Recently, I asked a friend in the industry for advice on psychological counseling. Psychology is broad and profound, and I have studied it for many days, but I only know a little about it, and I can't enter it. Fortunately, my friends did not give up, and I was tireless, so that I was at the beginning of my mouth. This record is here, as a coordinate on the way for individuals to know, or it may be helpful to other interested friends.

Psychotherapy "for the person, not for the disease"

The symptoms of a mentally ill person are like strong winds and waves on the surface of the sea, because there is a volcano erupting on the seabed. Medical intervention is only to smooth the wind and waves on the sea, while psychological intervention is to find the crater at the bottom of the sea and solve the problem completely.

You are a counselor, but first I would like to ask you what you think about Western medicine in the treatment of mental illness. I know that there are some counselors who are against medication, believing that drugs treat the symptoms but not the root cause, have side effects, and so on. What do you think?

I don't reject drug intervention this path. I don't think psychotherapy can do it all. For example, when a patient with schizophrenia comes to consult, I want to refer him; For patients with moderate depression or above, I also instructed him to cooperate with medication. From psychotherapy to medication, from community hospitals to specialized hospitals, it should be a synergistic system. Different patients, at different stages, can be treated with different treatment modalities or even a combination of treatments. This is the scientific attitude.

I often make the analogy that when a disease strikes, the symptoms of the patient are like the winds and waves on the sea. The root cause of the wind and waves is the eruption of a volcano under the sea. Medical intervention only smooths the wind and waves on the sea, and as for the eruption of volcanoes under the sea, it does not care. Psychological intervention is to find the crater under the sea and solve the problem fundamentally.

In this way, Western medicine treats mental illness and cures it, but it is only clinically cured and the symptoms are eliminated. Of course, this is also very important. If the waves are too rough, you won't be able to get to the bottom of the sea. Therefore, it is necessary to intervene with drugs first, and then psychotherapy can be started when the waves are a little smaller.

I don't want to pit medication and psychotherapy against each other. For people with mental illness, it doesn't matter what method they use, what matters is that they get better.

Western medicine treats mental illnesses based on the principle that most mental illnesses are caused by an imbalance of neurotransmitters in the brain, and medical intervention is to use drugs to regulate the chemical balance in the brain. I would like to ask, what is the mechanism of psychological intervention for mental illness? Does psychology admit that the physiological basis of brain disease is neurotransmitter imbalances?

Pharmacological intervention and psychological intervention belong to two systems, and the two paths are completely different, and one should not simply be used to apply the other. The scientific mechanism of the two is also completely different.

The neurotransmitter theory of Western medicine, I can accept. But I feel that Western medicine is aimed at disease; And psychotherapy is directed at the person. In addition to the symptoms, there is also an axis of personality, which is personality growth. Psychotherapy is a combination of both.

The principle of Western medicine treatment is now basically clear, and there is at least one direction. But the principle of psychotherapy is more complicated and cannot be explained. Sometimes it's just a feeling. It may be necessary to accumulate on your own. Accumulate to a certain extent, and you can see what is going on at a glance.

Here's an example. I once had a patient who was in a depressive state. But the pain point of letting her come to consult is that she is entangled in not knowing how to go in the future. It's a bit like obsessive thinking all day long.

Therefore, when I was consulting, I talked to her, but I couldn't talk about it. The first time I saw her, I had the feeling that she was very dry. A girl in her 20s is logically smart, but she is so dry and her vitality is draining. I realized that she might be depressed and told her, "You seem to be losing water." Hearing this, she burst into tears, and the emotions that had been frozen began to flow.

People with depression are already getting better if they are emotionally moving. But how this happened, I can't tell. I just built a relationship with her.

Does she feel that you have the right idea for her, so you can communicate and go on?

At least we're not going to turn around on those obsessions. Those tangled meaninglessness is her manifestation in a depressed state. If her depression is resolved, the specific problems she struggles with will be easier to deal with. It's useless to explain to her just on the level of thinking.

How to build up intuition

An important step in psychotherapy is whether you can build a good relationship with the client.

Speaking of which, I'm reminded of a story from Erickson. Known as "the greatest communicator of the 20th century" as a master of psychotherapy, Erickson spends a large part of his therapy efforts on establishing communication with his patients.

There was once a patient who had been hospitalized for many years and didn't talk to anyone, and no one could know what he was thinking. One day, while the patient was in the courtyard, Erickson came up to him, suddenly took off his clothes, turned them over and put them on again; Then, take off your own clothes and turn them over and put them on. At this moment, the patient smiled at him like never before. Then, Erickson patted him on the shoulder and said, "Now, tell me about you." From then on, the patient began to talk to him. As for the treatment, that's later.

This is a typical communication problem. You know, the medium of cognitive therapy is language. Cognitive therapy can be useful for people who have developed trauma after language skills have developed. However, people who have been traumatized in the pre-verbal stage, i.e., when they cannot speak, can only be treated in a non-verbal way.

I understand that Erickson's patient must have had a pre-verbal trauma, so it is useless for you to say anything to him. Erickson later became on the same frequency with him in order to establish communication.

So why did Erickson use the same frequency in the way of wearing clothes backwards? What does the reverse dress symbolize?

I don't know about this. Maybe because of his special experience, he will have some special talents. That's what I just said, maybe it's a feeling, an intuition. One of the most important aspects of psychotherapy is whether you can connect with the patient.

Psychotherapy is often based on subjective feelings. It's not as clear as a physiological issue.

If so, are you usually full of confusion at work? For example, you are at this step and don't know exactly what to do next? Are you not sure if you can cure the patient?

Of course, there is no standard answer to psychotherapy. We are not immortals either.

However, I have a colleague who says that a counselor should be like a tumbler. At the time of treatment, both of them collapsed, and it was not okay. At the very least, the counselor can show the client that the counselor can stand up even if the treatment doesn't work. This in itself is also therapeutic. In the same bad, uncomfortable state, he finds that you are still alive and knows that you can be alive too. This is an unspoken support.

You find out that you are not alone and that there are people with you, which in itself is healing.

Can you learn from the feelings, the intuitions you just mentioned?

We learn every day and learn from a lot of cases. As for intuition, I think everyone can have it, it's just that they don't usually develop it. Learn, experience, observe, and slowly you will form feelings.

Let's be more specific. There is a term in psychology called "embodied cog."

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Simply put, it refers to the strong connection between physiological experience and mental state, which can "activate" mental sensations. Vice versa.

I once received a visitor who was depressed. She was forcibly brought in, and she was very resistant and refused to speak. I wanted to have a relationship with her first, and in the process, I felt my chest hot and clogged, burning like fire. This is called embodiment. I understood that she had something she didn't want to express. At this time, it was useless to talk to her, because her emotional channels were blocked.

Can this be explained scientifically?

At first, I was surprised and shocked because it went against our educational background. But as the number of training and cases increased, my sense of this became clearer and clearer. In fact, we all have this ability, but we didn't pay attention to it, lacked training, and slowly disappeared.

What happened?

I said to her, "Your emotions are reflected in my chest. She said, "Yes, I'm so sick that I don't want to say anything." "That's when we started to build a relationship.

I said, "Then go back and vent your anger, and we'll talk about something else." "I suggested that she go find the person who made her angry and say what she had to say. She did what I said, and then there was a noticeable improvement. I'll be able to talk to her again.

Childhood trauma and loss of affection

A person's childhood trauma, covered by layers of defense, is finally broken down and manifests itself as a psychological disorder.

At this point, I still want to ask: Does psychology recognize the physiological basis of brain diseases? For example, as you just said, a person's childhood trauma is covered by layers of defense, and finally it is finally broken down and manifested as a psychological disorder. At this time, will there be physiological changes in his brain? That is, will there be a physiological basis for the psychological disorder he exhibits?

The two are not contradictory. Psychology in no way denies the social and physiological foundations. When a person is sick, there will be internal and external factors.

Let me give you a more typical example, a case of bipolar disorder. He would beat his mother when he was sick and took medicine for many years. There are also several people in his family who are depressed. Slowly as the counseling deepened, I discovered that genetics is of course an explanation; But this family, starting from the ancestors, has no ability to love, and cannot give the next generation something to love. Each of these children has developed some protective skills; and then to the next generation, there are drug addicts, and there are other ways to compensate; And then in the third generation, there are depression, obsessive-compulsive problems, and so on. I think this family lacks warmth and the ability to love.

What do you mean in this case, the genes that are the material basis are just appearances, and the essence is the absence of feelings?

Or maybe it's a parenting style.

I also had a case of phobia. He is still not married. His symptoms were that he couldn't see blood, and there was a black spot on the ground, and he thought it was blood, and he would be very afraid. Later, I slowly realized that he seemed to be a little compulsive, but in fact he was developing in a delusional direction. On the one hand, he behaved very well-behaved and serious; On the other hand, I really want to be cowboy and romantic. He usually puts this aspect down, but when it comes to intimacy, anxiety and fear are expressed. In his family, his cousins and cousins are in trouble with their marital feelings. They all grew up with their grandparents when they were young, and there may be problems with their parenting style.

You just said "trauma" repeatedly. Does it mean that mental illness can be understood as the manifestation of mental trauma in childhood in adulthood?

Roughly yes. In fact, each of us will have trauma, big or small. There are also some micro-traumas. Some children are relatively sensitive by nature, coupled with the lack of response from their parents, and over time, it is not a matter for other children, and it may become a big problem for him.

Psychotherapy is systems engineering

Many children are depressed or bipolar, but it is actually a reaction to family problems in him. Home remedies may be effective at this time. If parents are not involved, it is difficult for children to really get well.

There are many schools of psychology, do you belong to the psychoanalytic school?

It can also be understood in this way. Psychoanalysis, in general terms, works at the level of the subconscious. It's more of a metaphorical approach to the problem. For example, depression is a metaphor for constantly attacking oneself, so there will be suicidal problems in extreme times. When the metaphor is cracked, that is, when it is conscious, or when anger is expressed, he gets better.

What other schools of psychology are there?

General psychotherapy mainly includes cognitive therapy, behavioral therapy, family therapy, psychoanalysis, etc.

What is Family Therapy?

Family therapy is a group psychotherapy model that is implemented for families, and its goal is to help families eliminate abnormal and pathological situations. Family therapy believes that personal change depends on family change as a whole. Family therapy does not focus on the analysis of the internal psychological structure and state of individual family members, but focuses on the interaction and relationship of family members, and explains individual behaviors and problems from the perspective of family systems.

Here's an example. I once had a home sculpting session. The client had a serious lesion on his back, but he couldn't tell what was going on. When I made a family sculpture for him, I found 6 people to play the role of 6 people in his family. These 6 people don't know what the relationship within his family is like, and can only follow their feelings. At this time, the person who played his brother suddenly felt particularly uncomfortable in his back. This feeling is completely inexplicable, even more inexplicable than psychoanalysis. It's true that the client has a problem with his back.

Another time, a friend of mine had a child with bipolar disorder in the United States. Because it was too far away, I suggested that he find a local therapist. So he found a family therapy. The first time the family therapist saw him, he said, "Is there anyone in your family who is cheating?" It is true that the family is a system, but the symptoms are manifested in the child.

Family therapy is to look at the family as a whole and discover the trauma of its members?

Almost. Many children are depressed or bipolar, but it is actually a reaction to family problems in him. Home remedies may be effective at this time. If parents are not involved, it is difficult for children to really get well.

Subconscious and hypnosis

Induce the client into a subconscious state, integrate the doctor's words or actions into the patient's thinking and emotions, and promote the person's latent ability, so as to produce therapeutic effects.

I know that in the school of psychoanalysis, there is also hypnotherapy. This is more mysterious, can you talk about it?

Hypnotherapy refers to the use of suggestive language to induce the client into a special subconscious state, integrating the doctor's words or actions into the patient's thinking and emotions, and promoting the person's latent ability, so as to produce therapeutic effects.

The methods of hypnosis can be divided into direct and indirect methods. The direct method is to put the other person into a sleep-like state through short words or gentle touches; The indirect method uses small bright objects or monotonous sound sources to make the patient stare, listen, or touch the head or limbs with a "hypnotic object", while the therapist repeatedly suggests that the patient is in a hypnotic state.

At this point, according to the patient's condition, it can be clearly pointed out to him in positive and positive terms that the symptoms will disappear; or conduct psychoanalysis to find out the psychological roots of its pathology. After treatment, the patient is woken up in time or prompted to wake up gradually.

How does the subconscious mind affect a person's mental state?

The subconscious mind refers to the part of human mental activity that cannot be recognized or not recognized, and is the mental activity process that has occurred but has not reached the state of consciousness.

Although the subconscious mind is imperceptible, the way it influences conscious experience is the most basic. At an early age, people passively acquire some ideas and unconsciously internalize these ideas into their "system". "How a child perceives, how he or she faces the world, and the little things that seem trivial to an adult, will profoundly affect a child's development and may later develop symptoms of psychosis," Freud said. "If there is a bad influence around the child, it will be imperceptibly hidden in the depths of the child's heart, guiding his attitude and approach to life.

A person does not have this kind of analytical ability in childhood, and hypnosis can use the subconscious state to find the source of bad psychological problems, make the person aware of the irrational or subconscious deep concepts that exist in themselves, and use the experience and analytical ability acquired in adulthood to make judgments on such concepts, so as to achieve the purpose of correction.

Is the hypnotized person asleep?

No, hypnosis is not falling asleep. The hypnotized person is very awake, even more awake than usual. Hypnosis simply puts the person under hypnis into a subconscious state so that it can be treated according to the specific situation. Erickson, whom we just mentioned, often has patients undergo hypnosis with their eyes open.

Hypnosis in the narrow sense is not sleep. Hypnosis is divided into shallow, medium and deep, and there will be two states: one is that the subconscious mind is open, but the consciousness is awake, only shallow and moderate; The second is that the consciousness is not very clear, which is deep hypnosis. Generally, we can use light to moderate consultation. If it is too deep, the patient's speech will be slurred and no further treatment will be possible.

If you are awake when you are hypnotized, doesn't that mean that you need the patient's cooperation?

All hypnosis is essentially self-hypnosis. If you refuse, no one will be hypnotized. Erickson is known as a master of hypnosis, only to say that he is more likely to bypass other people's defenses.

Is what the patient sees, hears, and feels during hypnosis real or not? You can think of it as an image that is used to guide the patient to vent their inner emotions. Of course, you have to be very cautious about doing so. It depends on timing. When the time is ripe, you can touch it, otherwise the effect will not be good.

Because it requires interaction with the patient. When he feels safe, he will disarm his defenses and interact with each other; He doesn't feel safe, and if you force him to go, he feels even more unsafe and will resist, which is called impedance.

Be in awe of the unknown

A scientific attitude, the goodness of nature, and professional knowledge are the most basic for a counselor.

In this way, psychological counseling is a very complicated and difficult matter.

Counselors also have a lot of times when they can't do anything. You need to feel what's going on, how you feel. A lot of times you don't feel it because the client is defensive.

Symptoms are actually an expression, a metaphorical expression. Patients who are unable to express themselves from normal channels will express themselves through the channels of illness. We need to reconcile with the symptoms, not resist them. So that it is not threatening.

In the doctor's profession, the more dry and timid you are, the less timid you are. You have to be in awe of the unknown, especially if you're dealing with a person.

As a counselor, the most difficult thing is to build a good relationship with the client. Counseling is not really about instilling my values in you, but about letting myself go and accepting you.

What are the most important competencies of a counselor?

A good psychological counselor must at least have a sound personality. Personal growth is important. So we're always learning, experiencing, supervising, and we're not going to stop. Self-growth must keep up, otherwise personal factors will be mixed in the work, such as a sense of value, a sense of achievement, and one's own complex.

None of us will be so perfect. It is impossible for a counselor to solve all of his problems, but at least he must have a clear idea of which part of himself will have symptoms. For example, if I have homosexual tendencies, I need to be aware of my situation and make necessary adjustments when counseling a client. If you are not aware of yourself, not only will you not be able to see the patient well, but you will also bring your emotions to the other person, which may bring him a second trauma.

To sum up: a scientific attitude, the goodness of nature, and professional knowledge are the most basic qualities for a consultant.

A disease itself contains the power to heal. This is a vivid portrayal of the road to recovery from depression.