Psychotherapeutic intervention

Psychotherapeutic interventions are ways of interacting with the patient that have the potential to promote patient growth. Psychotherapeutic interventions can be divided into three main areas: "soft, hard and expressive techniques".

Soft techniques are procedures that tend to be gentle and allow the patient to do something rather than forcing them to do something.

Hard techniques are very powerful and dramatic, they can be uncomfortable and sometimes even painful. Soft and hard techniques focus on charging the organism by supporting breathing and dissolving the body shell. These techniques allow energy to flow into the emotions and move the patient to the point of action.

Expressive techniques involve an embodied experience of the patient's psychodrama, which has a symbolic meaning. They are focused on the non-retroflected action of the musculoskeletal system and its interaction with the surrounding environment.

Soft techniques
The essence is a more intense awareness of one's own body, psychological regression , more intense experience and expression of emotions. Their advantage is delicacy and mildness. Their basis is the touch of the patient's body, to whom the therapist communicates care and support. It represents a loving embrace that shows the therapist's human involvement.

Body Position
The positions can serve the patient to recognize a certain emotion that is blocked and insufficiently expressed. The therapist can support the patient to recognize and experience a certain emotion. Thus, the therapist himself can suggest a position that corresponds to the blocked emotion in the patient. The therapist can create attitudes that express anger, sadness , fear , love or joy. There are also certain more standard positions, such as "spread eagle" (a person lies on their back with their arms and legs spread, which evokes feelings of vulnerability or threat ). Further "fetal position"(lying and sitting) is associated with feelings of safety and solitude.

Group therapy
E.g. group touching and group lifting. If a patient is feeling emotionally wounded or abandoned, it can be a profoundly healing experience for them to lie on the ground and be touched by the group - gently, respectfully and lovingly laying hands on them. A similar experience can be gained by group lifting. Group members gather around the patient and place their hands under the patient. Ideally, two people lift the legs, two people lift the arms, two people are on each side of the torso, and one person lifts the head. It is important to have enough people to hold the patient without tension.

"Pre- and postganglionic" technique
The essence is work "supporting blood flow", the procedure of which is called "pre- and post-ganglionic" technique in applied kinesiology. The procedure is based on the theory that there are power vortices in the body that correlate with the pubococcygeal, axenic, cardiac, pulmonary, pharyngeal, and cervical plexuses. Places along the spine at the level of these plexuses are referred to as preganglionic centers. At the front of the body parallel to the preganglionic centers are the postganglionic centers. The technique consists of placing one hand on the preganglionic center, the other on the associated postganglionic center, and maintaining a gentle touch. The result is bringing the body's energy into balance.

Breathwork
An emotional problem is reflected in disturbed breathing. E.g. shallow breathing and sighing is associated with depression, chronic yawning with boredom , and heavy breathing with anxiety. Because breathing is a source of oxygen for the organism, insufficient breathing causes a decrease in the overall vitality of the organism, which manifests itself in fatigue, exhaustion, depression, feeling cold and numb. Interestingly, a person can take conscious control over the breath and increase or decrease the frequency and depth even though breathing is an involuntary rhythmic activity controlled by the autonomic nervous system. When breathing, the whole body is involved, it is a smooth movement and a rhythmic movement. It is a breath wave that can be felt from the head to the genitals. After a short time, the wave reverses and the exhalation follows. Two types of breathing are distinguished: diaphragmatic ( abdominal ) and costal ( thoracic ). The aim of the therapist is to support the patient to adopt full and deep breathing in which the whole body is involved. The simplest way to work with the breath consists in simply focusing the patient's attention on his breath.

Grimaces
Another option is to use the mirror as therapy, which is related to stretching the facial muscles - grimacing in order to relax them. Slow and careful use of this technique can reveal shame and embarrassment or emotions that are not allowed to be expressed through facial expression. We can extend this technique by asking the patient to make noises while grimacing.

Hard Techniques
The therapist uses them with more caution because they are strong and can be painful. Otherwise, the patient could be traumatized and would strengthen his defenses..

Eye Armor Release
The therapist darkens the room and leaves only one light point on (e.g. a light pen), which he moves about 30 cm above the patient's face in the range of eye movement. The patient follows this point. The result is a strong emotional reaction.

Gagging reflex
The patient drinks a glass of water at room temperature, then stands over the toilet bowl and puts his fingers in his throat to induce a gag reflex (everything must be supervised by the therapist). During gagging, the throat and diaphragm contract involuntarily, thus releasing stiff muscles. After this procedure, the patient may feel fear, anger or embarrassment, but usually there is a feeling of calmness and well-being afterwards.

Massage of tight muscles
One of the most important branches of hard techniques is the massage of contracted muscles under greater pressure.

In the eye segment, we focus on the temples, the hairy part of the head and the muscles in the area where the skull and spine meet. After such a massage, it sometimes happens that patients describe a change in visual perception - greater intensity or even sharpness of vision. The patient can keep their eyes open during the massage, which stretches the muscles that close the eyelids and the sphincters that hold the eyelids closed.

In the area of ​​the mouth, we especially massage the chewing muscles. The patient may have relaxed or clenched jaw muscles. When we massage the neck, we only deal with the back segment – ​​the front structures are too delicate. We can use the tips of the fingers (for more pressure) or the bellies of the fingers (for a gentler massage), similar to when massaging the back, the upper part of the trapezius muscle can be squeezed with greater force. In the back area, it can also be helpful to use the soft part of the fist like a hammer and use the blows to relax the muscles. However, this technique is mainly used for muscular backs. In places where the bones are closer to the surface, it is necessary to reduce the force of the blow, at the same time, be careful in the places where the kidneys are located and not hit them.

In the case of the chest, we focus again mainly on breathing. The patient lies on his back and the therapist places his hands on his sternum so that one hand rests on top of the other. Pressure can be slow and constant, slow and intermittent, or fast and intermittent. The pressure is applied only during exhalation so that the patient can breathe in without external obstacles. Ideally, the patient will connect the exhalation with the sound, and the therapist will gradually develop a sensitivity for this method. The pectoral muscles can be kneaded, squeezed or massaged with stroking movements from the sternum to the shoulders, the intercostal muscles can be stroked, which can be done in both directions. We avoid breast tissue.

We can quickly and strongly press the big muscles on the legs and quickly release them. To relax the gluteal muscles, the therapist asks the patient to stretch these muscles as much as possible while lying on his stomach. The therapist leans on them with his own weight, and the patient supports this weight with contracted buttock muscles. After these muscles relax, the entire pelvis can relax.

Expressive techniques
Expressive work consists in the movement of energy into the musculoskeletal system, where it is processed. In this work, the patient is encouraged to act on what feels natural and not on what gets in the way or is a continuation of old patterns of avoidance. The essence of expressive techniques is action, specific musculoskeletal movement. For an action to be meaningful, it must carry symbolic meaning.

Translating verbal expression into action
Much of psychotherapy's expressive work is verbal. For example, a patient who retroflexes anger by clenching his fist while talking about his superior ( action retroflex ) may be asked to pound a pillow ( concrete action ) that represents the superior ( symbolic interaction ). Concrete symbolic behavior then carries the symbolic meaning of expressing anger directed directly at an appropriate (symbolized) target. The engendered anger is then allowed to express itself. However, the patient must understand the importance of symbolic expression through spontaneous concrete action and distinguish it from the practice of actual behavior. It is an understanding between block and inhibition on the one hand andmoral inhibition on the other hand.

"Empty Chair" Technique
With this technique, the chair is the place where the patient's expression is directed, either in the form of a monologue (the patient sits on his chair and speaks to the empty chair), or a dialogue (the patient moves and speaks for the target person or thing). It is the dialogue that often leads the patient to an emotional level, so that when, in the role of the target person or thing, they talk about injury, fear or disgust, they hear it at the same time and can react to it. The therapist should not stop the dialogue too soon, the patient is ready to withdraw only after clear signs of satisfaction appear.

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