The authorship of the technique of holotropic breathing belongs to the now-living American psychiatrist of Czech origin Stanislav Grof, already mentioned in the Chapter “Psychedelic drugs“. After the legislative prohibition of the use of LSD in psychiatry, the Grof began to search for a legal alternative. Having tried many different methods of changing consciousness, he eventually stopped at a deep frequent breathing, which he called “holotropic” (holistic).

With a sufficiently long and intense deep breathing, the gas composition of the blood changes, carbon dioxide is washed out of it and oxygen saturation. Hyperoxygenation causes the practitioner effects similar to those arising from the use of LSD. In addition to the breathing technique itself, specially selected music and bodily manipulations by the teacher, techniques for overcoming pop-up muscle clamps and barriers are also used.

The session lasts about an hour and a half, the result is the ascent, the manifestation of unconscious material in the minds of holonaut. Grof believes that in this way it is possible to realize not only the deep personal experience, but also to go beyond it, in the area, which he calls transpersonal.

Here is how he writes about Grof:

“The content of holotropic States is often spiritual or mystical. We can go through a series of psychological death and rebirth and a wide range of supra-personal phenomena, such as feelings of unity and identification with other people, with nature, the Universe, God, discover something that seems to us memories from other incarnations, meet with bright archetypal images, communicate with ethereal beings and visit countless mythical lands. Our consciousness can be separated from the body and yet maintain its ability to perceive both the immediate environment and the most remote places.“

Stanislav Grof’s “Transpersonal vision»
The topic of transpersonal experience is very interesting and extensive, but beyond the scope of this study, those interested in this field of knowledge, I refer to the works of Grof, many of which are translated into Russian and available in electronic form. We are also interested in the practice of holotropic breathing in relation to an important topic for us, the treatment of depression.

Theoretically, if, according to Grof, holonaut experiences are equivalent to the effects achieved by the use of LSD, and also are safer, then this practice should have greater therapeutic value for the detection and study of hidden unconscious material, which plays a significant, as we found out above, role in the development of depression.

Reasoning in this way, I signed up for a seminar to a fairly well-known coach in one of the major Ukrainian cities. The seminar was held for three days, the program included two breathing sessions. Before the seminar, I told about my problem to the coach and received assurances from him that, at least, to eliminate the somatic manifestations of depression, holotropic therapy is the best. He told me his own story of getting rid of a chronic stomach ulcer with just one successful breathing session. During the session in his mind he had a vision of a medieval battle in which he participated and was stabbed with a sword in the area of the right hypochondrium, in right in place of the projection of ulcers on the anterior wall of the abdomen. Needless to say, after this experience, the pain stopped, and the instrumental study showed no signs of a disease resistant to therapy over the previous five years.

I must say that this story and everything I previously read about holotropic therapy, it is very reassuring, but unfortunately, I was waiting for another disappointment. I can’t blame the coach or talk about the ineffectiveness of the method itself, in any way. Just personally, I did not succeed. It was extremely difficult for me to physically withstand a given rate of breathing, especially given my pronounced asthenia. I lost my rhythm after a few minutes and could not return to it, despite all efforts. The same story was repeated at the second session, and as a result I had to come back empty-handed.

Holotropic breathing is a very interesting phenomenon worthy of careful study, but for its successful practice, it seems to me, it is necessary to be in good physical shape, which is rarely possible for a depressed patient. In addition, a certain inconvenience is the impossibility or, let’s say, the undesirability of independent practice. During a session you may lose control over their movements, disorientation in the environment, it can be easy to cause yourself some injury (without control on the part of the sitter?).

As for the analogy between the effects of holotropic breathing and LSD, which is carried out by the Grof, it is certainly an exaggeration. LSD gives almost instant access to unconscious material, which is stored for several hours, in the case of holotropic breathing, in order to gain such access, you have to make a lot of physical effort for at least an hour and as a result, if you’re lucky, to be able to open the door to the subconscious for just a few moments. The difference seems obvious to me.

Later, while doing primary therapy in the center of Dr. Yanov, I realized how naive were my ideas about the possibility of awareness of one traumatic episode from the past and the subsequent immediate recovery. But this is a story for another Chapter of the book.

Light therapy is indicated for people suffering from seasonal depression or seasonal affective disorder (ATS). Women between the ages of 20 and 40 are more likely to suffer from this disease. When ATS manifestations of depression are exacerbated in winter and subside in summer, with an increase in the number of Sunny days. It has long been observed that in the Northern latitudes, people are more likely to suffer from depression in the southern us States, this figure is 1-2% in the Northern reaches 10 %. According to some data, the prevalence of depression in Eskimos in Greenland reaches 80% of the total population.

The mechanism of exposure to light therapy is associated with the effect on metabolism in the body of melatonin, the hormone of the pineal gland, the secretion of which increases with the onset of darkness. The function of melatonin is associated with the regulation of human sleep, its secretion contributes to sleep, but at the same time there is an inverse relationship with the level of serotonin, the production of which decreases with increasing amounts of melatonin in the nervous tissue and Vice versa. As in other cases, biochemical disorders are not the only cause of depression, but rather serve as the basis for the emergence of a favorable background for its manifestation.

Exposing the patient to additional artificial irradiation with bright light, in many cases it is possible to achieve a positive result. Therapy usually lasts for a month, the effect is achieved in terms of several days to two weeks, the duration of the session from half an hour to several hours, depending on the response of the patient.

The convenience of this method is the possibility of its independent use, you can buy special lamps, up to 10 Lux, and practice at home. There are no side effects of the drawbacks – requires a certain amount of time, sometimes significantly.

Most recently, in April 2009, the results of a study by a doctor at the Falun psychiatric hospital in Sweden, Cecilia Rastad, were published. Dr. Rastad monitored 24 patients who received a course of light irradiation for 1.5–2 hours daily for 10 days. According to the data, more than half of the patients felt much better after the course, and they remained in good health for another month after receiving therapy. Characteristically, in Northern Sweden seizures of ATS is subject to 20 % of the population.

I personally have not tried light therapy, my depression did not differ seasonality, but the reviews of the method are good, as symptomatic therapy, it may be suitable for patients with appropriate manifestations of the disease. But we must be aware that in this way you can achieve only a temporary improvement in health, because the true causes of depression, the method can not have any impact.

Auto-training was proposed by the German neurologist Schultz back in the 30s of the last century, but was recognized and widely used in medicine only by the mid-50s. In fact, the method is a combination of meditation and self-hypnosis, Schultz took the most essential, in his opinion, elements of Indian yoga and adapted them for European perception, completely abandoning the religious and mystical component.

Auto-training is quite successfully used outside of medicine; for example, at one time it was part of the Arsenal of psychological training of many athletes. The use of the method allows you to quickly restore strength and overcome psychological barriers and achieve maximum efficiency from the physical capabilities of the body.

In psychiatry and neurology, auto-training is used for the treatment of various phobias and neuroses, in practice, this technique is an alternative to hypnotic effects, with the difference that the role of the hypnotist is the patient himself.

Like most other psychotechnical techniques, it is necessary to learn auto-training under the supervision of a specialist. The matter is not only that at wrong application of a method it is possible to worsen the condition (though small, but such risk really is present), but also in complexity of independent development, especially if there is no experience of similar practices in the past.

The whole process is divided into three stages: entering into a trance, pronouncing affirmations (suggestions) and exiting a trance. Perhaps the most important stage in the development of auto-training is the first, the depth of trance is usually less than the external suggestion carried out by a hypnotist. To enter into a trance, concentration is applied on the physical sensations of the body, alternately causing a feeling of heaviness and heat in the limbs, slowing breathing and heartbeat, coolness in the forehead, heat in the abdomen.

The development of auto-training takes time, rarely anyone can achieve tangible results from the first time. It is important not to force the process, to allow it to proceed naturally, with the manifestation of some perseverance and the correct use of technology the result is sure to be. We will not go into the details of the process now, they are described in detail in the relevant literature, and in any case, as I said, self-development of the method is not recommended, and an experienced coach in live communication will explain everything better than I can do it from the pages of the book.

After reaching the trance state, a mental repetition of the so-called affirmations, self-hypnosis formulas is carried out. In their preparation, too, it is desirable to consult with a specialist, there are a number of rules that should be followed. So, for example, it is not recommended to pronounce affirmations with a negative value, the prefix “not“. That is, instead of “I’m not worried“, it is better to repeat to myself “I’m calm.” In depression, affirmations are formulated in the appropriate direction: “ I’m calm“,” I’m good“,” I’m happy“,” good mood” and so on.

Out of the autogenous state should be gradually, positive affirmations are replaced by pronouncing the formulas of rest: “I rested“, “I am calm“, “I am full of strength“, “I will stand on the count of 3“; start a mental countdown and on the count of 3 or 5 open your eyes and exit the accepted posture for the process.

Conduct anger management ought to be sitting, when lying is a good chance to sleep and disrupt the process. The classic in auto-training is considered to be “the pose of the coachman”: the practitioner sits on the edge of the chair, the forearms of the hands are located on the knees, the hands hang down, the head is lowered. In such pose good relaxation, half-sleep is reached, but it is usually not possible to fall asleep at the same time. To do better in a darkened room, but not in complete darkness, as in the absence of vision, other senses become aggravated, which distracts and does not allow to achieve the necessary concentration. Complete silence is also undesirable for the same reasons, as long as there were no sharp stimuli.

Experts recommend to study three times a day, for 20-40 minutes. With the acquisition of experience, entering into a trance will take less time and, accordingly, the total time of each process will decrease. In addition, auto-training sessions contribute to high-quality rest of the body, as a result, the time allotted for sleep can be reduced, due to which the necessary time for training will be released.

The effectiveness of self-training is individual and largely depends on the suggestibility of a person. Good results can be obtained to overcome various phobias, including social, fear of unusual situation, public speaking. By relaxing you can achieve a temporary reduction in the level of internal tension, anxiety, insomnia. As for the treatment of depression, I am more skeptical.

In the initial period of training I received tangible progress in terms of overall improvement of health, reduce anxiety, increase activity, greater energy. But these phenomena were temporary. First, it is of course symptomatic treatment, the effectiveness of suggestion must be constantly maintained, and, stopping classes, you can quickly return to the previous state. Secondly, in fact, auto-training is the process of suppressing negative emotions by layering the inspired positive, problems and conflicts are not resolved, but only overlap with the constant repetition of affirmations. That is, there is neither a vacuum of suppressed energy, nor the cessation of its further accumulation, it is obvious that this can not be the best method to combat depression.

In order to achieve a sustainable result, positive affirmations alone are not enough, first of all, it is necessary to clear the consciousness, to give an exit to the accumulated tension. But even this does not guarantee getting rid of the problem, a conscious negative, although it loses a significant part of its negative charge, still remains in memory as a negative. In order to finally get rid of it, it is necessary to carry out the practice of replacing the negative state with a positive one, to create a positive emotional anchor to a traumatic situation. In this case, mental or verbal affirmations are not effective enough. Much better results can be achieved by using modern techniques of neurolinguistic programming, which we will discuss in the appropriate Chapter.

In my case, the rise from auto-training was observed for two months, after which the reality took its toll. In addition to short-term rest, I have not received any benefits from classes, too strong were my internal conflicts in order to be able to suppress them in this way. However, the skills obtained as a result of a variety of auditory training, extremely useful in the development of other similar techniques, which requires entering into a trance, such as qigong and transcendental meditation.

Summing up, we can say that, despite the presence of a certain positive effect associated with the training techniques of relaxation and deep rest, as well as a temporary reduction of disturbing symptoms, auto-training can not be a radical means to get out of depression. Too narrow focus of this method and the obvious limitations of the results have led to the gradual oblivion of auto-training as a means of Arsenal of modern psychiatrists and psychotherapists.

The term “psychedelics” was proposed by psychiatrist Humphrey Osmond and translated from Greek means “manifesting the soul” (psyche – soul, and delic – explicit, manifesting). These include preparations both chemically obtained, such as LSD, MDMA and DMT, and the active substances of various plants found in the wild: Mexican cacti, some species of poisonous mushrooms, vines in the Amazon jungle. Action psychedelics is primarily to change the usual perception of the world and achieve a special state of consciousness. This experience can be both positive and extremely negative, dangerous for the human psyche.

The history of medical use of psychedelics begins with the discovery and accidental use of LSD-25 by Swiss chemist albert Hoffman in 1947. While working in the laboratory, Hoffman spilled a negligible amount of the drug on his hand and, without suspecting anything bad, went home on his bike. Hoffman’s report on how he rode his bike through the streets of Basel under the influence of a large dose of LSD, became a legend. On the way he had a strong change in the perception of the surrounding space, there were fantastic vision, like a dream. The visions intensified and after he got home, Hoffman was scared he was going crazy. His neighbor he took for the evil witch, Hoffman seemed that his conscious possession of demons; deciding that is on the verge of death, Hoffman was asked to call him doctor.

By the time the doctor arrived, the crisis had passed, to his surprise, Hoffman felt himself full of strength and energy, as if reborn into the world. This state of health lasted all day. Hoffman wrote a report on his unusual experiences to the immediate supervisor, Dr. Arthur Stoll, whose son, a Zurich-based psychiatrist, became interested in studies of the effects of LSD in clinical settings. His report on the effects of LSD-25 on a group of healthy volunteers and psychiatrist patients, published in 1947, immediately became a sensation in the scientific world.

Initially, the LSD has high expectations regarding modeling them psychotic States similar to that experienced by patients with schizophrenia. It was assumed that this simulation will help to better understand the causes of schizophrenia, and to find effective drugs for its therapy. It soon became clear that the nature of the visions provoked by taking LSD had nothing to do with schizophrenic psychoses, and such studies were curtailed for lack of prospects.

But suddenly LSD was quite effective in psychotherapy of neuroses. The fact that under the influence of this drug as it eliminates the barrier between the unconscious and consciousness, greatly facilitates access to the displaced material that POPs up in the patient’s mind in large quantities in the form of awakened memories and unexpected insights. This description is undoubtedly a simplification of the mechanism of action of psychedelics, but for the purposes of our study it is enough.

Thus, psychodynamic processes occur much faster than traditional psychoanalysis, the doctor no longer has to break through the protective mechanisms of the patient’s psyche, which are weakened by the action of drugs.

Great work in the field of psychedelic therapy was carried out by the American psychiatrist of Czech origin Stanislav Grof. With this name we still have to repeatedly encounter in the course of our narrative, and so it makes sense to talk about it in more detail.

Stanislav Grof is an outstanding doctor and scientist who has devoted more than forty years to the research of unusual States of consciousness and spiritual growth, one of the founders and the most prominent representatives of transpersonal psychology. Some researchers compare it to the scale of contributions to modern psychology, with such giants as Sigmund Freud and Carl Gustav Jung.

Grof was born in Prague on July 1, 1931. From 1956 to 1967, S. Grof worked as a practicing psychiatrist, actively studying at that time the psychoanalytic model of consciousness and its application in the treatment of neuroses. During the same period he was actively studying psychoanalysis. In 1959, the Grof was awarded the Kuffner prize, a national Czechoslovak award given annually for the most outstanding contribution in the field of psychiatry. Since 1961, he has led research on the use of LSD and other psychedelics in the treatment of mental disorders in Czechoslovakia.

In 1967, as a fellow of the Foundation for support of psychiatric research (USA), Grof received the opportunity to undergo a two-year internship at Johns Hopkins University and subsequently continue his research activities at the Maryland center for psychiatric research. From 1973 to 1987, S. Grof lives and works at the Esalen Institute (big sur, California). During this period, together with his wife Christina, he develops the technique of holotropic breathing, an original method of psychotherapy, self-knowledge and personal growth, which we will discuss later in this book.

Grof is one of the founders of the international transpersonal Association (ITA) and has long been its President.

Currently, S. Grof is a Professor of psychology at the California Institute of integral studies. In addition to his main activities, he conducts training seminars for professionals (“Grof Transpersonal training”), as well as lectures and seminars around the world. Stanislav Grof is the author and co-author of more than one hundred articles and fourteen books translated into twelve languages.

The first acquaintance of Grof with the action of LSD occurred in Czechoslovakia in 1956. At that time, Sandoz, a company engaged in the industrial production of the drug, provided free samples to psychiatrists around the world in exchange for information about its effects.

Here is how about this experience tells himself Grof:

“I began to feel the effects of LSD forty-five minutes after taking it. At first it was a slight malaise, dizziness and nausea, then these symptoms disappeared and were replaced by a demonstration of incredibly colorful abstract and geometric visions, alternating in front of my mind’s eye with the speed of pictures in a kaleidoscope. Some of them resembled exquisite stained glass Windows in the medieval Gothic Cathedral, and others – Arabesque Muslim mosques. To describe the finesse of these visions, I would compare them to Scheherazade’s “a Thousand and one nights” and the stunning beauty of the Alhambra and Shanda – these were the only comparisons that came to my mind at the time. Today I am sure that my psyche has somehow generated a wild set of fractal images, like graphic images of nonlinear equations, which can give a modern computer.

As the session went on, my experiences wandered around and around this realm of aesthetic delights and were replaced by an unexpected encounter and confrontation with my subconscious. It is difficult to find the words to this intoxicating Fugue of emotions, visions and illuminating insights concerning my own life and existence in General, which suddenly became available to me at this level. It was so profound and overwhelming that it immediately overshadowed my earlier interest in Freud’s psychoanalysis. I couldn’t believe how much I’d learned in those few hours. A breath-taking feast of colors and an abundance of psychological revelations – they would be enough in themselves to turn my first acquaintance with LSD into a truly memorable event.

This day marked the beginning of my radical divergence from traditional thinking in psychiatry and the monistic materialism of Western science. I came out of this experience that touched my very essence, shaken by his power. At the time, I did not believe that the potential for mystical experience was natural to any human being by right of birth, and attributed it all to the effects of LSD. I felt that the study of unusual States of consciousness in General, and especially those caused by the effects of hallucinogens, as far as I can imagine, is the most interesting area of psychiatry. I realized that, under the right conditions, the conditions caused by the effects of hallucinogens-far more than just dreams, which play such a crucial role in psychoanalysis – really are, if you use the words of Freud, “the Royal way to the subconscious.” And, right there and then, I decided to devote my life to the study of unusual States of consciousness.”

Stanislav Grof, “When the impossible is possible»
His vast research experience on the use of LSD Grof summarized in the book ” the Field of the human unconscious.” In this study, Grof significantly expanded psychoanalytic cartography of the psyche, introducing the concept of transpersonal area, that is, part of the human consciousness, beyond his personal experience. The discussion of this undoubtedly interesting point of view is beyond the scope of this book, and I refer those interested in the topic directly to the mentioned work of the Grof himself.

We are interested in the information presented in the section “Psychodynamic experiences in LSD sessions“, in which the Grof describes the experience of its patients regressing under the influence of the drug in childhood and aware of long-forgotten early traumatic experiences:

“The experiences in this category come from the individual unconscious and from the spheres of personality available in the ordinary state of consciousness. They belong to the most important memories, emotional problems, unresolved conflicts and suppressed material of different periods of human life. Most phenomena occurring at this level can be interpreted and understood in psychodynamic terms. When deciphering, they require knowledge of the basic principles of the dynamics of the unconscious, given by Freud, and especially the mechanisms responsible for dreams, as well as familiarity with certain specific characteristics of LSD States and their symbolic language. Simple psychodynamic experiences take the form of re-living the emotionally intense (traumatic or beneficial) events of infancy, childhood, and later periods of life and re-examining attitudes towards them. More complex experiences are the embodiment of fantasies, dramatization of dreams filled with desires in reality, dreams taken from movies, and a complex mixture of fantasy and reality (highlighted by me. – Primas’. ed.). In addition, the psychodynamic level includes a variety of experiences that contain important unconscious material, appearing in a hidden form of symbolic masks, protective distortions and metaphorical hints.

Psychodynamic experiences are particularly common in the course of psycholytic therapy in mentally ill people and in uncontrolled LSD sessions in people with serious emotional problems. Much less often they occur in sessions of emotionally stable persons, whose childhood was relatively calm. In psycholytic therapy, psychodynamic experiences can predominate in several initial sessions, following each other, before being resolved and integrated, that is, included in the conscious experience, the underlying unconscious material is comprehended and the patient can move to the next level. In psychedelic therapy, such biographical material is worked out in the initial and final periods of the session. Sometimes psychodynamic experiences can predominate throughout a high-dose session, although preprogramming and the overall situation with this form of LSD therapy contribute to experiences at deeper levels of the unconscious. They will be described later (perinatal and transpersonal phenomena).

The phenomenology of psychodynamic experiences in LSD sessions is largely consistent with the basic concepts of classical psychoanalysis. If psychodynamic sessions were the only type of LSD experience, they could be considered as laboratory evidence of the main Freudian prerequisites. Psychosexual dynamics and fundamental conflicts of the human psyche, as they are described in Freud, with extraordinary clarity and vitality are manifested even in the sessions of naive newcomers, never subjected to psychoanalysis, not familiar with psychoanalytic literature and have not experienced any direct or indirect effects of this direction. Under the influence of LSD in these individuals experiencing a regression into childhood and even early infancy, revive in memory the various psychosexual traumas and complexes of sensations related to infantile sexuality, and confronts conflict, including the activity of various libidinal zones”.

S. Grof ” Areas of the human unconscious»
Remember the sentence I highlighted in the text. We’ll get back to him later.

In the Soviet Union experiments with LSD conducted by Kiev psychiatrist Maria Telishevska receiving convincing results in the treatment of patients with alcoholism. It is no secret that in the formation of alcohol dependence psychological factor is important. The results of the research Teleshevsky was published in the monograph published in 1964 by the publishing house “Medicine”.

Further developments are well known. The massive abuse of psychedelics and primarily LSD, which resulted in a whole “psychedelic revolution” of the 60s, could not but cause a response from the authorities, outlawed not only LSD and its analogues, but also imposed a ban on medical research with their use. Without casting the slightest doubt on the correctness of the decision in respect of restrictions on the mass availability of the drug, it is necessary to Express regret about the hasty prohibition of further study promising drugs in psychotherapy.

After reading this Chapter, perhaps someone will be tempted to experiment with psychedelics on their own. You do not need to do this in any case. First, it is illegal, and by purchasing such drugs on the black market, you should be aware that you are breaking the law and can cause serious trouble. Secondly, you can never be sure what exactly you sold under the guise of LSD or MDMA. No one guarantees the quality of the drug, the dosage is also uncontrolled. Moreover, under the name “ecstasy”, for example, sold dozens of tablets with a variety of chemical components, it may very well be that MDMA in the tablet is not at all and it consists of some absolutely you do not need psychostimulators, mixed with heroin.

And most importantly. Even applying yourself clean psychedelics and in the correct dosage, you run the risk of irreparable harm to your mental health. This is no exaggeration. The flow of unconscious material can be so strong and so shocking that the human psyche will simply not be able to bear it, to cope with the volume and intensity of experiences. The result may be an even greater flight into the disease, aggravation of all symptoms, until irreversible changes.

A prerequisite for therapy with psychedelics is the presence of an experienced specialist who can guide you through this test, to prevent, if necessary, a severe crisis, to return to reality, to help correctly interpret what is happening.

I believe in the future of psychedelic therapy. Even now we can observe the gradual rehabilitation of the medical use of such drugs. In Switzerland, since 2008, the use of LSD in the treatment of cancer patients and other terminal conditions is allowed. Dr. Mithofer in the United States provides MDMA-based psychotherapy to sexually abused women with very good results.

Let’s wait for the full legalization of psychedelic therapy, no need to engage in Amateur activities, the risk is too great. In addition, currently there are other, non-drug and completely safe methods of working with consciousness, which we will discuss below. One of these methods is auto-training.

It is generally recognized that the combination of psychotherapy with drug therapy is more effective than the use of each of these methods separately. They are not alternatives to solving the problem, but, on the contrary, complement each other perfectly. When conducting psychotherapy is of great importance the activity of the patient, his involvement in the process. Active participation of the patient allows him to develop certain behavioral skills and mechanisms of self-regulation, which teach to cope effectively with difficult life situations and increase the chances of a person not to fall into repeated depression in the future.

The most common currently and effective in the treatment of depressive disorders are three types of psychotherapy: psychodynamic, based on the work of Freud and his followers and the methods of psychoanalysis developed by them, behavioral therapy and cognitive psychotherapy.

According to the psychoanalytic concept, the cause of depression is unresolved and suppressed unconscious conflicts. This approach was most detailed in Freud’s book “Sadness and melancholy”. According to his ideas, the basis of depression is laid in infancy, when the child is taken from the mother’s breast. The resulting mental trauma and lack of adequate compensation cause a state of dissatisfaction and the development of self-esteem disorders, leading ultimately to the development of depression in adulthood. The views of Freud on depression was developed in the works of Melanie Klein and Donald Winnicott.

The merit of the psychoanalytic school is a detailed study of the core of depression and a correct indication of the role of unconscious factors in its development. The task of the therapist in the conduct of psychoanalysis is the discovery of repressed traumatic situation, the awareness of her patient, re-experiencing and healing. At the same time, the psychodynamic school pays insufficient attention to other sources of unconscious conflicts that are not directly related to the traumatic removal from the mother’s breast. Its big drawback is also the neglect of social factors and traumatic situations from the present, which can lead to the development of a depressive episode. Psychoanalysis is a long process, sometimes treatment can be delayed for many years, which limits the widespread use of this method in successful therapy of depression.

Behavioral psychotherapy appeared in the Arsenal of psychotherapists relatively recently, finally formed into a whole doctrine, it was only in the 50s of the last century, after which it quickly gained popularity and developed in several directions. Common to all types of behavioral therapy is the idea of human behavior as a result of training, which radically distinguishes it from psychodynamic concepts. Behavioral therapy is aimed at solving the current problems of the patient by changing behavioral patterns, passivity, rejection of pleasure, isolation from the environment.

The Creator of cognitive therapy is Aaron Beck, who has tried to combine the best of both approaches. Cognitive psychotherapy combines the work with the actual problems of the patient, and with his deep beliefs and perceptions. Beck believes that the cause of the depressive disorder is inherent in the patient’s worldview and interpretation of the events happening to him. The aim of cognitive therapy is to change the patient’s negative thinking to positive by careful individual work and detection of cognitive, mental errors in the patient’s reasoning.

Currently, the last two methods are often combined into one called “cognitive-behavioral therapy”. From the name it is clear that in this way an attempt is made to combine both approaches, correction and behavioral and mental errors. Perhaps it is no exaggeration to say that cognitive-behavioral therapy is the most common type of psychotherapy now. Its popularity is explained by the relative brevity, especially in comparison with psychodynamic therapy, in which treatment can last for years, and the resulting relative cheapness, a large number of empirical (experimental) data confirming its effectiveness.

On average, ten to twenty psychotherapeutic sessions are required to achieve some result. In my case, it took more than fifty. I visited a therapist for a year and a half, once a week, each session lasted about an hour. During the sessions, we discussed the situations that concern me from today’s life, possible options for their development and what effect they can have on my life.

In favor of cognitive-behavioral therapy, I can say that first of all, some effect is achieved due to the fact of communication with the therapist. If the latter manages to establish reliable contact with the patient, to create a trusting relationship, the very expression of accumulated fears, the opportunity to share them with someone in a safe environment, “pour out the soul” already leads to some subjective changes in the emotional status of the patient. In my case, it happened that way, after a short period of rubbing, I quickly opened up to the therapist and immediately felt some relief. Passing sessions after that was no longer a burden, on the contrary, I was looking forward to them. Also, therapy really helped me to deal with some hypertrophied fears, to realize that their consequences may not be as severe as I initially thought.

The thing is that, being in a depressed state, you do not delve into the essence of your problem, it scares and disarms you so much that you continue to engage in its mental chewing on a superficial level, do not take the next step, just feel that it will continue to be bad and scary. The role of the therapist is to take you by the hand and mentally go through this path, critically evaluate it, do what the patient is not able to do on their own. It is important to avoid any pressure on the part of the therapist, it should only help you to understand the hypertrophy of the problem by asking questions, offering to evaluate the possible variants of development of events.

As a result, your problem does not disappear, but its value, significance, if very roughly, decreases.cognitive-behavioral therapy does not eliminate the source of your pain, but teaches you to live with it. Well, that might be justified, too. Such therapy did not cure me, and I did not take less drugs, but in some situations I began to feel more confident, less fixated on certain problems that worried me at that time.

As for psychoanalysis, I have only a brief experience of this procedure, which I interrupted after several sessions, and I still believe that I did the right thing. For all the fidelity of the theoretical basis of the method, to its practical results, I am extremely skeptical. First, it repels the duration and cost of the process. Secondly, the method is extremely subjective, very much depends on the personality of the psychoanalyst, his ability to correctly interpret the signs that your subconscious mind gives.

I also have strong doubts about the treatment of the depressive disorder itself by psychoanalytic methods. It seems to me that psychoanalysis can be effective in cases where the cause of neurotic disorder is reduced to some one suppressed root episode. This occurs in the pathogenesis of various phobias and obsessive-compulsive conditions. If the therapist manages to get to the displaced episode and help the patient to realize and relive it, then there is a recovery or a marked reduction in symptoms. To illustrate, we can consider the example given by Freud in lectures on the introduction to psychoanalysis, I will allow myself to give this passage as a whole:

“Nineteen-year-old blooming gifted girl, the only child of her parents, whom she surpasses in education and intellectual activity, was an unruly and playful child, and in recent years without apparent external causes has turned into a nervous. She is very irritable, especially against her mother, always unhappy, depressed, prone to indecision and doubt, and finally admits that she is not able to walk alone in the squares and large streets. We will not deal with her difficult painful condition, requiring at least two diagnoses, agoraphobia and neurosis of obsessive-compulsive conditions, but will focus only on the fact that this girl has also developed a ceremonial bedtime, from which she makes her parents suffer. We can say that in a sense, any normal person has his own ceremonial laying down to sleep or requires compliance with certain conditions, the failure of which prevents him from falling asleep; he clothed the transition from a state of wakefulness to sleep in certain forms, which he repeats in the same way every evening. But anything that requires a healthy sleep environment can be rationally understood, and if external circumstances cause the necessary changes, then it is easily obeyed. But the pathological ceremonial is uncompromising, it is able to achieve the price of the biggest victims, and it is in the same way covered by the rational justification and at superficial consideration it seems different from normal only by some exaggerated carefulness. But if you look closer, you can see that the veil of rationality is too short, that the ceremonial includes requirements that go far beyond rational justification, and others that directly contradict it. Our patient as a motive for their night precautions leads to the fact that she needs to sleep and it should eliminate all sources of noise. To this end, she acts in two ways: she stops the big clock in her room, all the other clocks are removed from the room, she does not tolerate even the presence of her tiny clock on the bracelet in the nightstand. Flower pots and vases are made on the Desk so that they could not fall at night, break and disturb her in her sleep. She knows that all these measures can only have a seeming justification for demanding peace, the ticking of a small clock can not be heard, even if they remained on the bedside table, and we all know from experience that the uniform ticking of a clock with a pendulum never interferes with sleep, but rather acts sleepy. She also recognizes that the fear that flower pots and vases left in their place at night can fall and break themselves is unlikely. For other requirements of the ceremony she no longer refers to the need of rest. Indeed, the requirement that the door between her room and her parents ‘ bedroom remain half-open, the fulfillment of which she achieves by inserting various objects into the half-open door, it seems, on the contrary, can become a source of disturbing noise. But the most important requirements apply to the bed itself. The pillow at the head of the bed should not touch the wooden headboard. A small pillow for the head can lie on a large pillow only as forming a rhombus; head then she puts exactly along the long diagonal of the rhombus. The feather bed (”Duchent”, as we say in Austria), before it can be covered, must be whipped so that its edge at the feet became quite thick, but then it will not miss the opportunity to smooth this accumulation of feathers again.

Let me go around the other, often very small details of this ceremony; they would not teach us anything new and would take us too far from our goals. Do not lose sight, however, that all this is not so smooth. At the same time, it does not leave the fear that not everything is done properly; everything must be checked, repeated, the doubt arises about one or the other precaution, and as a result, it takes about two hours, during which the girl herself can not sleep and does not allow frightened parents to sleep.

The analysis of these torments was not as simple as in the case of the obsessive action of our first patient. I had a girl to do suggestive hints and propose interpretations, which every time she was rejected with a resounding “no” or accepted with contemptuous doubt. But this first negative reaction was followed by a period when she herself was engaged in the possible interpretations proposed to her, selected the appropriate thoughts, reproduced memories, established connections, until, on the basis of her own work, she accepted all these interpretations. As it happened, it is also more inferior in the performance of the obsessive precautions and before the end of treatment declined from just ceremonial. You should also know that the analytical work, as we now do, directly excludes the sequential processing of a single symptom until its final clarification. Moreover, sometimes you have to constantly leave one topic in full confidence that you will return to it again in another connection. The interpretation of the symptom that I am about to tell you is thus a synthesis of results that, interrupted by other work, take weeks and months to produce.

Our patient is beginning to gradually realize that during her sleep preparations, she removed the clock as a symbol of the female genitals. Watches, which can be symbolically interpreted in a different way, acquire this genital role due to the periodicity of processes and the correct intervals. A woman can boast that her menstruation occurs with the correct clockwork. But especially our patient was afraid that the ticking of the clock would interfere with sleep. The ticking of the clock can be compared to the pulsation of the clitoris during sexual arousal. Because of this unpleasant feeling she really woke up repeatedly, and now this fear of erection was expressed in the requirement to remove from herself at night running hours. Flower pots and vases, like all vessels, are also female symbols. The precaution that they do not fall and not break, therefore, not devoid of meaning. We know a common custom to break a vessel or plate during the engagement. Each one present takes a shard that we should understand how the waiver of claims for the bride from the point of view of the marriage custom to monogamy. Regarding this part of the ceremony the girls got a memory and some thoughts. Once as a child, she fell with a glass or clay vessel, cut her fingers, and was bleeding heavily. When she grew up and learned the facts of sex life, she had a frightening thought that on the wedding night she would not bleed and she would not be a virgin. Her precaution against the fact that the vase did not break, means, thus, the denial of the entire complex, associated with virginity and bleeding at the first intercourse, as well as the denial of the fear of bleeding and opposite to him the fear of] not to have bleeding. To prevent the noise for which it took these measures, they had only a remote relationship.

The main meaning of her ceremony, she guessed one day, when she suddenly realized the order that the pillow did not touch the headboard. Pillow for her has always been a woman, she said, and the vertical wooden backrest – man. Thus she wanted – by magic, I might add – to share a man and a woman, i.e. to separate the parents to prevent them before the marital act. This same goal she tried to achieve before, until the introduction of ceremonial, more direct way. She feigned fear, or used existing tendency to fear in order not to give close the door between the bedroom and the nursery. This requirement still remains in her present ceremonial. Thus she created itself opportunity eavesdrop on for parents, but, using this opportunity, she once acquired insomnia, which lasted months. Not quite pleased with the opportunity to interfere with her parents in this way, she sometimes made sure that she slept in the marital bed between her father and mother. Then the “pillow” and”headboard” really couldn’t connect.”

From this example, it becomes clear that the success of the interpretation of painful symptoms in psychoanalysis is very dependent on the professionalism of the therapist, requires patient work and really helps in a number of disorders lead to recovery. The problem is that in the case of depression, it is rarely possible to identify any one episode from the patient’s past, which served as the direct cause of the disease. There are many such episodes, they are superimposed on each other, increase internal tension, until it finds a way out in the symptoms of the disease. Obviously, a lot of work needs to be done to identify and work out, one after another, each such traumatic event. And of course, psychodynamic therapy does not help the patient to solve his problems with real events occurring in the present.

Data on the effectiveness of psychoanalysis in depression are contradictory and, at least for me, unconvincing. Effective and reliable tools for detecting suppressed unconscious material in the Arsenal of psychoanalysts today I do not see. But they existed and were actively used in the 60s of the last century. Such tools were psychedelic drugs.

Do you have depression?

Many people think that depression is a bad mood. This view is certainly wrong, if you are a living person, then you have inevitable periods of emotional decline and recovery. Depression begins when you lose the ability to cope with such downturns. If a healthy person is yelled at by the boss, his mood will certainly deteriorate, this is completely normal. Such a person will stay in a bad mood for some time, but then inevitably he will be distracted, will work this negative on an unconscious level and will live on. There may be situations when the" precipitate " will still remain for a long time (how to deal with this, I'll tell you below), but nevertheless this episode will not poison the rest of a healthy person's life.

When depression is different. The most common signs of its presence are causeless bad mood, loss of the ability to enjoy life and increased fatigue for at least two weeks. Under the wanton here refers to the lack of daily traumatisierung factor causing an emotional depression. It doesn’t mean that if you’re rude on the bus, you have a reason to fall into melancholy for the next two weeks.

It should also be borne in mind that depression can be masked, that is not manifested through bad mood, and any somatic factors, disorders at the level of organs and systems of the body. Such depression is also unpleasant because it is poorly diagnosed. This is exactly what happened in my case, six months I was treated for anything, but not for depression. During these six months, I managed to undergo treatment for thyroid insufficiency, gastroesophageal (gastro-esophageal) reflux, gastric erosion, irritable bowel syndrome, chronic myocarditis, giardium and a number of other diseases.

Fortunately, there are quite objective methods for diagnosing depression. To assess the presence and severity of the disease, specialists use several scales, such as the Hamilton, Beck or Gotland scale. All of them are a set of questions, for each of which there are several possible answers, estimated by a different number of points. It is believed that the assessment should be made by a psychiatrist, and this is correct. It is always easier for a specialist to objectively assess the accuracy of your answers, clarify unclear points, ask leading questions.

At the same time, if you suspect that you have a depressive disorder and think that you are able to answer the questions as honestly as possible, it makes sense to test yourself before you run headlong to a psychiatrist. A negative answer may not always be correct in the case of self-test, but a positive is a sufficient reason for a visit to a specialist.

For independent work more than others suitable scale Zang.

Zang scale for self-assessment of depression (ZDRS)

Zang scale for self-assessment of depression (The Zung self-rating depression scale) was first published in the UK and subsequently received international recognition. It is developed on the basis of diagnostic criteria of depression and the results of a survey of patients with this disorder. Assessment of the severity of depression on it is based on the patient’s self-assessment. The scale contains 20 questions, each of which gives an answer to the frequency of occurrence of a particular feature, ranked in four gradations: “rare”, “sometimes”, “often” and “most of the time or constantly.”

Method of application: before starting the procedure, the subject should be acquainted with the method of working with the scale. The scale is filled in by the subject, and the specialist does not take part in its filling. The time required to fill in takes a few minutes.

The total score is determined by the results of the answers to all 20 points.

How it all began

Analyzing now my past, trying to find the causes of depression, I understand that there is no one traumatic situation that led to the development of the disease. Undoubtedly, my childhood experiences played a huge role. I was quite a weak physically and sickly child, and although I’m still not fully aware of everything that scared and traumatized me in the deep past, the intensive therapy I went through at Dr. Janov Center in Los Angeles and months of practice of my method convinced me that the roots of the problem grow from childhood.

At the same time, in full accordance with the causes of depression, set out in one of the previous chapters, in my mind there were a lot of quite conscious traumatic episodes from the less distant past and even the present. All this tension grew like a snowball and did not find a way out, in the end the psyche had to not withstand such pressure and break. That is what happened in August 2002.

At that time, I only suffered from the flu and was still in the recovery period, was weakened physically, residual effects continued to manifest themselves. It so happened that in the same period I was under the influence of chronic stress associated with problems at work and difficult relationships with his girlfriend. Problems have not been resolved for several months, and if the complexity of the working order, I objectively could not have any significant impact, the solution to the problems in my personal life was not due to the blocks, beliefs, blinkers, if you like, that existed in my mind at that time. All this mental stuff accumulated for decades and did not allow me to breathe calmly and carefully analyze the emerging life situations.

One fine morning I woke up and was surprised to find that my heart was beating faster than usual, without any physical or intellectual stress. Without paying special attention to it, I went to work, by the end of the working day to heartbeat the expressed shortness of breath was added. This went on for a few days, but I was really worried when I started daily bursts and drops in body temperature, with nothing obvious associated and not following any sustainable pattern.

My medical education played a cruel joke on me. The emotional sphere at that time had not yet been touched, and I was looking for the cause of ill health in anything but a depressive disorder. By the third week, my condition began to bother me seriously, I developed severe asthenia, I was tired very quickly and could not concentrate on doing any, even the most simple work.

The trip to the therapist and the General examination revealed no abnormalities, except for palpitations. There was a suspicion of myocarditis, which was rejected after a special instrumental examination. The next stage was the elimination of hormonal disorders, a detailed analysis revealed a slightly reduced level of thyroid hormones, and the next stage of my epic began.

On the recommendation of an endocrinologist, I started taking thyroxine, the main product of the thyroid gland, with regular blood tests and monitoring of hormone levels. I must say that the process is not fast and we spent another month to fix the minimum violation that was found in me. Needless to say, it did not produce any results.

Since I did not receive adequate treatment, my condition continued to deteriorate, and now he added disorders of the digestive system. The first was a stable heartburn, after taking almost any food, it quickly led to the development of pain in the stomach and the emergence of erosion of the gastric wall. In addition to thyroid hormones, I started taking drugs to reduce the acidity of gastric juice and was treated with antibiotics for the eradication of Helicobacter pilory, a bacterium that causes stomach ulcers.

As soon as I heal one manifestation of the disease, as she found a way out in something else, now I had to deal with gastroesophageal reflux, an extremely unpleasant disease, manifested by the casting of undigested food and gastric juice from the stomach into the esophagus. Another series of examinations, unsuccessful drug therapy and the proposed surgery aimed at narrowing the diameter of the gastro-esophageal valve. All this against the background of continuous deterioration of the General state of health.

I understood that the operation would not solve anything and would not save me from suffering. It was necessary to find the root cause of the disease, and I went to London, for examination in Cromwell Hospital, one of the best private hospitals in the UK. By this time, I looked so depressed that, to the credit of my therapist, he didn’t have to exhaust me with numerous and unnecessary tests. First of all, looking at my hormonal tests and conducting an external examination, he immediately said that my thyroid is all right, and advised me to immediately throw out all my pills for hypothyroidism.

Then, after asking me in detail about the symptoms of the disease and the effect of the treatment (or rather, its absence), he was the first to utter the fatal word: “Depression”. In other circumstances, I would have been extremely upset by such a diagnosis, but by that time I was so exhausted that I was even glad to see him. Anything to get some certainty and the right treatment. I had no idea what was ahead of me. I was sick by this time for about six months.

What is mental health

How many times have you dreamed about going back to your "pre-depressive" emotional state? Return not at the cost of daily intake of a handful of pills, constant drowsiness, the feeling of a metal helmet, worn on the head, killed at the root of sexual desire, but really, so that without the help of medicines you can laugh when watching comedies, do not poison the life of others with your downcast, perform elementary work for an hour, not for a week. But if you think that's mental health, you're wrong.

Of course, against the background of your current state and what was before the depression, it seems a pipe dream and something completely unattainable, but remember, before the illness, you did not have to experience unmotivated anxiety, emotionally react to some little things and then regret your behavior, be afraid of public speaking and avoid noisy parties? Depression is a very unpleasant disease, but it gives you a chance to reconsider your life, beliefs and values, to uproot the emotional anchors that have settled somewhere very deep in the subconscious, to remove the blocks and restrictions imposed by someone, to get rid of bodily and mental clamps, to regain the ability to feel as you felt in childhood, when the colors were brighter, and the food tastier, and each new day brought a lot of new positive impressions.

Don’t stop at what doctors call “remission,” don’t agree to spend the rest of your life on a “maintenance dose” of antidepressants, it’s not real life, you have the right to demand more.

So what is mental health?

I would like to remind you once again that I do not pretend to be scientific and admit that my vision of some aspects of the problem may differ from the currently accepted medical paradigm. But I have a moral right to my point of view, after all, all these volumes of medical research, mountains of pills, and dozens of hours spent in the therapist's chair didn't give me the result I was able to come to on my own.

Antidepressants and psychotherapy were able to bring me to a relatively stable state, that is, I could go to work, with some very small degree of efficiency to perform their duties, to maintain some minimum necessary social relations with friends and colleagues. At the maximum for me therapeutic dosage of drugs I had panic attacks, which was already a great relief, increased mood, passed insomnia. But at what cost!

I wanted to sleep all day, about any productive work and the speech couldn’t be, I added 10 kilograms in weight, ceased to go in for sports, didn’t test any sexual attraction. For a long time I was sure that I was doomed to such existence until the end of my days, and internally already reconciled with it.

After I started meditative practices, which I will write about in detail below, my optimism increased, I was able to reduce the dose of antidepressants twice the maximum level, at some point I even completely refused to take them. But, unfortunately, this state lasted only a couple of months, the first stress at work drove me back into a deep depression.

But even at the peak of my emotional recovery, I realized that it was difficult to call it recovery. My mood was extremely volatile, I overreacted to the slightest stressful situation, slept badly.

And only now I understand what real emotional health is. This does not mean a constant good mood and the absence of any anxiety and excitement. This condition also refers to the pathological in psychiatry called “germanically”. You may have met such people in your life, I knew two of them, and both of them were scientists for some reason. They could talk and work for hours, almost days, never tired and never listened to anyone, always stayed in some elated euphoric state. At the same time, the lives of others they turned into hell, to communicate, and even more so to live with such people is absolutely unbearable, and they themselves are rarely happy and successful. I don’t think that’s something to aspire to.

By mental health, I mean something completely different. A person is healthy, if in the absence of any external influence his emotional state is stable, he feels balanced, with a slight deviation towards the positive, he is calm, but energetic and collected, able to concentrate on the task and at the same time get satisfaction from his work.

A person should get satisfaction from the process itself, whatever he was doing, to regain the taste of life, the ability to feel, to feel the world as it was possible in childhood. We all understand that the children’s brightness and freshness of sensations lost, and put up with it. But it shouldn’t be like this. To correct this state of Affairs, we first need to understand why this is happening, to discover the causes of this phenomenon of loss of a part of ourselves. About them we will talk in the next Chapter.