sulierebaze orientirebuli fsiqoTerapiis Sesaxeb
rezo korinTeli
ilias saxelmwifo universiteti
XX saukuneSi samamulo fsiqiatria da fsiqoTerapia ganicdida biologiuri mimarTulebis gadaWarbebul zegavlenas fsiqologiuri da socialuri faqtorebis nawilobriv zogjer ki sruli uaryofis xarjze.
fsiqiatriisa da fsiqoTerapiis ganviTarebis Tanamedrove etapze sul ufro meti yuradReba eTmoba aramarto fsiqo socialur aspeqtebs aramed pirovnebis sulier ganzomilebasa da pirovnebis zrdaze mimarTul midgomebs. amis damadasturebel TvalsaCino magaliTs warmoadgens fsiqikur daavadebaTa axali klasifikacia, romelic globalizaciiT gamowveuli fsiqikuri xarvezebis aRmofxvrazea mimarTuli da romelic mzaddeba msoflio fsiqiatriuli asociaciis mier da pirovnebaze mimarTuli fsiqiatriis saxelwodebiT iqneba cnobili.
misi ZiriTadi postulatebi da principebi Camoyalibebulia 2007 wlis msoflio fsiqiatriuli asociaciis regionalur kongresze SanxaiSi am asociaciis prezidentis J.E. Mezzich- is moxsenebaSi.
Ppirovnebaze mimarTuli fsiqiatria Psychiatry for the Person efuZvneba Semdeg principebs (Mezzich J.E. 2007):
1. igi mimarTulia pacientis mTel pirovnebaze mis rogorc avadmyofur aseve jansaR nawilze da aramarto mis avadmyofur nawilze;
2. mkurnalobis procesSi CarTuli unda iyos fsiqiatris Mpirovneba mTeli misi adamianuri resursebiTa da potencialiT da aramarto misi is nawili romelic abstraqtul-ganyenebuli, saWiro informaciiT aRWurvil teqnikosTan asocirdeba;
3. mkurnalobis procesi pirovnebaze unda iyos mimarTuli rac gulisxmobs imas, rom mkurnalobam xeli unda Seuwyos pacientis cxovrebis proeqtis ganxorcielebas, mis TviTrealizebas;
4. mkurnaloba pacientis pirovnebasTan erTad, samkurnalo procesSi misi aqtiuri CarTviT unda xorcieldebodes. rac gulisxmobs mkurnalobis procesSi pacientTan pativiscemiT aRsavse TanamSromlobas da mis daxmarebas.
Ees principebi aSkarad migvaniSnebs imaze, rom fsiqitria aRiarebs pirovnebaze mimarTul sulieri ganzomilebis momcvel models. A
antikuri da Suasaukuneebis medicina adamians ganixilavda holisturad anu pirovnebaSi aRiarebda biologiuri, fsiqo-socialuri da sulieri aspeqtebis Tanaarsebobas da daavadebis eTiologiaSi yvela am aspeqtis monawileobas.
Aam statiis mizania sulierebaze orientirebuli fsiqoTerapiis im ZiriTadi principebis ganxilva romelic aerTianebs am tipis FfsiqoTerapiis gansxvavebul mimarTulebebs.
Gcnebebis AaRrevis Tavidan acilebis mizniT pirvel rigSi unda mkafiod ganisazRvros sulieri ganzomilebis cneba, romelic transpersonalur fsiqologiasa da fsiqoTerapiaSi gamoiyeneba. misi fsiqologiuri definicia mas unda ganasxvavebdes rogorc religiur-konfesiuri sistemebis gansazRvrebisgan, aseve adamianis pirovnebis sxva aspeqtebisgan. igi Tanaarsebobs fizikur da fsiqo-socialur ganzomilebebTan da xasiTdeba J. Hiatt-is mixedviT (Hiatt J. 1986) Semdegi principebiTa da atributebiT:
1. aqvs hermenevtikuli da noeturi funqcia. igi ganekuTvneba pirovnebis im instancias romelic sazrisisa da mniSvnelobis, WeSmaritebis da sagnebisa da movlenebis arsis wvdomiTaa dakavebuli; romelic absoluturis, maradiuli realobis ZiebaSia da im faseulobebisadmi erTgulebaSi vlindeba romelTac pirovneba absolutur Rirebulebebad miiCnevs;
2. es sazrisi da mniSvneloba uxilavi da aracnobieri sferodan momdinareobs. fizikuri samyaro, misi suraTi da mis Sesaxeb warmodgena zedapiruli aRqmis Sedegia. xolo namdvili realoba eqstrasensoruli aRqmiT miiRweva; aq rwmena dominirebs “obieqturi Semowmebis” standartebze. es rwmena efuZvneba im darwmunebas, romelic Tvlis rom fizikuri realoba ar aris erTaderTi;
3. es sulieri ganzomileba ZiriTadad gancdaSi gveZleva da mas ufro intuiciuri, vidre cnebiT-logikuri, xasiaTi aqvs; is gulisxmobs arsebobis da yofierebis URrma, uSualo gancdas, mis wvdomas gonebiT da ara gansjiTa da abstraqtul cnebiTi azrovnebiT. amis gamo is mecnierebis mier aRuwerel da amitom subieqtur movlenad miiCneoda;A
4. is statikurobas moklebuli dinamikuri procesia da warmoadgens ufro uwyvet nakads, vidre struqturas. igi organuli mTelis moZrav nakads ufro asaxavs, vidre statikuri nawilakebis meqanikur urTierTobas da ganicdeba rogorc SedarebiT aradiferencirebuli energiis mdgomareoba;
5. es nakadi evoluciuria, anu miiswrafis srulyofisaken. gansxavavebiT adamianis fsiqo-fizikuri ganviTarebis adrindeli paradigmebisagan mas aSkarad teleologiuri xasiaTi aqvs;
6. sulieri ganzomileba vlindeba pirovnebis specifikur qcevasa da konceptualur sistemebSi. am gziT Cveni goneba zogjer cdilobs mis dakonktretebas. maTi specifikur Sinaarsze did wilad moqmedebs adrindeli, ukve gancdili gamocdileba, ris gamoc isini kargaven cocxal kavSirs da veRar asaxaven sulier realobas. isini universaluri procesis obieqtur manifestacias warmoadgenen da sulieri zrdis saSualebad SeiZleba iqcen. magram aq aris erTi saSiSroeba, kerZod, is, rom maTi dogmatizaciis SemTxvevaSi es obieqtivirebuli fsiqologiuri gancdebi sulieri zrdis ara mxolod saSualebad ganixileba, aramed WeSmaritebis saboloo instanciis saxes Rebulobs. Mmeore saSiSroeba maT sxva fsiqologiur procesebTan aRrevaSi mdgomareobs, rasac maTi gaqroba moyveba;
7. pirovnebis sulier aspeqts individze zemoqmedebis maintegrirebeli sinTezuri funqcia aqvs. is aerTianebs pirovnebis gancalkevebul nawilebsa da Tavs uyris gancdaTa fragmentebs da maT erT mTelSi aqcevs. igi, agreTve, aRiqmeba rogorc pirovnebis srulyofisa da samyarosTan misi harmoniuli urTierTobisaken mimarTuli mamoZravebeli Zala. sazrisisa da mniSvnelobis masazrdoebeli gamTlianebis es unari izidavs adamians da pirovnebac misken miiswrafis. amas aRwers erik eriqsoni me mTlianobis Ego integrity cnebaSi (E.Ericson 1959) da mas k.g. iungis centriskenversiis cneba Seesabameba (C.G.Jung 1966)
sulieri ganzomilebis fenomenologiuri gamovlena xdeba am sferosTan uSulo Sexeba-Sexvedris dros, romelic aris xanmokle da moulodneli da xSirad gamoucnobi rCeba. igi garkveuli wvrTnis (meditacia, locva) Sedegad miiRweva, an SeiZleba mZafr emociurad damuxtul da egzistencialurad mniSvnelovan situaciebSi (sikvdilis saSiSroeba) gamovlindes. am dros adgili aqvs cnobierebis Secvlil mdgomarebas, romlis drosac adamiani ganicdis droisa da sivrcis sazRvrebis an gafarToebas, an srul gaqrobas; paTosis da sixarulis, an Rrma neitralobis intensiur grZnobebs. am dros adamiani yofierebaSia CaZiruli. igi moculia arsebobiT da ara fiqriT am arsebobis Sesaxeb. es gancdebi gamouTqmelia sityvebis simwirisa da siRaribis gamo.
abraham maslous (Maslow A. 1968) Tanaxmad ordinaruli cnobiereba sagnebze dakvirvebisas axdens maT klasificirebas adamianis moTxovnilebebisa da interesebisadmi maTi mimarTebisda mixedviT. mag adamiani SeiZleba daewafos xelovnebis romelime nawarmoebs sakuTari codnis gaRrmavebis, an sxvebze STabeWdilebis moxdenis mizniT. magram, dakvirvebisas saganma SeiZleba adamiani mTlianad moicvas, igi daikargos mis mSvenierebaSi da ganWvritos igi yovelgvari analizis da klasificirebis gareSe. aseT SemTxvevaSi mSvenierebis uSualo gancda TviTmizans warmoadgens. amgvar mdgomareobas maslou being cognition-s uwodebs. (Maslow A.1954, 1968).
maslou aRwers agreTve e.w. pikur gancdebs (Maslow A.1954 1968). am gancdisas adgili aqvs dauinteresebel Wvretas (being cognition), romlis drosac Cven sagnebsa da adamianebs uangarod, yovelgvari piradi dainteresebis gareSe vuyurebT. am dros pirovnebas ukiduresi bednierebis gancda eufleba.Mam gancdebs adgili SeiZleba hqondes religiur-mistikuri, an esTetikuri gancdebis, SemoqmedebiTi aRmafrenisa da inteleqtualuri insaitebis da sxva dros. pikur gancdebs xSirad Tan axlavs sakuTari mes sazRvrebis dakargva. am dros adamiani sakuTar Tavs, Tavis identurobas droebiT iviwyebs.
yvela egzaltirebuli gancda rodi miekuTvneba pikur gancdas. magaliTad, sportsmenis sixaruli da egzaltacia didi gamarjvebis gamo ar warmoadgens pikur gancdas, radganac is aRiarebis moTxovnilebis dakmayofilebiT aris gamowveuli.
pikuri gancdisas aRqmuli obieqti ganicdeba rogorc unikaluri da dasrulebuli. igi aRiqmeba mzrunveli siyvaruliT da misi sxvasTan mimarTebisa da Sedarebis araviTari saWiroeba ar arsebobs.
pikuri gancda erTianobis tipiur gancdas warmoadgens, romlis drosac Cven sakuTar Tavs erTi mTlianis calkeul aspeqtad aRviqvamT, im mTlianis, romlis calkeuli nawilebi harmoniul urTierTkavSirSia erTmaneTTan. erTianobis am mdgomareobaSi yvela aSkara diqotomia gadalaxulia da Serigebul TanxmobaSi imyofeba. uiliam jeimss rom davesesxoT am dros samyaroSi arsebuli yvela dapirispireba, winaaRmdegoba da konfliqti, romelic yvela Cveni ubedurebis mizezia TiTqos erT gamTlianebul realobaSi lRveba. maslous dakvirvebiT, pikuri gancdebi rCeulTa xvedri rodia. isini xSiria, magram rigiTi adamianebisaTvis isini SeumCneveli rCeba. xolo TviTrealizebadi adamianebi maT gansakuTrebul yuradRebas aqceven.
sulieri ganzomilebis mqone adamianis axali modelis da reduqcionisturi samedicino modelis SeTanxmeba, maTi Tanaaraseboba garkveul siZneleebs qmnis. dasavluri mecnieruli midgoma im postulats eyrdnoba, romelic Tvlis, rom obieqturi dakvirveba SesaZlebelia, romelic aSkarad ganasxvavebs damkvirvebelsa da dakvirvebis obieqts da maT Soris gamyof zols aRiarebs. es midgoma samyaros absolutur drosa da sivrceSi meqanikuri kanonebiT moqmed manqanad aRiqvavs, romelSic nawilakebi erTmaneTisgan carieli sivrciTaa gancalkevebuli. miuxedavad imisa, rom kvanturi fizika da fardobiTobis Teoria abaTilebs da aqarwylebs am postulatebs mecniereba da medicina mainc eyrdnoba maT. subatomur da varsklavTaSoris doneze dro da sivrce absoluturi aRaraa, mizez-Sedegobrivi kavSiri linearuli araa, elementaruli nawilakebis nacvlad adgili aqvs procesebs, xolo materia energias warmoadgens.
samyaro warmoadgens uwyveti energiis moZrav vels, romelSic materia, am energiis kondensaciis gziT, ganuwyvetliv iqmneba, transformirdeba da SemdgomSi qreba. Aam samyaroSi nawilebi urTierTkdakavSirebulia, sadac damkvirvebeli,subieqti ganuyofelia dakvirvebis obieqtisgan. aqedan gamomdinare damkvirvebeli moqmedebs sakvlev obieqtze.
Tanamedrove mecnieruli hipoTezis mixedviT samyaro cnobierebisgan damoukideblad ar arsebobs. amitom nebismieri Teoria fizikuri samyaros Sesaxeb cnobierebis Teoriasac unda iTvaliswinebdes. siRrmis fsiqologiaSi aracnobieri warmoadgens gonebis da fsiqikis im nawils, romelzec evkliduri sivrce, linearuli dro da kauzaloba, subieqt obieqtis gansxvaveba ar vrceldeba da romelSic adgili aqvs obieqtTa identurobisa da urTierTcvlilebis ganuwyvetel nakads.
Kkvantur-fardobiTobis, fsiqodinamikuri da sulier modelebis Tanxvedra migviTiTebs imaze rom fenomenalur samyaros safuZvlad udevs energiis dinamikuri veli. aRmosavluri da dasavluri antikuri sulieri tradiciebi iziarebdnen am TvalTaxedvas da Tvlidnen rom xiluli samyaros safuZvelSi RvTaebrivi energiaa.
sulierebaze orientirebul fsiqoTerAPias Cveni me-s, TviTobis (Self), daavadebis bunebis, Terapiuli procesisa da meTodebis GANsxvavebuli xedva aqvs.
igi Semdeg principebs eyrdnoba:
1. Yyovel CvenTagans sulieri momwifebis, TviTrealizaciis (Maslow 1954) , individuaciis ( Jung 1966 ) unari aqvs;
2. sulieri simwife da zrdasruloba gulisxmobs Cvens identificirebas sakuTar autentur mes-Tan, TviTobasTan;
3. adrindeli fsiqoanalitikuri modelisgan gansxvavebiT, romelic me-s konfliqtur da nevrotul instanciad ganixilavda, sulierebaze orientirebuli modelis Tanaxmad Cveni autenturi Mme ukonfliqto, janmrTel, gamTlianebul centrs warmoadgens;
4. adrindeli fsiqoanalitikuri modelisgan gansxvavebiT, romelic mes funqcionirebas cnobier da aracnobier doneebze aRiarebs sulierebaze orientirebuli modelis mixedviT, Cveni ordinaruli me arsebobs da funqcionirebs cnobier, aracnobier da ufro Rrmad gandevnili autenturi me-s doneze;
5. Zveli modelisgan gansxvavebiT, romelic miiCnevs rom daavadeba gamowveulia konfliqtiT, axali modelis Tanaxmad, avadmyofoba gamowveulia autenturi me-sgan daSorebiT da masTan identificirebis gaZnelebiT;
6. mkurnalobis procesi mdgomareobs pacientis mcdar me-sTan ganSorebis, dezidentificirebis da autentur mesTan identificirebis procesis xelSewyobaSi.
mkurnalobis axali da Zveli meTodis SedarebiTi analizi mocemulia qvemoTmoyvanil sqemaze
Zveli modeli mkurnalobis axali modeli
Terapiuli procesi mimarTulia Terapiuli procesi mimarTulia konfliqturi nevrotuli mes autenturimesTan identificirebaze
adaptaciaze. rac xels uwyobs ordinaruli mesgan
dezidentificirebis process.
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fokusirebulia Terapia fokusirebulia ara daavadebaze,
paTologiaze. aramed ganviTarebisa da sulieri
srulyofis gzaze da am gzaze arsebuli
krizisis integrirebaze.
paTologiis cnebebiT operireba
sargeblobis momtani aRaraa. yvela
problemuri situacia ganixileba, ara rogorc
garTuleba da paTologia, aramed
rogorc sulieri zrdisTvis gankuTvnili
Semecnebis SesaZlebloba.
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Terapia ganixileboda Terapia mimarTulia cxovrebis autentur, rogorc qmedebaze, formebze, kerZod autentur realobaze
rogorc samuSao dafuZnebuli yofierebisa da qmedebis
procesi, mimarTuli nevrotul wvdomasa da swavlaze.
me-Si zrdasruli siyvarulisa
da Semoqmedebis unaris miRwevisaken.
------------------------------------------------------------------------------------------------------------------------------samkurnalo efeqti miiRweva samkurnalo efeqti ZiriTadad miiRweva
insaitis gacnobierebis Terapevtis da pacientis autenturi mes
empaTiisa da jansaRi urTierTobiT da meditaciuri cnobierebis
urTierTobebis damyarebis ganviTarebiT. agreTve insaitis empaTiis
gziT. da Terapiuli urTierTobebis gamoyenebiT.
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gancdebis Sefaseba xdeba gancdebisadmi meditaciuri cnobierebiT
grZnobiTa da gagebiT. midgoma - Rrma TanagrZnoba Tanaarsebobs
mijaWvulobas moklebul sulier simSvidesTan.
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Super Ego-s Serbilebas Super Ego ganixileba rogorc
aqvs adgili. usargeblo struqtura,
Canacvlebulia autenturiMme-Ti.
sulierebaze orientirebuli fsiqoTerapiis teqnikebSi yvelaze ufro mniSvnelovania Semdegi:
1. Terapevtis cnobierebis done misi sulieri simwifis xarisxi;
- Terapevtis sakuTar autentur me-sTan identificirebis unari da done;
- meditaciuri gacnobierebis done, romelic gulisxmobs sxeulis SegrZnebebis, emociebisa da azrebis srul gancdas, magram amave dros, maTgan dizidentificirebas, maTi gankiTxvisa da moqmedebaSi moyvanis (acting out) gareSe;
- mkurnalobis procesis ganmavlobaSi Terapevti ar unda iyos orientirebuli rezultatze, anu Terapevti ar unda cdilobdes pacientis “awyoba-SekeTebas”;
- mkurnalobis procesSi winaswari codnisa da gegmis ar arseboba xels uwyobs Rrma SemoqmedebiTi samkurnalo spontanuri procesis aRmocenebas;
- ganixilavs sulieri zrdis gzaze krizisul mdgomareobas da ara paTologias;
- Terapevts arasodes unda daaviwydes, rom is Tavisi pacientis msgavsia. Terapia urTierTaRmoCeniskenaa mimarTuli. igi TanamSromlobaze dafuZnebuli mogzaurobaa da ara avtoritarul urTierTobebze agebuli procesi, sadac fsiqoTerapevti warmoadgens avtoritets, romelic urCevs pacients da eubneba mas, Tu rogor unda moiqces.
amgvarad sulieri ganzomileba warmoadgens pirovnebis im aspeqts, romelic hermenevtikul-sinTezuri da noeturi funqciis matarebelia da romelic miiswrafis absoluturi WeSmaritebisaken, Tumca arcerT religiur sistemas ar miekuTvneba. sulierebaze orientirebuli fsiqoTerapia avsebs im xarvezs romelic warmoSva erTis mxriv, biologiurma fsiqiatriam da meores mxriv reduqcionistulma fsiqoTerapiulma midgomebma.
Reference
1. Eriksen E. identity and Life Cycle.Psychological Issues New York,international University Press.,Vol. 1 No 1 1959
2. Hiatt j. Spirituality ,Medicine and Healing Southern Medical Journal Vol 79 N 6 736-743
3. James W. the Varieties of Religious Experiences Newyork Longmans green and Co,1902
4. Jung C.G. Two Essays On Analytical Psychology. The Collected Work of Carl Gustav Jung Princeton NJ Princeton University Press,Vol 7 ,1966
5. Jung C.G. Conscious , Unconscious, and Individuation The Archetypes and the Collective Unconscious The Collected Work of Carl Gustav Jung Princeton NJ Princeton University Press,Vol 9 ,1966
6. Maslow A. Motivation and Personality (2 nd ed.) New York; Harper & Row 1954
7. Maslow A. Toward a Psychology of Being ( 2nd Ed.) Princeton ,N.J.:van Nostrand,1968
8. Mezzich J.E. Globalization and Psychiatry for the Person. WPA regional Conference/CSP Annual Congress Shanghai 2007
On Spiritually Oriented Psychotherapy
R.Korinteli
Ilia StateUniversity
Tbilisi Georgia
The article describes spiritual dimension of human experience and the main characteristics of spiritually oriented psychotherapy. It shows how spiritually-oriented psychotherapy differs from classical psychodynamic psychotherapy. The main features of spiritually oriented psychotherapy, its new model of self, therapeutic process and therapeutic techniques are discussed.
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