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You will become a human only when you will learn to see a human in another one. - A. N. Radischev


Practice on management






Priests from the Svjato Uspenskaja
Pochaevskaja Lavra (Monastery)
are visiting RC Choice

«Ideal parents» certainly wanted only the best for their child. Without any doubt they spoke correct words to him. But it is well-known – the relations which really exist in a family bring up a child, and the spoken words are only "scenery". Protecting from a feedback from world around or deforming it, parents have inculcated in their child steady belief in the difference from others, the superiority over them. He became alone, helpless and dependent on people. At the same time he lacks such necessary for a life understanding of generality, similarity with other people, abilities to overcome difficulties and a strain, abilities to limit infantile claims for the world. Now it is necessary for us to change it in cooperation with parents and train him valuable life along with people.

One of the basic conclusions of the state experiment of 1993-1997 was that the main obstacle for obtaining the result is narrowly medical approach to the addiction problem, so-called «medical model» treatments. This model is justified in case of the long experience of a substance abuse with expressed serious mental and corporal disorders. This model sharply limits our therapeutic possibilities in work with youth. Relations «the doctor - the patient» practically relieve the patient of responsibility for the behavior. In such case the doctor assumes overall responsibility. Besides, such approach practically ignores questions of motivation of the young man to change his own condition and do not consider character of his relations with people at all. Partner relations are required to have an effect. Searches of the most effective form of providing support to our patients have led us to understanding of the necessity to figure out features of his mental turn as deep, as it is possible. In our opinion, psychoanalysis gives such possibilities better than other ways. At the same time we do not consider that dialogue with the therapist in his office allows achieving qualitative positive changes. The former attitude and behavior will not disappear, if they are not replaced with others.

Not at once but eventually it became clear for us that determinative are not own psychotherapeutic positions but specifics of the patient and a therapy task. In other words, we use various receptions of influence on the cognitive, emotional and behavioral aspects of our patient depending on the tasks of the therapeutic stage. Various complexes of these methods should supplement each other. We are convinced that the main requirement of success of therapy and the main therapeutic factor is the creation of therapeutic environment. In other words, an environment possessing therapeutic possibilities.

There is nothing that is bearing even a faint resemblance with hospital in our center. Our attitude to a young man arriving to the center is not like to an ill person. We consider him as the person (the young man), who has vital problems and, who is certainly, capable of solving them. Currently there are no people in our team, whose duty is his "bringing up" and "lecturing" him. Each of our team members is responsible for a certain site of a center life. The beginner joins to a center life and relations with the people at once that are arising in the course of various kinds of activity. Complexities, problems and conflicts are the basic material for work in psychotherapeutic group. People that surround the beginner have passed the same way and now well understand his situation. Habitual ways of achievement of the superiority and manipulation not only are not working, but also become an analysis subject in psychotherapeutic groups. "Exacerbation" of the illnesses that elapsed in the childhood is not giving any advantages either. It does not mean that the habitual behavior is condemned or it is forbidden. He, certainly, has the right to choose it, but in such case he will have to accept its consequences. That is, his behavior is his responsibility. And consequently it is necessary to think, choose and refuse.

He has to think much about many things. Then comes a realize, that if to consider feelings, thoughts and desires of the other people, his behavior contradicts his belief about himself as about the "kindly", "loving" and "noble" person. And negative reaction of people is a direct consequence of his acts. Along with it, any constructive behavior, not demonstrative, but sincere aspirations will be noticed, approved and supported.

All situations induce the novice constantly to think. Ability to think and make independent decisions is encouraged and stimulated. That is, comes a possibility and necessity to reconsider his own attitudes. It appears other people have requirements and desires which are important too. It appears that people debt nothing to him. Not all of his desires should be necessarily executed. Therefore it is necessary for him to learn to refuse from impossible ideas and to wish possible things. In the course of the diversified activity and relations with people, we help the patient to understand, that the person cannot be either completely dependent and helpless, or completely independent and alone. Nobody should be absolutely independent, each person can need assistance. It is necessary to develop in him ability to operate irrespective of others and, at the same time, ability to establish friendly relations, mutual aid relations. Our task is to help the young man to develop ability to make independent decisions. The important feature of our centre is an active participation in his life of the former patients and their parents.


Creation, maintenance and development of therapeutic medium is the primary goal of the doctor, as a matter of fact - content of his work. The doctor himself is a part of therapeutic medium. Relations of the patient with the doctor are the major factor of therapeutic process. The doctor at such approach, first of all is the person, with his own strong and weak sides. The diploma, professional terms and any other medical attributes are not enough here. It is most necessary to be that what you want to learn another. And it is not only and not so much in an office, but also in various situations in a various life of the centre. Speaking a simple language, the result is impossible without valid, instead of ostentatious respect and trust to the doctor as to the person. Speaking even more simply, the therapist should be authoritative person for the patient. The issue here refers not to the medical treatment, as to educational treatment of a person. To establish sincere, human, partner relations with our narcistic patient is a problem that is not very simple. In our opinion that is professionalism and qualification of the doctor who is engaged in rehabilitation of addicted persons.


Leonid Sauta
doctor psychotherapist