of something that does not exist.
So, in acute cases there are no problems with the beginning of the work, because the experience «strikes’ the energy circuit of a person or, rather, the contour of their feelings so much, that neither the patient nor the doctor finds it difficult to identify the «theme’ for work. The locus of experience also does not require long definition. The head «rips apart’ with the concerns, the chest is «pressed by resentment’, the fear «gathers all the power’ in one’s stomach, etc.
It is not so easy to determine the location of the «threshold’ and «sub-threshold’ experiences. In these cases, some tricks may be needed in order to find them and neutralize. Either it will be a subtle conversation, revealing the «zones of indifference’ of the patient, or something like what I want to describe as a special approach in the identification of hidden problems in the patient’s experience.
From the drawing
The beginning of ‘from the drawing’ is one of the favorites in my practice. The instruction to the patient is as follows: “Draw a symbolic figure of a person of squares, circles and triangles, the number of elements in the figure is 10”. If the patient has additional questions, it can be explained that the total number of elements that make up the figure is 10, but their quantitative ratio is arbitrary. It is advisable to draw without giving it much thought. It is possible to change the size of the squares, circles, triangles.
In some cases, I propose to color the figure and almost always to denote the age of the character. We will not consider the variety of options based on the constructive drawing of the person now. This is a separate topic. Let us examine only some cases of using this beginning. I was shown this test and some of the possibilities it offers by V. V. Libin15, to whom I am grateful.
The use of this test in somatopsychotherapy is different from Libin’s expert one, in which the quantitative ratio of geometric figures in the drawing is important to make the conclusion about the main problems of a patient and his personal style.
In our case, this task is used for a completely different purpose – therapeutic. The authors of the expert system recommend asking for five drawings of a human figure at once. In our ’therapeutic system’, this does not seem appropriate. The first drawing is the last one. It means that the state, genetically related to it, is immediately subjected to study.
Subsequent (post-therapeutic) products will be new, and again one picture will be enough to fix the change. I give importance to the age of the character (it is not practiced in the original test). I also use colors for this test.
Below there will be many specific examples of using the drawings. Now I would like to focus only on general issues.
The work with the drawings becomes relevant only after the obvious distortions in the patient’s condition are worked out. Psychotherapeutic communication goes into a new phase – the phase of cleaning the consciousness of ’polluting’ formations’ in a systematic mode. When the patient is generally calm and there are no other emergency topics for work today, then they get the task to draw a symbolic figure of a person of squares, circles, and triangles.
After the drawing is made and the age of the character is indicated, attention is transferred to the sensations in the body associated either with this drawing or (more often) with the age indicated near the drawing. «Where are the feelings associated with the age of N years? At the level of the head, chest, abdomen, or anywhere else?» As a rule, sensations are detected at the level of one of the mentioned zones and it turns out that they are associated with some experience, more often unpleasant, sometimes pleasant, but always significant.
When the first episode of work ends with the patient’s calmness, ’closing’ the old experience, an alternative, more productive response in such situations can be find. As soon as the cycle of work with a separate experience is completed, the same task can be given again – to draw a figure of a person from the already known elements. To give or not to give this task again depends on, firstly, whether the patient has enough strength to do another cycle of work, and secondly, on how much time is left till the end of the session. In case the patient is not tired and there is enough time left, work cycles can be repeated an unlimited number of times. Remarkably successful patients can work out up to 5—10 episodes per hour. But the general rule is one episode per a session.
I recommend paying attention to the description of this kind of work in the Chapter «The Case». There you can see the typical ’growing’ of person from session to session.
In conclusion, I would like to say that starting the recovery process with a constructive drawing of a human figure can help a lot in a systematic work through the patient’s problems during the psychotherapeutic communication. Using the drawings can help the patients to determine what was in the depths of their consciousness delaying their free development. They help to actualize the hidden experiences that seem to belong to the past, but, nevertheless, remain in the present and continue to have a negative impact on the patient’s life. It is difficult to overestimate the usefulness of drawings as an indicator of the patient’s condition when everything only outwardly looks normal.
In cases where the patient is experiencing significant anxiety and is clearly aware of their trouble, the use of drawings becomes unnecessary, even inappropriate. With all the sympathy for them, we must realize that they are the artificial means of obtaining material for the work.
Both in case of work from a conversation that reveals the actual experience, and in case of work from the drawing, the so-called ’principle of non-slipping’ works. The first mention of a significant experience is a sufficient reason to study it. Listening to the enumeration of the patient’s troubles is a useless exercise. To deal with their consequences is much more productive.
From the dream
The starting point for the work can also be a dream. Here is one example of the work “from a dream’ in more details, as no description of this kind is further expected.
The main idea is that any dream as a whole or its elements are provided with a specific charge or their combination. For every dream there is an equivalent in sensations at the level of the body. So, the question is: «Where is the feeling associated with this dream or the dream element?» For example, the patient’s respond is ’in the head’.
The dream of patient P. was determined by the experience of betrayal, and his feelings associated with it were in his back.
From heads to tails
Patient P. is twenty-eight years old. He is not married and lives with his mother. His father, abusing alcohol, died when he was fourteen. At the age of twenty-four he went through a difficult parting with his girlfriend who was waiting for him from to resign from the Navy. He gave up his Midshipman shoulder straps for her. But after his return from military service she decided to leave him. The patient took her statement about their break-up as a blow which caused much pain.
He tried to forget her. He started dating another girl he had been introduced to. Their relations were warm but without love, and their wedding did not take place. Because of that he was very upset, and everything began «to fall out of his hands’.
Being soft and deep by his character, he used to write poetry and paint in his youth. He was also interested in philosophy. But now he has not got any special interests. He complains about «lack of spirituality’ in his life. He says that he does not want to do anything. «There is no purpose in my life. I am waiting for some fairy godmother or social worker to come and help me rebuild myself. I am still a dime. But I was thrown from the heads to the tails,» P. sums up his sad story. Some time ago because of all that background he began to drink a lot of alcohol with his friends to ’feel better’.