воскресенье, 9 августа 2015 г.

Dianalysis as integrative psychotherapy and counseling

Благодаря Андрею Иришкину (Канада) нашлась потерявшаяся в 2009 году статья о дианализе (http://applied.world-psychotherapy.com/article.php?post=468)! Спасибо, Андрей!

Dianalysis as integrative psychotherapy and counseling
Vladimir Zavyalov

PhD, Professor of psychiatry, chief of the department for psychotherapy
of Novosibirsk state medical university Novosibirsk, Russia.
Abstract. Every method of psychotherapy should be adapted for real people, be adjusted to a concrete case so as to match it to a client’s mentality. This initial axiom is considered to be a creation basis for dianalysis. The purpose of the present article is to acquaint the reader with the new approach in the field of psychotherapy and psychological consultation –dianalysis and its axioms. This modality of the psychotherapy is based on the highest level common sense armed with absolute dialectics of Russian philosopher A. Losev. In article main principles of the dianalysis and the scheme of carrying out of dianalytical session are discussed.

Keywords: dianalysis, absolute dialectics, axioms for psychotherapy, personalism, help, symbol, therapeutic idea, integration.

The mentality is understood here as a habitual or characteristic mental attitude that determines how a client of psychotherapist will interpret and respond to life situations.
The modality dianalysis has a clear and self-consistent theory of the human being, of the therapeutic relationship, and of health and illness. Health (in psychological sense) is understood as a state of wellbeing acquired thanks to the process of mind-synthesis, the ability to find a solution in some problem domain and the ability to integrate parts of global “sociocultural code” of life.
Illness (in psychological sense) is viewed as a state of unwellness, anxiety and loss of good behavior control, because of poor mind-synthesis, inability to find a solution in some problem domain and inability to integrate parts of global “sociocultural code” of life.

History and Background
Dianalysis as a system of integrative psychotherapy and counseling has been created, formulated and developed by Professor V. Zavyalov. It represents the results of his practice for more than 30 years as a scientific researcher in the field of clinical psychological analysis of personality of alcohol addicts [16] and as a clinical psychologist and diagnostician working with the Rorschach test, TAT, MMPI, Szondi test and others, and, of course, as a psychotherapist in different clinics and hospitals in Novosibirsk.
In 1975, his first book “Emotions and Imagination, clinical-psychological research” written together with Prof. Banschikov and Prof. Korolenko was published. The idea of imagination as treatment with mental images was developed in the book and contributed much to the author’s personalistic outlook and dianalysis. Imagination is considered to be the highest cognitive function that connects the Past and the Future and unites all separate meanings in a person. For many years, Prof. Zavyalov had been calling the therapy he practiced as the Imago therapy.
Till 1993 the author of dianalysis had been participating in various educational programs and projects fostering such modern methods of psychotherapy as Transact analysis, Ericksonian hypnosis, Neuro Linguistic Programming, Existential therapy, Cognitive therapy of A. Beck, the Reality Therapy of W. Glasser , Direct Confrontation Method of Jack Rosberg among Russian psychotherapists [18].
After getting acquainted with the works by the famous Russian philosopher A.F.Losev (prohibited under Soviet power and published only in 1993), his “Dialectics of Myth” in particular, Prof. Zavyalov understood how exactly those numerous methods in psychotherapy and clinical psychology could be integrated into one system embracing all the sides of therapy practice in psychotherapy.
It is worth mentioning that A.Losev expanded the phenomenological method of Husserl to include symbolism and mythology [6, 7]. Prof. Zavyalov has derived Losev’s method of absolute dialectics and the absolute mythology and after processing this method has been adapted and incorporated into psychotherapy. Thus, the ideas of dianalysis have been elaborated and formulated. 

There are five formulated postulates (or axioms) — the propositions that are accepted as true in order to provide a basis for logical reasoning:
• Help-axiom
• Problem-axiom
• Reality-axiom
• Person-axiom
• Symbol-axiom

“All you need is help.” It is the slogan for the psychotherapist. The only thing that he/she can give to the client is help; not “the Influence on psyche for the purpose of treatment”, not “correction of the mentality”, not “love” (including “therapeutic love” and its analog — “agape” or “true Christian love”), not “struggle against illness”, not “the best programs for brain activity”, not “the right way in life or Dao”, not “environment improvement”, not “normalization of social ecology” and not give money or any real recourse, certainly. Only help in “reorganization of mental content during live dialog”; this is the maxim of dianalysis or moral maxim.
Help-axiom is the courageous acceptance of the evidence of the existence of necessary restrictions in the client-therapist relationship because this relationship is paid. Money or its equivalent (missionary mood, self-knowledge through the client, any use of the client for own needs) is ineradicable mediator between client and therapist because psychotherapy is professional activity and every psychotherapist exists in market field, psychotherapist should sell its service favorably, in other words — to make the real bargain with the client, hence the mutually advantageous transaction. Psychotherapist cannot sell the welfare to the client, only “protect the welfare to the client” according to “Statement of ethical principles of the EAP” [11], cannot sell the mental and body health also, cannot sell the “new person” or even “new look on the world”.
A psychotherapist can sell its “qualified working hours” only. The predicate “qualified” means legal, well educated (“completed successfully the preparatory and specialized training in psychotherapy” [11, 12] and humanistic higher education), ethical (corresponding to ethical standards and professional duties of psychotherapists) and specialized in separate discipline of psychotherapy (modality).
The term “working hours” means “the exercise of psychotherapy” [11] applied to certain problems and special inquiries of the client. The last is itself real work and first is the quality of this work.
Essence of Psychotherapy according to dianalysis is special help -“psychological help” or even “just logical help”, hence “the help theory” should be the base theory, but not “the theory of personality”. Such theory should be determinate by the purpose of “therapy” (necessary changes and transformations in mind state, intellectual condition and behavior of the client), tasks, ways of decision-making and the plan for execution of collaboratively found decisions in mutualism style.

The Idea of Mutualism as “help-exchange” among people is very accepted in dianalysis. This idea is based on the well-known book “Mutual Aid: A Factor of Evolution” [5] of the Russian researcher and philosopher Prince Peter Kropotkin; because of his title of prince and theory of anarchy, he was known as «the Anarchist Prince». Oscar Wilde described him as «a man with a soul of that beautiful white Christ which seems coming out of Russia»[15]. So, this singer of personal freedom certainly should be the important figure (as some image and ideal) in the context of any psychotherapy for a Russian soul and Russian-speaking people.
After examining the evidence of cooperation in nonhuman animals, «savages,» «barbarians,» in medieval cities, and in modern times, Peter Kropotkin concludes that cooperation and mutual aid are as important in the evolution of the species as competition and mutual strife, if not more so.
Modern scientist, Douglas H. Boucher, argues that «Kropotkin’s ideas, though unorthodox, were scientifically respectable, and indeed the contention that mutual aid can be a means of increasing fitness had become a standard part of modern sociobiology” [3].
Last years that opinion proved to be true that there was a wide social Self-help movement: more 700 000 groups in America only [4].

“All you need is the mind.” It is the next slogan. What is the mind necessary for? To understand the inevitable problems and correctly explain the world. If the person does not understand his problem, then another person or some organization will resolve his or her problem for their advantage. In dianalysis problem is understood as contradiction in mind and attempts to reconcile its contradictions, for example, harmonize one’s goals with one’s abilities, getting two things, two wills, and two ways and so on to correspond. No mind — no problem. There are no problems — the mind is not necessary. It is evident.
The term problem is used instead of the term illness or disease. If we give help, instead of a treat, then this term is necessary to us. Moreover, then the help-axiom and the problem-axiom supplement each other. The problem is the reflection of external conflicts and the mixed life events and also internal conflicts and body/mind events in mental level. “Problemless” existence is not real, even the deepest dream Includes contradictions, unresolved conflict of opposites and struggle of “unconscious tendencies and hidden forces” (banal nightmare). 

Most brightly the problem is expressed in a paradox phenomenon. On dianalytic slang, it sounds as “logical centaur”. For example, there are some well-known paradoxes:
• Socratic paradox:»I know nothing at all.» This “centaur” consists of knowledge (head) and ignorance (body). The knowledge and ignorance — full contradictions — belong to the same system of knowledge. It is absurd, but at the same time it is the very high moral principle: to be poor in spirit is to acknowledge honestly as it interprets Christian Beatitude in the New Testament.

• The paradox of hedonism: When one pursues happiness itself, one is miserable; but, when one pursues something else, one achieves happiness. This is ethical “centaur” with happiness-body and head- something else. While the head is occupied by something strange, the body stays in a happy condition. Moreover, “Happiness cannot be pursued; it must ensue, and it only does so as the unintended side-effect of one’s personal dedication to a cause greater than oneself or as the by-product of one’s surrender to a person other than oneself”. Possibly, it was the preparation for techniques creation «paradoxical intention» — paradox contra paradox.

• Buridan’s ass: How can a rational choice be made between two outcomes of equal value? Buridan allowed that the will could delay the choice to more fully assess the possible outcomes of the choice. Ass — a metaphor of the person which cannot make decisions because of the weakness of the rational argumentation — a person, who has “wooden brains” (Eric Berne) or “straw brain”. So-called “straw man” is «a person of no means,» or one who deliberately accepts a liability or other monetary responsibility without the resources to fulfill it, usually to shield another party. To «attack a straw man» is to create the illusion of having refuted a proposition by substituting a superficially similar proposition (the «straw man»), and refuting it, without ever having actually refuted the original position (Wikipedia). 

Moreover, so on. There is a whole library of paradoxes. The Classical paradox in psychotherapy is the neurosis. Is neurosis disease? Yes and No simultaneously! Yes, because abnormal functioning is present. No, because illness (organic disease) is not present. Illness without illness? Yes. It is “logical centaur”.
To be (disease) or not to be (disease) that is the question… for assessment and psychotherapy appointment. One of the decisions of this clinical paradox is recognition of the existence of so-called “factitious” disorders — “not real, genuine, or natural” as it is described in DSM-IY. So, such disorder exists but does not exist, in fact: exists in the mind only. What to do? To deal with a problem or hidden paradox in the mental space of the person, which the seeks psychological (logical) help. Pertinently to remind here, that the psychotherapy has appeared as a way of treatment of neurosis’s — imagined illnesses (after historical discussion about Franz Anton Mesmer’s method and phenomenon of “animal magnetism” [9]).
The context of any problem is a state of helplessness: a man cannot resolve the life’s problems because does not accept the help from other people, does not use “prescribed recourse”. Sometimes such context turns to an independent problem, for example, depression. 

Helplessness itself is the reason of various difficulties which the psychotherapist faces in real practices. Learned helplessness, as it is known (Seligman, 1975), is a psychological condition in which a human being or an animal has learned to act or behave helpless in a particular situation, even when it has the power to change its unpleasant or even harmful circumstance.
Learned helplessness theory is the view that clinical depression and related mental illnesses result from a perceived absence of control over the outcome of a situation. It is paradoxical, the person requiring the help and capable to receive it from the other person, does not accept this help.

“All you need is peace.” What for? Peace is necessary because a person should have the possibility to resolve external conflicts and have successful self-realization in the social environment. The third postulate of dianalysis also is fundamental despite its simplicity: human reality is the social one.
Reality philosophically is the synthesis of the Thing and its Name. Human reality is named reality, “talking reality” (Losev). Reality is the state of the world as it really is rather than as one person might want it to be, but one person might be able to understand the world or reach any understanding through naming (to receive the true names of real things from people and culture standards). Only in the reality there is an antagonism of various interests, forces, the parties, currents, and groupings.
Conflicts in mind — are personified (and more often deformed) mental representation of external conflicts. However, a person also is a part of this reality; he enters into a set of opposing groups and so on. The person is both the participant and the witness of both the event and the situation. Thus, human reality is very complex and difficult for simple understanding because it is like plural reflections in the system of parallel mirrors. The helper adds to this system one more — his system of “parallel mirrors” which is not easier than mental mirrors of his client.

Reality is also understood as duality of Nature and Culture, in other words — “nonhuman environment” and “human environment” according to some researchers [1]. Reality is a strange amalgam of contradictory of Nature & Culture, Object & Name, that different people see in some different way. The third postulate asserts that the world consists of real objects with which the person establishes semantic (comprehended to some extent) relations. 

The world is objective and is given to us in subjective expression through a symbol.
When we think, we mean not simply words — phonemes, morphemes etc., but real-life objects. More often we operate not with real objects and not with «mental analogues» — images and representations, but with hidden relations between them — «Clamps of Being» (Losev).
If a split between objects and names increases, then the world becomes incoherent for any person: this person has the deficiency of “clamps” or “not enough connections” in terms of dianalysis. He or she has to cope with such duality which is endured as rupture in consciousness and is expressed with symptoms.
We can find the similar ideas in Reality Therapy developed by Willam Glasser. As unsatisfactory or non-existent connections with people are the source of almost all human problems, the goal of Reality Therapy is to help people reconnect. This reconnection almost always starts with the counselor/teacher first connecting with the individual, and then using this connection as a model for how the disconnected person can begin to connect with the people he or she needs.

“All you need is sense.” What for? For Understanding Oneself and the Other, eliminating inner conflicts and being the real person with well-developed Personality. What are distinctions between the person and the personality? As Losev in his work “Dialectics of a myth” wrote: “The person is a fact. She exists in history. She lives, struggles, is born, flourishes, and dies. She is always a life rather than a pure concept. A pure concept must be realized and materialized. It must appear with a living body and organs” [6, p.74]. The pure concept is necessary for reflections and construction of judgments about the concrete human being as the notion “Personality”.

According to philosopher Nikolay Berdyayev, the human personality is the dynamic system like a cosmos: it must be maintained in proper balance to facilitate positive interactions with other individuals with nature. Russian word «lichnost» may be translated as either “personality” or “individuality”, but Russian thinkers have argued that its essential spiritual meaning should not be confused with the notion of atomized, lone individual that predominates in the West [2].

The Christian Ontological Personalism (unreligious variant) is accepted as a clear, self-consistent and adequate theory of the human being an unreligious variant of which is presented in the works of Russian philosophers Losev and Berdyayev. According to the theory a human being is influenced by two global processes i.e. biological evolution and cultural coevolution within particular historical time and specific geo-politic place.
The human being has the dual nature. This basic point of view is supported by “culture-historic theory of development of the human psyche” (sociocultural approach) of Vygotsky and by “The Meta-Theory of Mental Processes” of Vekker [13,14,17].

Philosophically the personality is defined as «synthesis of the subject and objects». It is the first of 12 synthetic maxims of Losev in «Dialectics of Myth». Psychologically the personality can be defined as «semantic all-unity of the person» instead of notorious “Identity” or “Self” (Zavyalov, 2004). So, this postulate of the personality is the statement of the obvious truth — first of all each person has his name, his history, the destiny and full freedom in choosing. The person is wholesome and indivisible. The body shares on parts, but not the person.

The Person — the carrier of problems. To carry on itself as a Cross (on which Jesus was crucified) means that the person himself is not the principal cause of problems, at the best the person is the co-author of the problem together with the Reality. “To carry on” also means “to have a free interpreted version of real events and hold it in the mind.” As it was proved still by Benedict Spinoza, Man’s soul has not any problems and does not contradict itself.

“All you need is the name.., secret names for understanding the problem”. The Symbol is an expresser of a problem (while the Reality is a source of problems; the Personality is the carrier of problems, and the Problems themselves are subjects of the professional interest of the Helper). Symbol definition in dianalysis is the following: “another-being-of-sense”. It means that one thing (visible) specifies in another thing (invisible) like some semantic pointer or an ideal index. Thus, the first one can be taken as the symbol and as independent single thing. 

So, any symbol has dual semantic areas: itself and the other. Here “itself” refers to some object, which is chosen as “expresser“ of something, and “the other” refers to some area of the consciousness of the one who learns something. Symbol will be never exhausted because refers just to the consciousness but not to another thing. If one thing points to another thing (now invisible), then it will be only a “sign” but not “symbol”.
Certainly the word (in the sense of “the name”) is the main symbol for the psychotherapist. Any non-verbal sign can be taken as a symbol also, but sign is always exhausted in any way and can be deciphered by anyone, for example, so-called in the technique of “reading” people, according to some dictionary of language of a body [10]. The symbol concerns to representational process or any basic cognitive process in which some entity comes to stand for or represent something else, therefore symbol-axiom plays the major role in disclosing of a root of a client’s problem. 

In any case the true meaning of a word or body expression is reached with the help of therapeutic “symbology”: symptom or its analogy (narrative, complaints, hints on certain difficult circumstances, even gossips on own private life and so on) is accepted as symbol and hence is distinguished as expression of personal meaning, personal myth and visage of the personality of the client and of course as a attempt of synthesis of any contradictions , which in this time was not absolutely successful.
Shortly, symptom (Problem) in therapist’s communication (Help) taken as expresser of a problem (Symbol) shows us the Personality in all its concrete embodiment on the fields of fight for survival needs-satisfactions and self-realization (Reality).

Dianalysis is the art of connection, the art of meanings connection. It is continuation of the tradition of Socrates and his «smart talk», or dialectics, or “clever conversation” among free men of the Ancient Greece. Here we may recall the work of Paul Dubois «Les psychonévroses et leur traitement moral» (1904), in which an ancient dialectics named «Socratic dialog» is described as «persuasion therapy» and so-called rational approach for treatment of neurotic disorders.
By the way, Dubois believed it was necessary to appeal to a patient’s intellect and reason in order to eliminate negative and self-destructive habits.
He also believed it was necessary for the physician to convince the patient of the irrationality of his/her neurotic feelings and thought processes [9]. In dianalysis “Socratic dialog” has been transformed into “pentad dialectics”.

The basic method of dianalysis is logical designing (Logos) using «pentad models». The pentad is a logic structure of reason which has been deduced from Losev’s works. Pentad dialectics differs from Hegel’s dialectic triad as the real maintenance (the fourth moment, namely — «factuality», «corporality») is brought in it. This form of
dialectics is based on “absolute dialectics” [22, 23] — synthesis of the dialectic logic and the general mythology. It represents some set of methods united in “Five Moments of Essence Knowledge” or so-called “Pentad” [20, 21]:

1. The One. The stage of syncretic and abstract thinking “in-all” and “wholeness” — the starting point of dialectics and intellectual intuition while grasping fusion of something.
2. The Many.The stage of the differential and conceptual thinking using five main dialectical categories: being, identity, difference, rest, movement.
3. The Becoming. The stage of transcendent thinking or thinking the unthinkable. It is the synthesis of the stable and formed being with the unstable and amorphous other.
4. The Fact. The stage of concrete thinking about embodied or incarnated ideas.
5. The Symbol and the Myth. The stage of mystical and symbolic thinking about “not- becoming-thing” or the myth (personal myth of the client).

The symptom taken as the symbol can be considered :as the “one” (1), as a class of “many things” (2), as a transcendence process in the person’s life or “becoming personality” (3), as a single fact in some context (4), as a personal myth and the symbol of “other-life-of-person” or “the second destiny” in which the symptom is incarnated. Thus, the main method in dianalysis is the all-round consideration of a given problem.
This rendering of the symptom is an original form of therapeutic intervention in dianalysis . The method itself uses techniques of help for a person without any direct or apparent effect on Psyche with some medicine, physical influence, social control and power. It only changes the personal meaning of psychological content of his real behavior. There are five ways to change personal meaning [19]:

• Abundance of conceptions( conceptual machinery) is diminished through dianalytic interview;
• Uncertainty in cognition and perception is eliminated in the course of dianalytic discussion (variant of Socrates’s dialog);
• Dianalytic imagination helps to overcome occupation with unrealistic and “unhappy end” images (go around “Curve of Meaning”);
• Dianalytic reorganization of some combinations of elements in a person’s experience stops chaos process in mind;
• Amplification of meaning of life through dianalytic narration techniques demand using creative procedures such as “myth designing”, “story telling,” dream interpreting, plot construction within a frame of a personal myth.

Methodology is the collection of theories, concepts or ideas, the comparative study, and the critique of the individual methods that are used in a given discipline or field of inquiry (Wikipedia). In dianalysis many theories and concepts concerning psychotherapy and counseling are integrated into two big groups named “Pentad” and “Decalogue”. Pentad is the set of logic and ways of understanding a problem. Decalogue is the set of principles of processing a problem (10 principles in all).
Pentad. Pentad in methodological point of view is the well packed and compact set of historically developed types of thinking: naive-naturalistic thinking or common sense (1), scientifical-demonstrative thinking (2), phenomenological thinking (3), critical thinking (4), and myth-poetical thinking (5).
The “pentad dialectics” is embodied into practical ways of therapeutic work: diagnosis and intervention forms.

Dianalysis maintains the tradition of diagnosis and assessment set forth in Multiaxial Evaluation System of DSM-1V. In dianalysis, there are Five Levels for recognizing, understanding and coping with personal problems very similar to Five Axes Diagnoses in Multiaxial Evaluation system of DSM-IV.
Such traditional form of intervention as Socrates’s dialog is practiced in dianalysis as well. Treatment is focused on supporting personal meaning.
Thus in dianalysis there are Five Levels for recognizing, understanding and coping with personal problems where 

Level 1 is focused on naming a Problem (assumption, supposition, presupposition, “theory”);
Level 2 is focused on content of Psyche (cognitive content, mental objects, knowledge, noesis);
Level 3 is necessary for processing and transforming Psyche Content (goals of behavior, motivation, drives, perspectives of future);
Level 4 is for the realization of the Person Becoming in a functional State (embodiment of an idea);
Level 5 gives the symbolic representation in Symbols of Life (artifacts, personal myth, narration, mental potential and other symbols of living personality).

Understanding personality as the highest form of synthesis (person as a myth, and myth as conscious-verbal-personal form unfolding itself in history) and not as a variant of the human being adaptation can be regarded as some new aspect in understanding of human nature.
Dianalytical theory of help is seeking an answer to the main question: how to help a person without any direct or apparent effect on Psyche by a medicine,through physical influence or social control and power but only by changing a personal meaning of psychological content of his real behavior. 

There are five ways “forms”) to change personal meaning:
• Abundance of conceptions( conceptual machinery) can be diminished with dianalytic interview;
• Uncertainty in cognition and perception is eliminated in the course of dianalytic discussion (variant of Socrates’s dialog);
• Dianalytic imagination helps to overcome occupation with unrealistic nd “unhappy end” images (going around the “Curve of Meaning”);
• Dianalytic reorganization of some combinations of elements in a person’s experience can stop chaos process in mind;
• Amplification of meaning of life through dianalytic narration’s techniques demands using creative procedures such as “myth designing”, “story telling”, dream interpreting, plot construction within a frame f a personal myth.

The interview or questioning of the person in a special manner is the main and universal way of our help to the client. The interview and include the other “forms” of the dianalysis such as discussion, imagination, reorganization and amplification to the extent where their application will be dictated by tasks formulated. Any session of dianalysis begins with the interview and comes to its termination with interview (consultation or conversation with the client). Because dianalysis ranks among the integrative psychotherapies (in Russian sense — “integrative” means “all-included”) every session can comprise other psychotherapeutic procedures inducing change: psychological interventions such as Insight, Interpretation, Paradoxical Intention (V.Frankl), Modeling and Role Playing, Cognitive Restructuring (in A.Beck’s or Ellis’s manner), Systematic Desensitization, Systematic Intervention by Johnson (for alcoholics), and others. In that case dianalysis smoothly passes to the Polymodal Psychotherapy by V.V. Makarov [8].

The philosophical slogan of dianalysis is as following: “Peering at the Eidos design Logos”. The Eidos means personality in all senses: personal visage, personal miracle history given in words (“myth” in Losev’s interpretation), total expression of the person including symptoms of the disease or any difficulties.
Decalogue. The so-called Dianalytical Decalogue gives a clear rationale for treatment and intervention.
It represents 10 principles or strategies of getting a person from pathological state and describes the results to be fixed by new definitions and through new structure of consciousness so that a person can catch and hold the changes needed. Empirically found in the course of 35 years of practice in psychotherapy the order of principles represents the order of succession of therapy accomplished. 

The names for the principles are the names for the domains, each domain being the field for the most important definitions.
Decalogue can be used in two ways as an algorithm of succession in therapy and intervention as well as the content of help that can be specified endlessly.

Ten principles of accomplished psychotherapy describe competence of Dianalysis in such areas as
• interpersonal relations (Diada)
• knowledge-mining and system analysis (Diagnosis)
• communication ability (Dialog)
• reasoning by elimination or analysis of a problem and alternatives (Dilemma)
• problem-solving technique (Dynamic)
• synthetic thinking (Dialectic)
• transfer of the positive result of psychotherapy into new fields (Diversification)
• social-support (Divergence)
• good consumption counseling (Dietetics)
• narration and speech making skills (Diatribe)

These principles of accomplished psychotherapy are used for three purposes:
1. Modeling of desirable result of therapy (the description of requirements of the client in terms of Decalogue);
2. Realization of the plan of therapy and the description of the process of therapy or intervention.
3. Fixing of the reached results in 10 areas of activity of the person in conformity with the classification in 

All these principles of work are carried out in the Protocol of Dianalysis (see it lower).
Dianalysis is a method of integrative psychotherapy registered in Russia and methodology of client organizations and individuals counseling as well.
The name Dianalysis was invented to define a new system of notions in psychotherapy and counseling in our attempt to avoid using the names of well-known trends and modalities in world psychotherapy.
The word “Dianalysis” means “together with a client”-di- and “through analysis”-analysis.
Dianalytical therapy requires analytical thinking from both — a psychotherapist and his client.
Analysis is focused on revealing the meaning of client’s emotional experience and the sense for his personal growth, dialogical and dialectical thinking being a tool for relieving a client’s mind from so-called mental viruses and mental misconceptions.
Dianalysis is built on dialectics where one should take into consideration the opposites and reconcile them in some third notion. 

Dianalysis tends to integrate human mind through the synthesis of the opposites to overcome the damage done by multiple forms of personal, professional and social narrow-mindedness and to enhance the quality of life.

Problematics of dianalysis
Some addictions ( alcohol, drugs, computer, game, work), inner conflicts represented as neurotic symptoms, neurotic disorders, psychosomatic symptoms resulting from neurosis, personal crisis in persons emotionally unstable and having difficulty in coping with personal relations are defined as areas for enquiry and application.
Duality of consciousness causing dissociation and fallacy in logical argumentation is the main goal for research in dianalysis. Dianalysis is practiced as individual psychotherapy in medical centers and for out patients as well, in counseling and coaching for businessmen, in counseling persons with marriage problems, in family therapy, in making examination of some dubious decision of experts for legal advice offices [20, 21]. 

Case presentation
Our client is a neurotic with heartache waiting for a possible infarction. There is no infarction at the moment, but around its possible appearance on the stage of life some events keep developing: the husband hopelessly waiting for his infarction is terrorizing his wife making her suffer from his possible death with a prospect to live without any money left. He is writing fake wills, and he is demanding his wife to confess her adultery as he wants to know the whole truth before he dies. He pretends to be saint and innocent himself torturing his wife with his words. For example, “I’ll, die, and you will be blossoming without me.
So beautiful and attractive for those males round you…” “When I die, bury me near my sweet home.” “How will you live without me beside you?”
How to organize his life so as to make him take charge of his business and stop his sinking into useless fantasies about diseases and premature death? First of all, let’s ask ourselves: is our client in “preinfarction state” or is he in hysteria? It is definitely no infarction nearby, any signs of myocardial ischemia, only hypochondria, his ideas about possible disease, but not a disease itself.

Much time will pass, 40—45 years at least or more, till he may die of infarction, and it is a good time resource. The reorganizing of the content of the symptom was taking place in sincere conversation, in deep personal contact between the psychotherapist and his client, the constant verification of the client’s experience interpretations being made with no reference to the client’s clinical experience. The contents of the symptom had been taken as a symbol. 

In dianalysis the “pentad dialectics” is used as the main cognitive tool in revealing the deep meaning of the client’s life experience. First of all, the main components of the conduct situation were picked out.
In our case, there were six main components or the characters, all of them having been equal in their importance for the client.

The components picked out were given some independent status, each having some personal name and the meaning of existence, hence each component having its ontological status.
While trying to find the meaning of existence for each component it is of importance to distinguish between nomen and phenomenon (after Husserl).

It helps the client start thinking independently about each component.
Thus in his consciousness his pathological way of connecting the content with the component begins to ruin, and there appears the possibility for each component to have an independent development in his consciousness. Everything takes place in close personal dialog between the client and the psychotherapist.
Then the facts are separated from their interpretations. A fact is taken as some fixed element of the consciousness. The client is quite unable to do it himself, and the therapeutic conversation can help the client to fix the things that can be taken as facts and to distinguish them from their interpretations. Then a new meaning for each component was found, and new connections between the components were established.
Thanks to this process, the client began to differentiate these two states — between problematic state with fear to die of infarction and the positive state with care for his wellbeing. 

The changed state of care is so-called “therapeutic idea.” The differentiation between fear and care appeared in the client’s consciousness and then was fixed there in the course of therapeutic work with the client (табл. 1).
Tabl. 1
The main results of symptom reorganization according to the Protocol of Dianalysis®
Components of the situation
Fate for the components in the state “Fear of infarction”
Changed fate for the components in the state “Care for wellbeing”
Kate, his wife, he seems to have no sex appeal for her
A nurse in home hospital
A friend who is interesting enough to live with in comfort
Gala, his girlfriend, a fool who wants too much
A blackmailer, who is extorting money
A pleading woman
His father, reminiscences about his death of infarction
A vampire
A teacher of life
His business Alpha Plus, he is sick and tired of
A vehicle that is moving so slowly
A locomotive of life
His money, invested into some vague business
All profits missed, his Past
Bright profitable Future
His sensitive and painful body
Dreary and gloomy thoughts about living with broken heart that doesn’t work at all
A body with a big spacious heart to accommodate so many good things

The Protocol of the Dianalytic Session
General notes. The Protocol represents some general plan of treatment for some problem’s state of the person and the way of fixing everything that occurs during the session. Each session should be finished as if it is a unique session of psychotherapy and disposable meeting with the client.
In Russia, almost all cases of psychotherapy belong to short-term psychotherapy [24].
Last five years all cases in my private practice are distributed in such order (sequence):
Single session — 35% cases
2—5 sessions — 30% cases
6—12 sessions — 20% cases
More than12 sessions — 10% cases
More than 50 sessions — 5% cases
Thus, 85% cases belong to the class of «out-patient intensive short-term psychotherapy» and only 5% to the long-term psychotherapy, some cases having lasted for 4-5 years.

The stages of a session. Any session of dianalysis consists of five formal stages generated by dialectical analysis («Pentad») of the psychotherapeutic process:

1. Situation (One)
2. Interpretation (Many)
3. Moving Idea (Becoming)
4. Realization (Fact)
5. Summery (Personal Myth)

The first stage or step involves defining the client’s presenting his or her problem which at this moment seems to be a stream of the most different events. Certainly, such a «stream of consciousness» should be divided into classes of events interesting to us for the further reorganization: therapy in dianalysis begins with the first-dropped word of the client (or when he/she frowns suddenly). Moreover, first of all we should know a real situation: «What is going on actually?» It is not so easy because we never are real participants of events in the life of our client (thank God). We can be only «virtual observers» led by our intellectual intuition trained beforehand at training sessions. The situation of help given-taken and the client-therapist relationship is one of the parts of a big class named shortly «The Situation».

The second stage involves the pilot study of the client’s epistemology: «How does he or she get to know the situation and turn it into understandable one?» This is client’s situational know-how: his or her manner of thinking over the last events, the ways of interpretation of the facts, using conceptions and so-called «stereotypes» and so on.

Step by step, the therapist supports the client for the paradigm shift from «problem-as-story» to «problem-as-synthesis of contradictions». Very often client learns with surprise that his or her symptom is more or less successful attempt to connect his or her opposite intentions, or the combination of ideas into a complex whole, or the creation of any synthesis in terms of dianalysis. At this stage the main aid of the therapy becomes obvious that the real purpose of the therapy is making a synthesis of oppositions more successful for the client without eliminating the symptom and its psychological content (symbolic cognitive content).

The third stage requires the gathering of more precise data for creating the Therapeutic Idea, which should cause the important changes in emotion, cognition, behavior, spirit, and even body state of the client.
The Therapeutic Idea includes many concrete ideas united round the understood problem and possible decisions in a context of the personality growth of the client. 

This is a «moving idea» indeed because such idea moves person towards some new perspectives in his or her life, gives a «new look» at the old coping strategies in some areas of the life. The very important point is the establishment of true goals which the client should pursue and separate them from a pure dream.
A dream is an unrealistic goal in life, but the beautiful dream can decorate any life with the high sense of self-esteem, self-belief, and self-confidence. 

Without such high sense of a dream, a successful activity in life would not be achieved. The fantasy dream should amuse the person; the visible goal should be reached any way. It is one of the rules in dianalysis.
In the fourth stage, we establish a working process regarding the variables of realization of the moving idea. The realization ways are modeling of benevolent outcomes, role-playing to assess skills, mind-mapping and using several forms of visualization of the problem, mutual planning of a treatment and so on. The client should be ready to make an act now or in the nearest future. This act will express the increased personal responsibility, freedom expansion in reality interpretations, and the innovative approach to some difficulties of life of the client.

The main purpose of the fifth and final stage is to fix the reached results through some procedures. Positive changes in a condition of the client are fixing through the procedure of naming the new qualities of the person in behavior, thinking, spirit, and personality.
This is an old traditional ceremony in Russia; roots are connected with magic of a word: «To call things by their proper names». It is important to find these «proper names»
The Name in Russia is real social reinforcement because «The Word» expresses and articulates the «Constants of Culture» [25]. Thus, new names connect the person with his or her native culture and people shared the same culture.

If we believe a society is the carrier of culture then it is necessary to recognize that in culture there are all answers and all solutions (in ethically sense), but they should be thought over and matched with the current time and real place («here-and-now») as well as with «current state» of the client. We make with client the positive innovations («innovation» means here the first attempt to carry something out into practice) in his or her life, but not inventions («invention» means here the first occurrence of an idea for a new product or process). «Nothing is new under the Sun.» Innovations are new ways for the client doing useful things and applying the old tested methods of survival and growing up (табл. 2).

Tabl. 2
General scheme and schedule of the Protocol of the Dianalytic Session
Client’s Side
Therapist’s Side
External event
Life Event
Internal event
Problem as a story
Problem as a logic
Not good Synthesis
Attainable goals
Aims of a life
Access to Resource
Unattainable purposes
Therapeutically Idea
Mutual Planning
Short Resume
New Problem

Explanations of the parts of the protocol. There are 24 parts: 12 parts are on the client’side, and 12 parts are on the therapist’side. Of course, this is super formalization of any genuine dialog between the therapist and the client. Each side is a kind of mirror and completes the other one. The cumulative effect of treatment or consultation depends on work on both sides of such a «barricade». An ideal execution of the dianalytical session as in any other modality in psychotherapy depends mainly on full cooperation between the client and the therapist. Fight in a reception room is the worst variant. Fortunately dianalysis is directed on revealing and managing internal and external conflicts.

The dianalysis has been created at the beginning as methodology of psychotherapy for Russian-speaking people. We had to comprehend and modify real avalanche of Western methods of psychotherapy that had been rushing through Russia from the end of 80-years up to the present moment. This process of the modification and adaptation of western modalities exported from Europe and the USA to Russia has not been finished yet. There appeared a number of national modalities with dianalysis among them. About 40 new modalities nave has been registered in PPL — Russia Branch of EAP by this moment. 

The future of the psychotherapy is an integration according to the president of PPL professor Victor Makarov: «The best and most original ideas from each modality can be handed down and assimilated by an integrative, multimodal, polymodal and another system of psychotherapy» [8]. Meanwhile, any theory of the personality could not unite such a variety of approaches in the field of psychotherapy and psychological consultation. Any theory of psychopathology or abnormal psychology could not unite western modalities and eastern approaches as well. Dianalysis is an attempt to develop an integrative approach which would include «the most original and the best from each modality» and should have some strong logical structure connecting «a set of sets» of numerous ways of help to people. Instead of some «theory» we offer «simple common sense» (whenever possible highest level) armed with dialectics tempered by time.

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