interpretation of the doctrine of the typology of characters to the detriment of the patient and the people around him. As well as various psychopathological states that are opposite in their content to defensiveness: hysterical and epileptoid psychopathy with aggressive tendencies without any feeling of inferiority.

Separate moments of therapy with creative self-expression Burno advises using a district psychiatrist and any medical doctor in the work.

Therapy with creative self-expression also has its psychohygienic forms in a healthy everyday life. This is quite relevant with modern respect for any creativity, with the current prevalence of subclinical, including defensive, disorders, if necessary, mass creative enthusiasm to prevent a variety of mental disorders, alcoholism, drug addiction, substance abuse of the younger generation.

From Bourno's creative self-expression therapy, much can be learned for psychology and pedagogy with significant benefits for society as a whole.

Thus, we considered one of modern trends domestic psychotherapeutic school, based on a deep analysis of the treatment and correction mechanisms that manifest themselves in the course of visual and other creative work, as well as during the discussion of the created works in a group or with a therapist. We saw that due to the connection of intellectual and creative operations, psychotherapeutic contact is facilitated and the doctor's access to the patient's psychopathological experiences, which in turn helps the patient's associative and communicative adaptation, his greatest involvement in the life process, understanding and acceptance of himself and others, and, consequently, and to all medical process as a whole.

Creative Expression Therapy Burno

Developed by M. E. Burno (1989, 1990) and is 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 method of short-term therapy with creative drawing.

Name T. t. s. B. points to the connection of this method with creativity therapy (creative therapy, arts therapy), but at the same time the author also notes its originality: 1) imbued with subtle clinicalism, i.e. consistent with the clinical picture and the patient's protective forces manifested in it; 2) is aimed at teaching the patient the methods of healing creative self-expression with an awareness of the social usefulness of his work and his life as a whole. The purpose of the method is to help the patient to reveal his creative possibilities in general, and above all in his profession. Method - practical expression of the concept emotional stress psychotherapy Rozhnov, elevating, inspiring personality, addressed to 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 response, anxious experience of one's inferiority). There is also experience of its use in alcoholism, family conflicts, both for therapeutic, and for psychohygienic and psychoprophylactic purposes.

The main techniques of T. t. B.: 1) the creation of creative works (composing stories, drawing, photographing, 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, 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 culture close, consonant with the patient); 4) collecting items that correspond or, on the contrary, do not correspond to the individuality of the patient, in order to learn about the characteristics of his own personality; 5) immersion in the past by communicating with the objects of your childhood, looking at photographs of parents, ancestors, studying the history of your people or humanity as a whole for a deeper awareness one's own individuality, one's "roots" and one's "non-randomness" in the world; 6) keeping a diary or other kind of records with the inclusion of elements creative analysis certain events, works of art and science; 7) correspondence with a doctor whose letters are of a psychotherapeutic nature; 8) teaching "creative travel" (including walks along the streets or out of town) in order to identify the patient's attitude to the environment and form his ability to analyze this attitude on the basis of knowing his own personality; 9) teaching the creative search for the spiritualized in the everyday, the unusual in the ordinary.

The listed methods in the course of treatment are often intertwined with each other in the corresponding individual and group explanatory and educational work of the psychotherapist. They are implemented in a psychotherapeutic environment - in a special living room, which is lit with dim light, where music plays softly, tea is served and there is an opportunity to show slides, 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 a feasible study of other human characters, etc.). The duration of this stage is 1-3 months. Stage 2 - knowledge of oneself 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) homework of patients (the study of artistic and scientific literature), creation of creative works, etc.); 3) evenings, meetings psychotherapeutic group(8-12 people each) in the psychotherapeutic living room with reading aloud works written by patients, slide shows, discussion of patients' work (2 times a month for 2 hours). At the same stage of treatment, various psychotherapeutic techniques can be combined T. t. B. with other types of psychotherapy and drugs.

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. So, psychasthenic psychopaths, in accordance with their characteristics, usually need sufficiently detailed scientific and medical 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 apply their inherent autism in all sorts of useful activities (mathematics, philosophical and symbolic artistic creativity etc.). In the treatment of patients with epileptoid psychopathy, special attention should be paid to the moral realization of dysphoric tension; while approving the honesty and uncompromisingness of such patients, it is necessary to suggest to them in a friendly way that they will achieve much more in life if they try to be more indulgent to 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 with behavior in everyday life ( learn 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 as in individual work, and in groups (based on the existing 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, encouraging them by their own example, by the example of other patients, using the mutual interest of the members of the psychotherapeutic group in each other's creativity, and also discussing the question of consonance of their experience with the content of the works or works they create. famous painters and writers.

A few practical tips:

1. Ask the patient to read aloud in a group a story-memories, for example, about childhood in the countryside; at the same time, let him show the slides he has now made of those herbs and flowers that grew in his village in childhood; let him show his drawings, albeit inept, but touching with sincerity, memories of rural landscapes, the house in which he lived; let him turn on a tape recording of the birds singing that he heard there, etc. The patients, together with the psychotherapist, try to feel 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, to compare with his own characteristics, to tell and show in response something of his own on the same topic, to suggest to each other possible ways of creative (and therefore healing) self-expression.
2. On the screen in comparison - 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 vision of the ancient Egyptian. Where is more consonance with the artist? Not just what I like more, but where more of me, my character, my attitude. View, talk about how these two attitudes continue in the paintings famous artists of all times, in poetry, prose, music, cinematography, creativity of group members; what is the strength and weakness of each of these attitudes; in what, in what matters various synthonic and artistic people usually happily find themselves in life; how psychasthenic patients differ from them in all this, etc.
3. If at first it is difficult for a first-time patient to express himself creatively, you can ask him to bring to the group several postcards depicting paintings of artists or favorite animals and plants that are consonant with him; you can offer to read aloud a poem by your favorite poet in a group, turn on a piece of music that you like (that is, as if about him, as if he himself wrote, if he could).
4. The psychotherapist participates in the group own creativity revealing his personality (character) to patients. For example, he shows on a slide how he himself involuntarily “clings” to ominous clouds with a camera, expressing his feelings symbolically and autistically; or, if he is syntonic, he demonstrates slides depicting nature, how he naturally dissolves in the surrounding reality, without opposing himself to the fullness of life; or, talking about creative communication with nature, shows how he himself feels, understands his peculiarity, sincerely communicating with a flower consonant with him (“my flower”), how exactly this communication with a flower (including photographing it, drawing, describing in notebook) emphasizes its originality.
5. You should not load insecure patients with a frightening 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 and moral reflections and experiences that are so necessary in our time. It is important and useful to apply this "power of weakness", which is filled with Dürer's melancholy, depressed by doubts, in life. The patient should be helped to become more useful to society without breaking himself, without trying to artificially turn himself into his “bold”, “impudent” opposite (which is what many deficient patients initially strive for).

So, for example, in the group of creative self-expression, by common efforts we show the “modern Hamlet” that behind his everyday impracticality, indecision is an invaluable moral scrupulousness, the ability to philosophically, witty comprehend reality and tell many people about themselves and the wondrous dialectic of life as they themselves couldn't. Realizing that bravely aggressive, practical deeds are not his destiny, that, perhaps, Darwin, Tolstoy, and Chekhov would have been tormented by defensive experiences in the appropriate environment, the defensive patient will begin to respect this “Darwinian, Tolstoyan, Chekhovian” thing. Confirming his true worth, he will sooner learn to engage more resolutely in the necessary practical work.

One can give an example of how a patient, a gifted mathematician, but timid, distracted, physically fragile, awkward, literally tortured himself in physical education classes with complex exercises, despising his weakness and impracticality to tears. As a student, he continued to "break" himself while climbing, and soon died, falling into the abyss. Apparently, with the help of T. t. B. he could feel and realize that his bodily fragility, awkwardness can even be respected as an integral part of the mental and bodily constitution, without which there would be no his mathematical gift. The author of the method, M. E. Burno, emphasizes that in this he sees the difference between a truly clinical psychotherapy, which individualizes each case, and a psychologically oriented one, in which a situation could arise of turning 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 polyclinic, 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 take a significant place in the system of rehabilitation of the mentally ill. T. t. s. B. is contraindicated in severely depressed individuals with suicidal thoughts. In this case, in an atmosphere of inspired creativity, the feeling of dreary hopelessness, remoteness from people can even deepen.