When I was a student at the St. Petersburg IT University, for many years I had the idea to study some sections in medicine in order to better understand my health problems, and to study medicine right away in English. This idea shot very hard (despite the difficulties with the language at the very beginning), and after a couple of years I was googling exclusively in English, read webmd and medicalnewstoday, solved problems from the American analogue of the USE (Advanced Placement Psychology and Biology), used Amazon as starting point when choosing books, and also looked into The Merck Manual.
My impression is that in Western medicine, psychotherapy is based on CBT, and psychoanalysis has long since gone into narrow private practice. An experienced physician will NEVER recommend psychoanalysis as a treatment. However, when I began to communicate with my acquaintances from St. Petersburg (they are all fairly well educated and engaged in intellectual work), it turned out that 4 out of 4 (100%) believe that psychoanalysis is the basis (foundation) of psychotherapy. I had a very big break in the template and tried to figure it out ...
Immediately I apologize for the large number of grammatical and spelling errors in my text. I donated Russian for English to gain access to a wealth of knowledge and translate it for you.
Is psychology a science or not?
And that depends on what language you are using. The Russian word "psychology" carries a negative connotation and is usually associated with manipulation and deception, as well as with trash books "about nothing." And in the west, psychology is a full-fledged science based on mathematics (statistics), using an experimental approach and two dominant schools (behavioral and cognitive).
Back in school, I began to deeply think about what was wrong with psychology. I had depression with a seasonal pattern, and I hoped to master psychology on my own and figure it out myself. I reflected a lot on my thoughts and noticed that if you think in different ways, you can successfully regulate your mood. You can also measure mood numerically (on a scale from 0 to 10), measure BEFORE and AFTER some activity, and then mathematically process these results and draw conclusions about the effectiveness of the approaches based on the average values. I have invented something like a primitive CBT, where every morning I go through a special leaflet with questions, remember negative thoughts and reformulate them into positive ones. This was in 2013 and I remember how my quality of life improved.My goal is to learn English someday and find a field of psychology that has thought exercises.
Psychology as a University Subject
In 2019 I decided to try to study psychology in more detail and found the Canadian course " Introduction to Psychology " on the cursor. A very good and high quality course, voluminous and interesting at the same time. I was wondering how psychology can be a "subject" at the university. I completed the course in about a month and a half, and learned a lot, a lot, from clinical and cognitive psychology, to an introduction to neuroscience and the principles of memory. A very clear and clear picture of what psychology is like has formed in my mind. I highly recommend this course as he perfectly dot the i.
As for psychoanalysis, it is only in the chapter "History". Steve Jordan (lecturer) first introduces fundamental concepts of psychoanalysis that seem quite amusing, like anally holding and anally pushing personality types or the Oedipus complex. Then Steve said a set at once, which I will remember for a lifetime:
And as far as the effectiveness of psychoanalysis is concerned, ANY therapy will be more effective than no therapy. Especially for patients with big wallets.
It turns out that there is no point in paying 3000 rubles per hour for a "specialist" - psychoanalyst. You can just as effectively take a supportive psychologist for less money, and you can also find people on Avito who are ready to communicate with you and support you in difficult times for a rather modest amount. This is if you have no friends.
The lecturer also noticed that the basic concepts of psychoanalysis were taken by Freud from the air and by their nature we cannot experimentally test or prove them. It is very reminiscent of religion when a certain set of postulates is given without proof and for taking on faith.
In my social circle
Actually, I began to ask my acquaintances what they think about psychology in general. It turned out that among all my friends there is not a single supporter of CBT (!!!). I managed to convert 2 out of 4 acquaintances to the CBT Party and now I have them, but then it seemed like some kind of madness. I began to feel like a CBT cultist, which is wonderful in practice and allows me to improve my quality of life. I took the Beck Depression Test on a regular basis and saw that mood can be quantified. I started practicing the exercises from David Bjorn's book Mood Therapy. Clinically Proven Ways to Beat Depression Without Pills... At that time, it had not yet been properly translated into Russian, and I read it in English, and I did the exercises in it too, and it went well. I also developed an android app to do these exercises on my smartphone and track them. I had 3 powerful CBT series for several months (late 2018, early 2019 and late 2019). By the end of 2019, I managed to learn to live even better than my healthy friends. I measured their Depression Index and mine, which dropped to zero for a short period of time. True, if you do not do them, then he usually returns to the level of mild depression, but all the same, these exercises leave a powerful imprint in the mind and in some aspects "switch" the work of the brain.
This leads to the first cool advantage of CBT - you can practice it completely on your own, and the entrance threshold is not very high (although at first it was not familiar). In the case of CBT, you quantify your mood (BDI test), and you can even graph and watch the depression index fall. Studies have shown that CBT can reduce mild to mild depression in just a couple of months in the average patient (see the graph at the very beginning of the book). It was this schedule that I got, and maybe even more favorable.
In the case of psychoanalysis, no average guarantees are given to you, and no measurements will be made, indicators will not be tracked. The sly psychoanalyst will tell you that you need to walk for at least a year to achieve at least some results, and at the same time they will not be guaranteed even for such a duration. This is very convenient and beneficial for the psychoanalyst, because it is possible for months to siphon money from the patient for the "analysis", while the result of the work cannot be controlled or verified. This creates an ideal environment for scammers. It is possible to draw analogies with some state projects of strict secrecy, which are hidden precisely because there is nothing to show, except for cutting.
In 2018, one friend (whom I later turned to CBT) also had mood problems and actively recommended me a psychoanalyst who is “good”, “cute”, “experienced” and “empathic”, and also charges 4000 rubles per hour ... I knew about CBT back then, but decided to go to the appointment. At the reception, I described my problems and said that I had heard about the scientific approach and measurements, about the dominance of CBT in Western medicine. I told him that I want him to analyze me according to the canons of psychoanalysis (or psychodynamics), and that I will test all the concepts and ideas that he puts forward by reading literature in English. And then he began to give the back. This was my first and last psychoanalytic session.
The situation with CBT in St. Petersburg
Clinic Scandinavia, one of the largest multidisciplinary clinics in St. Petersburg, puts CBT in the first place. Yes, order matters.
Now let's see what the Mayo Clinic offers us - one of the largest private medical and research centers in the world (located in the USA).
The first three types of psychotherapy are subtypes of CBT (CBT, DBT and ACT). Those. CBT is so popular that even its subtypes are mentioned as separate destinations!
It should be noted here that both clinics act rather "cunningly", with the aim not to miss out on profits from psychoanalysis, but at the same time not to impose ineffective approaches. Therefore, they mention psychoanalysis after CBT, because the psychoanalyst in the clinic will refer them to CBT if they have serious problems. And if the problems are not serious and the patient wants psychoanalysis because he saw him in TV shows and films a lot and also helped his friend, then let the clinic make a profit. This is a very subtle medical manipulation, and the wolves are fed and the sheep are safe. But, again, if you read specialized medical literature on specific problems (Depression, Anxiety), then there will be NO references to psychoanalysis. I also read a book on seasonal depression from Dr. Rosenthal, psychoanalysis is not recommended at all, and there is a whole chapter about CBT.
One of the strongholds of CBT in St. Petersburg is the beCBT center. I asked questions to Alisa Kovpak (She and Dmitry Kovpak are the founders of the center and adhere to Western canons, studied under Beck in the USA). Here's what she said about psychoanalysis in Russia:
When Otto Kernberg, the classic and creator of psychoanalytic therapy focused on the transference (conducting research on effectiveness), came to Russia, he said that in modern psychoanalysis it looks different in contrast to what was presented during supervision by domestic specialists. In Russia, specialists are more involved in undifferentiated counseling, but they believe that this has psychoanalytic roots. (....) Now the situation is different, the situation is psychoanalysts, trained to all standards and effective, but there are a couple of them ...
It turns out that most psychoanalysts sell themselves for the price of full-fledged specialists, but at the same time provide consulting-level services that can be obtained much cheaper. Here it is, deception! Cheating, which can pose serious risks to your health and future.
Where are the roots
I have long tried to figure out why psychoanalysis is so popular. One acquaintance said that his parents are ardent supporters of psychoanalysis, because psychoanalysis was taught as a subject in the 90s at the Faculty of Sociology of St. Petersburg State University (it may still exist), it was introduced into the educational program. In St. Petersburg there is even a whole institute of psychoanalysis (guess what year it was founded). I can forgive a lot of our education. I can forgive the obsolescence of the IT program. BUT, you cannot forgive the officials who for money (most likely) pushed into the TOP universities an outdated school of psychology that is not based on research (in normal countries it would be cut off for this reason) and is used in private clinical practice to siphon money.
I believe that psychoanalysis was very convenient in the 90s (and still) for three reasons:
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- Collapse and devastation in medicine. The average Russian does not trust the average doctor (and for good reason). From my own experience, I even in modern medicine in St. Petersburg saw a huge number of jambs (including very rough jambs, there will be separate articles about them). A doctor in the Russian Federation is not an authority for a Russian. If he directs to CBT, the Russian can still go to a psychoanalyst
Although, these are my guesses. If among the readers there are those who worked in this area in the 90s, let them expand on this topic in more detail.
How to learn CBT
My area of expertise in CBT is centered around depression and David Björn's great book, Mood Therapy. A clinically proven way to beat depression without pills . In 2019, it was properly translated into Russian, so I strongly recommend its deep study. This is if you have mood problems. CBT has been used successfully for many other problems, and ideally look for a self-help book that specializes in your problem. Or a specialist. Of course, in case of serious problems, you should contact a specialist.
On Habré, the topic of artificial intelligence is very popular, and the reader may have a question - is there a bot-psychotherapist? Of course, there are working prototypes, but they are of extremely low quality. At best, they only measure the Beck index and give a three-column technique (ABC model), and the rest are instructional videos of meditation practices that can complement but not replace CBT. I chatted with WoeBot and Wysa for a week and was not satisfied. They seem to give at best 20% of David's book, although there could be some cool chapter-by-chapter customization and a lot more CBT exercises and assorted test-measurement-charts instead of goofy videos.
If you have interesting and exciting personal stories about CBT or Psychoanalysis, you can send them to jandorwizard@gmail.com.