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.
Lecture “Human Psyche. Functions of the psyche"
PSYCHE
Plan:
- The concept of the psyche
- Functions of the psyche
- Disturbance of Consciousness
Literature:
- Vygotsky L.S. Psychology. –M.: Publishing house EKSMO-Press, 2010.
- Danilova N.N., Krylova A.L. Physiology of higher nervous activity: textbook. University with a degree in Psychology. –M.: Moscow State University Publishing House, 2009.
- Leontyev A.N. Selected psychological works: In 2 volumes. T.2. /Ed. V.V. Davydova et al. – M.: Pedagogy, 2008.
- Maklakov A.G. General psychology. – St. Petersburg, 2008.
1. The concept of the psyche. Functions of the psyche.
We feel tastes, smells, see objects, experience emotions. Some of us have an absolute ear for music, others have a good memory; Some enjoy walking, others enjoy reading books. Why can we experience and feel something, why are we so different from each other? Something gives us all these opportunities. This is our psyche. It is the properties and functions of the human psyche that provide us with everything we see, hear, feel, and how we behave.
The psyche is given to a person from birth, but develops in the process of life. It develops depending on the experience gained and circumstances. We need the psyche to receive, combine, understand information about the world around us, compare it with our needs and develop the necessary behavior. The basic functions of the psyche provide a person with adaptation to different conditions, the ability to communicate, learn, and, if the need arises, to survive. All functions are closely related and interdependent, therefore the normal psyche is holistic, they ensure the interaction of a person with the environment.
Psyche is a reflection of reality by the brain, manifesting itself in a person in the form of mental phenomena.
All mental phenomena are divided into three groups:
1) mental processes;
2) mental states;
3) mental properties of the individual.
Mental processes
are divided into:
1) cognitive (sensation, perception, thinking, memory and imagination);
2) emotional;
3) strong-willed.
Mental conditions
are divided into: 1)
motivational
- desires, interests, drives, passions;
2) states of organized consciousness
(manifested in various levels of attentiveness and efficiency);
3) emotional
(emotional tone of sensations, emotional response to reality, mood, conflicting emotional states - stress, affect, frustration);
4) volitional
(states of initiative, purposefulness, determination, perseverance, etc.
Borderline mental states of personality also differ
– psychopathy, character accentuations, neuroses and states of delayed mental development.
Mental states can be short-term, situational and stable, personal.
To psychic properties
personalities include:
1) temperament;
2) personality orientation (needs, interests, worldview, ideals);
3) character;
4) abilities.
This is the traditional classification of mental phenomena, coming from I. Kant. It underlies the construction of traditional psychology. However, this classification suffers from an artificial separation of mental processes from mental states and typological properties of the individual: cognitive, volitional and emotional processes are nothing more than certain mental capabilities (abilities) of the individual, and mental states are the current uniqueness of these capabilities.
2. Functions of the Psyche
- Communicative – provides the opportunity for people to communicate with each other.
- Cognitive – allows a person to understand the outside world around him.
- The regulatory function ensures the regulation of all types of human activity (play, study, work), as well as all forms of his behavior.
Factors of mental development Factors of mental development
it is generally accepted:
- heredity (the ability of an organism to repeat similar types of metabolism and individual development over a number of generations);
- environment (the social, material and spiritual conditions of his existence surrounding a person);
- developmental activity (the active state of the body, manifests itself when the movement programmed by the body towards a certain goal requires overcoming environmental resistance).
There are different points of view regarding the origin of the psyche:
- Idealistic -
the mental (soul) in its origin is not connected with the body (the biological carrier of the soul) and has a divine origin; - Dualistic -
there are 2 principles: mental (ideal) and biological (material). These two principles develop in parallel and are to a certain extent connected with each other. - Materialistically,
the phenomenon of the psyche is due to the evolution of living nature, and its existence should be considered as a property of highly developed matter.
Vygotsky Lev Semyonovich (1896-1934) - Soviet psychologist, author of the work “THE HISTORY OF THE DEVELOPMENT OF HIGHER MENTAL FUNCTIONS.”
Vygotsky L.S. showed that humans have a special type of mental functions that are completely absent in animals. These higher mental functions constitute the highest level of the human psyche and are called consciousness. They are formed during social interactions.
Higher mental functions (voluntary memory, voluntary attention, logical thinking) are of a social nature.
- First conclusion
in the work of Vygotsky L.S. answers the question: “How do relationships with the environment differ between animals and humans?” and it sounds like this:
The environment acts on the animal, modifying it and forcing it to adapt to itself. Man acts on nature and modifies it.
2) Second conclusion
lies in the fact that
a person, having mastered nature, learned to master his own psyche, he acquired higher mental functions, expressed in forms of voluntary activity (only a person is able to force himself to remember the necessary material, to pay attention to something).
3) Third conclusion
lies in the fact that a person tries to master his behavior with the help of psychological tools. (Vygotsky L.S. called them signs).
Signs are
artificial means with the help of which primitive man was able to master his behavior, memory, etc.
The main conclusion of Vygotsky’s concept:
“Man is fundamentally different from animals in that he has mastered nature with the help of tools. This left an imprint on his psyche - he learned to master his own higher mental functions. To do this, he uses psychological tools (signs). The universal and most typical system of signs is speech.”
Four levels of development of the psyche of living organisms
1. Irritability is
a property that distinguishes living matter from dead matter.
Manifests itself in the forced activity of a living organism. The higher the level of development of the organism, the more complex the manifestation of its activity.
Plants have the primary form of irritability (for example: “tropism” - forced movement towards the light).
2. Sensitivity -
characterizes the general ability to sense.
A distinctive feature from irritability is that living organisms have the opportunity to respond not only to biological environmental factors, but also to biologically neutral ones. (Characteristic of more developed organisms: worms, mollusks - the ability to avoid harmful environmental influences).
3. The behavior of higher animals is
a complex set of reactions of a living organism to environmental influences.
The higher the level of development, the more complex his behavior. Learning ability.
4. Human consciousness is
the highest level of mental reflection and regulation, inherent only to humans.
Consciousness acts as a continuously changing set of sensory and mental images that directly appear before the subject in his inner world and anticipate his practical activity.
A person refracts all perceived information about the world around him through a system of ideas about himself and forms his behavior based on values, ideals and motivational attitudes.
Only humans have the highest level of mental consciousness!
CONSCIOUSNESS -
the highest level of mental reflection of reality, manifested by the individual’s ability to be aware of the environment, present and past times, make decisions and manage their behavior in accordance with the situation.
Conscious activity is one of the highest psychological functions. Without the participation of consciousness, it is impossible to imagine any completed complex action.
The disease can change self-awareness, in particular, disrupt the awareness of oneself as a patient or the understanding of oneself as a person, one’s “I”.
3. Impaired Consciousness
In clinical practice, two large groups
pronounced pathological states of consciousness:
- Darkness;
- Shutdown;
1) Clouding of consciousness
includes:
- Delirium-
violation of orientation in place, time and environment, provided that orientation in one’s own personality is maintained.
The appearance of abundant visual and auditory hallucinations, usually of a frightening nature, is typical. The visual image is often various zoopsies (rats, mice, snakes, etc.). These disorders are accompanied by psychomotor agitation: the patient experiences fear, anxiety, tries to defend himself, and flee. The sympathetic nervous system is activated (increased blood pressure, sweating, trembling, tachycardia). In an acute condition, the patient poses a certain danger to others. After leaving the state, a partial memory of the experience is retained. Delirium is most often observed in alcoholism; in everyday life it is classified as “delirium tremens.”
- Amentia (amentive state
ie
) -
observed in severe and long-term illnesses (infections, septicopyemia, etc.).
Orientation in the environment, in time and in one’s own personality is disrupted. The patient does not comprehend his surroundings; his speech consists of fragments of phrases. Often the patient is agitated in bed. The painful condition can last for a long time.
- Oneirod
(dream-like state) - characterized by incomplete, often double, orientation in place, time and one’s own personality. The patient seems to be immersed in a world of dream-like fantastic dreams: he is on other planets, in exotic gardens, etc.
Moreover, he is not the main character, but rather an accomplice, in contrast to the state of delirium, in which the patient empathizes with vivid visual and auditory deceptions, and builds his behavior accordingly.
The facial expressions of patients are characteristic: sometimes they are detached and sad, sometimes they are “enchanted.” The eyes are often closed or half-closed. If you try to make contact with the patient, he can talk about his dreams and at the same time give his name and room number (double orientation). Memories of the experience remain. Patients talk colorfully about the most acute painful disorders. Oneiric disorders of consciousness are observed in acute endogenous psychoses and some infectious diseases.
- Cmoderate state
reminiscent of the state of a person at twilight, when he sees only a small number of dimly lit surrounding objects.
In such states, consciousness seems to slide, attention stops only on individual phenomena. The patient is well oriented in the environment, his self-awareness is changed. Behavior is dominated by automated actions that are outwardly quite orderly. The patient gives the impression of a person deeply immersed in his thoughts and fenced off from his surroundings. Sometimes frightening hallucinatory delusional states develop: the patient runs in fear or attacks imaginary enemies. In such cases, he is dangerous to others.
The twilight state is observed in epilepsy and organic diseases of the brain. The twilight state occurs suddenly and can also end unexpectedly. It usually lasts from several minutes to several hours, less often days. The memory of the experience is not retained.
- State of ambulatory automaticity
also characterized by automated forms of behavior. Awareness of the environment and self-awareness are altered (as in half-asleep). This includes sleepwalking (somnambulism, sleepwalking) and trance - a violation of consciousness, in which the patient can perform purposeful actions, travel by transport during the day, go to another area
The state of ambulatory automatism ends as suddenly as it appeared. If, upon leaving it, the patient finds himself in an unfamiliar environment, then he cannot give himself an account of what happened.
- Disorder of self-consciousness, and
Or
depersonalization is
a painful feeling of alienation of one’s own personality, conscious and painfully experienced by the patient himself.
The body has changed (it has become large, small, heavy, light) and its usual layout (long arms, short torso, excessively large head, etc.)
In the clinic of internal diseases, loss of consciousness is predominantly encountered (from mild to complete).
2)
Switching off consciousness
includes:
- Nullification
(from Lat. pubes - cloud) - mild impairment of consciousness.
Consciousness becomes foggy for a few seconds or minutes, covered with a light cloud. Orientation in the environment and one’s own personality is not disturbed, memories of events after a painful disorder are preserved.
- Somnolence
(drowsiness) - a long-term (hours, days) state resembling drowsiness.
The orientation is not affected. More often this occurs against the background of neurotropic intoxication (poisoning with alcohol, sleeping pills, etc.).
Based on the depth of disturbance of consciousness, coma, stupor and stupor are distinguished.
.
- Stun
- a state of incomplete wakefulness, which is characterized by loss or disturbance of varying degrees of severity of the coherence of thoughts and actions, due to a severe disorder of attention, drowsiness. Patients are lethargic, inhibited, and do not immediately respond to questions addressed to them; intelligence is reduced, memory is weakened.
Stunning occurs in varying degrees of severity and is observed in diabetic hyperglycemia, lobar pneumonia, peritonitis, neuroinfections, anemia, typhus, etc.
- Sopor
(Latin “unconsciousness”) - a deep stage of stunning.
The patient is immobilized, it is not possible to evoke responses from him, with the exception of pain (withdrawal of the hand when painful stimulation is applied to it), and the reaction of the pupils to light. The response to speech is either weak or absent. After a short awakening (with mild stupor), the patient again falls into an unconscious state and does not remember the moments of awakening in the future. This condition is observed in severe infections, intoxications, and severe cardiovascular decompensation.
- Coma-
a state of complete loss of consciousness.
The patient has no reactions to stimuli (speech, pain). There is no sleep-wake cycle. Eyes closed. It is observed with further aggravation of the above conditions, as well as with severe traumatic brain injury.
- Fainting -
sudden loss of consciousness caused by short-term anemia of the brain (due to spasm of cerebral vessels).
Coma and fainting differ from each other not only in external clinical manifestations, but also in the reasons that caused them and the nature of the course.
In coma and deep stupor, in addition to impaired consciousness, other symptoms are observed:
- Disruption of the normal breathing rhythm ; in severe cases, breathing becomes chaotic, and depressed breathing may even be observed;
- Impaired reaction of the pupils to light
(impaired eye movements, observed when lifting the eyelids or floating movements, fixation of gaze).
Causes of impaired consciousness:
- Neurological (stroke, status epilepticus, brain tumors, head injury, etc.);
- Metabolic (diabetes mellitus, hypothyroidism, adrenal insufficiency, liver failure, etc.);
- Hypoxia (asphyxia, severe heart failure);
- Sun or heat stroke;
- Poisoning.
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.
Features of male psychology
Men are more concentrated, but the concentration time is very short, which is why representatives of the stronger sex, who have a clear goal in life, are so energetic and always achieve their goals. Their attention is not scattered on other goals.
At the same time, it is much more difficult for men to withstand prolonged physical and psychological stress. Men's thoughts have a clear direction. They find it difficult to switch from one topic to another. If men talk about cars, then another topic of conversation will be opened only after this one has completely exhausted itself.
