OH for Psychosomatic Disorders

Ganushkina Maria Petrovna


“Application of Associative Cards in Counseling and Psychotherapy for Patients with Psychosomatic Disorders”

This article was published in Russian (“ИСПОЛЬЗОВАНИЕ АССОЦИАТИВНЫХ КАРТ В КОНСУЛЬТИРОВАНИИ И ПСИХОТЕРАПИИ ПАЦИЕНТОВ С ПСИХОСОМАТИЧЕСКИМИ РАССТРОЙСТВАМИ”) in the book Метафорические ассоциативные карты: Начало пути (Metaphoric Cards: The Beginning of the Way), OH-Studio: Minsk, 2010, www.OH-Studio.narod.ru.

A translation of the article into English is below. PDF download links for this article in Russian and English are at the bottom of this page.

About the Author

Ganushkina Maria Petrovna (Minsk) is a medical doctor, neurologist, psychotherapist, psychologist, teacher, and the author of the course “Psychosomatic Disorders: Theoretical Models and Practical Approaches to Diagnostics and Correction.” She is a member of the Developing Group of Analytical Psychology in the Republic of Belarus and of the Russian Association of Art Therapy. In her practical work, she uses katathym imaginative psychotherapy, Jungian sandplay therapy, associative metaphoric cards, art therapy, and fairytale therapy. She has experience in group therapy with children and adolescents. At the present time, she does individual counseling and psychoanalytic therapy, including with patients with psychosomatic disorders.

Application of Associative Cards in Counseling and Psychotherapy for Patients with Psychosomatic Disorders

Alexithymia is considered one of the basic causes for psychosomatic disorders at the present time (Latin a – negative, legere – to read; Greek thymos – feeling). Psychosomatic patients have extremely limited ability to express their experiences verbally and to connect them with body sensations. It is typical for such patients to be emotionally illiterate, lack imagination, have a deficit of imaginary thinking, and have a broken symbol-creation function. All of the above-listed traits of alexithymic (psychosomatic) personality are serious obstacles when verbal methods are applied in counseling and psychotherapy. Associative metaphoric cards work effectively in such a situation. The cards help to resolve the problem of verbal expression for affects and conflicts, to develop symbolic thinking, and also to train the imagination.

In working with psychosomatic patients, I’ve developed the method “History of Illness.” The associative cards PERSONA and HABITAT are used for this exercise. The patient selects 3-4 cards from the PERSONA deck: the first – image of him/herself before the illness, the second – image of him/herself during the illness, the third – image of him/herself as healthy (or if he/she will/would be healthy). The fourth card may symbolize an image of him/herself several years after the recovery.

From the HABITAT deck, the patient selects cards which symbolize “bridges” between the previously chosen images, that is, life periods which the person experienced just before the beginning of the illness, during the illness, and at the recovery period.

During the process of the patient selecting the cards, I ask questions related to the periods being explored.

First period:

  • “What difficulties/complications did you experience and what changes happened in your life before the illness (information about family members and his/her relationships with them, home conditions, work activity changes, losses, appearance of new significant people)?”
  • “What lead to the illness (illness trigger)?”
  • “What resources were inadequate (personal strengths and time, assistance from others)?”

Second period:

  • “Where and how were you treated?”
  • “How did you rest?”
  • “How did you react emotionally to the illness?”
  • “What feelings helped you express your illness?”
  • “Did the illness help you feel safe?”
  • “Did the illness give you a chance to get more attention and love?”
  • “Could it be that the illness helped you avoid something?”

Third period:

  • “What did you refuse, what did you gain, and what did you learn during the illness?”
  • “What conclusions did you make?”
  • “What benefits and compensations did you get from the illness?”
  • “What was the value of the experience you received and the conclusions you made?”

If the patient reaches an awareness of the sense of his/her psychosomatic disorder, we discuss after that how it is possible to reach satisfaction of his/her needs (which was realized by using the illness) in a different way (without use of illness).

Future, after illness:

  • “How do you see your life in 1, 3, 5, 10 years after disappearance of the illness?”
  • “What has changed in your surroundings (significant others, professional activity, key events, and so on)?”
  • “How do you take care of yourself (self-regulation, self-preservation, self-comfort)?”
  • “What is your way to be happy and to get joy from life?”

The SAGA and COPE card decks can be also used for work with this group of patients.

I use cards the MORENÁ deck for finding resourceful places, with the aim of arousing feelings of safety, joy and pleasure in patients; also for feelings of power from interactions with nature forces.

Об авторе [About the Author, in Russian]

Ганушкина Мария Петровна (г. Минск), врач-невролог-психотерапевт, психолог, преподаватель авторского курса «Психосоматические расстройства: теоретические модели и практические подходы к диагностике и коррекции», член «Развивающейся группы» Аналитической психологии Республики Беларусь, член Российской Арт-терапевтической ассоциации. В практической работе использую кататимно-имагинативную психотерапию, юнгианскую песочную терапию, ассоциативные метафорические карты, арт-терапию, сказкотерапию. Имею опыт групповой психотерапии  детей и подростков. В настоящее время – индивидуальное консультирование и психоаналитическая терапия, в том числе пациентов с психосоматическими расстройствами.

This translation of the article into English is available as a PDF (download the PDF).

The original article in Russian is available as a PDF (download the PDF).

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