Heal or destroy

The psychologist can harm his client - and he will not happen. This is how it happens

Several tens of thousands of psychologists and psychotherapists have been working in Russia, and the demand for psychological assistance has been growing steadily in recent years. At the same time, most experts are not in professional associations and do not cooperate with services that select psychologists, and there are no other control over their work: when the therapist harms customers, they often have nowhere to go. “Cold” found several stories when customers had complaints about psychologists - and found out how the professional community was trying to fight abuse.

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In February 2017, 23-year-old Alexander Selivanova (the name and surname changed at her request) talked with a young man who, like her, often spent time at the Green Door's Antikafafa in the center of Moscow. Word for the word - and it soon became clear that Dmitry is a psychologist and was ready to offer the girl his services.

Selivanova agreed. Two years before, she was diagnosed with bipolar affective type II disorder, prescribed pills and directed to psychotherapy. By the time she met Dmitry, she quit the therapist and began to feel worse. “I could not evaluate his professionalism then,” says Selivanova. - Dima looked competent. If I met him now, I would probably suspect something. Psychotherapists of customers from the street do not take. They should not intersect outside the context of therapy. ”

Selivanova began to go to regular sessions to Dmitry. (In communicating with clients, he calls himself Dima or heaven; several close friends of the psychologist told the “cold” that his real name is Kryukov.) At the same time, they continued to meet and communicate in the “Green Door” from time to time - and in one of these conversations, the hooks did not have a specialized psychological education. At that moment, this did not bother Selivanov: "I worked as a tutor too without a diploma."

Therapy lasted about nine to ten months. During this time, the girl told Kryukov a lot of personal information, which she had not shared with anyone before. And then, according to her, he invited her to meet. As Selivanova says, at that moment it was she who insisted on stopping therapy.

They had polyamoric relations: Selivanova at that time had a permanent partner, Kryukov came to them home, introduced her to his girlfriend. The novel lasted a couple of months, after which the former psychotherapist "merged". “If at first I experienced a vague interest in him, then, frankly, I was already in love with him,” says Selivanova. -I praised for some time, loaded. And then it began to reach me that something more serious happened. ”

Field for abuse

In Russia, psychotherapy began to gain popularity from about the 2000s, says Natalya Kiselnikova, candidate of psychological sciences and co-founder of the Ethics and Psychotherapy College in Psychology and Psychotherapy. In recent years, demand has been growing steadily: mental health has become much more accessible, they write about it in the media and blogs, they make films, celebrities regularly talk about their psychological problems publicly. However, as Kiselnikova clarifies, the bulk of psychologists in Russia are educated young people living in big cities.

According to the Zigmund.online online psychotherapy service team, the main reason for the demand for psychotherapy is that young people look into the future without optimism and expect new crises-political, economic, climatic (this is confirmed by polls conducted in different countries of the world). The feeling of helplessness in relation to global problems makes people try to establish at least their inner world. “Kovid and events of 2022 also warmed up the situation,” adds the co -founder of the psychological platform of Alter Olga Kitain. “We will reap the fruits of their influence on the psychological well -being of people for a long time.”

There are no reliable information about how many practicing psychologists and psychotherapists in Russia. According to the head of the online school "Psycodemia" Maria Danina, there are about 60–70 thousand. The World Health Organization in 2015 believed that the country has 4.64 psychologists per 100 thousand people - that is, about seven thousand specialists (Natalya Kiselnikova considers this number heavily underestimated). Some experts are included in professional communities and works with services like Alter and Zigmund.online. However, the majority work in the gray zone - on themselves, without participating in any professional communities. Anyone can be called a psychologist and provide psychological services. There is simply no certification and licensing in Russia. Only psychiatric care is regulated : a psychiatrist is a doctor who can prescribe medical examinations and prescribe tablets.

“If at your reception a wallet, a thief may find and detain law enforcement officers,” the psychotherapists Alexei Demin, Anton Veprin and Nastasya Solomin in the popular science book “Enough this to endure”, answering frequent questions about therapy. “But if the therapist will aggravate your disorder of eating behavior in case of ignorance or indifference, there will simply be nothing to hold him accountable.” Such conditions potentially create a huge field for abuse: as one of the “cold” psychologists surveyed by the “cold” formulates, “there are no sanctions, there is no fear that you can lose everything.”

Enrace unofficially

As Olga Kitaina says, it is best to try psychotherapy are convinced by the personal experience of loved ones and sundress radio. Most of the heroes of this article, one way or another, who suffered from psychologists and psychotherapists, learned about them from their friends and acquaintances.

So it was with Elena Khromova (the name and surname were changed at her request) . In December 2019, she turned on the recommendation of her former young man to the psychotherapist Dmitry, who also called himself the sky, the same specialist, who used to go to Alexander Selivanov. She was then 22 years old, and she had no experience in therapy. The first couple of months they called up Skype, the session cost 3.5 thousand rubles per hour. When Elena finally got to a specialist for a full -time meeting, she clarified what kind of education he had. According to her, Kryukov replied that he was a clinical psychologist, graduated from the Moscow State Psychological and Pedagogical University (MGPPU).

Khromova believed his word: since therapy helped to remove the alarm, it did not occur to her confirmation. Later, she began to realize that in their joint work, oddities regularly arise. After each meeting, Dmitry hugged her goodbye. Sessions could last longer than the planned hour. After them, the psychologist sometimes smoked grass and invited Elena to drag on. “He asked why I refuse what context I would agree in,” she recalls. “Then nothing confused me at all, because I was young and naive.”

On March 8, 2020, after the next session, Elena and Dmitry decided that they would not continue therapy, because they worked out all its requests. During a smoke break, as she claims, the psychologist said: “I usually do not offer anyone like that, but since we have finished communication in the framework of therapy, I would suggest you hang out unofficially.” Khromova admits that she “bought” to such a “special” attitude and agreed. “[At the time that remained until the end of the session] I was sitting on the chair,” she recalls. “He sat on the floor nearby, hugged and stroked my legs, talked to me about something.”

When time came to an end, Khromova, as before, paid for the office and the services of a psychologist. After that, they walked late around Moscow. “I thought we were just hugging, as before, and I would dive in the subway, and he leaned over and kissed me. I went home and did not quite understand what it was, ”says Khromova. After that, according to her, they began the “slurred format of relations”: they sometimes spent time together, hugged, kissed, engaged in petting (Kryukov denies that something similar was within six months after the end of therapy). After some time, they began a full -fledged relationship - and lasted about a year. As Elena says, when she turned to Kryukov for support, he invited her to conduct a psychotherapeutic session for money - she agreed three times (the psychologist says that she did not conduct any sessions in relations with Khromova). After they broke up, she blocked Dmitry in Telegram, so as not to find out the relationship with him.

I do what I want

At the end of 2016, 21-year-old Marina Kolmykova did not understand what to do with her-later it turns out that she had depression. At some point, a friend sent her a link to the public of a psychologist Daria Bondar and noticed that it seems to him that she was close to Kolmikova in spirit. The girl never went to a psychologist and did not understand how to choose a specialist, so she decided to just sign up for a session.

But how to choose a psychotherapist?

The authors of the book “Stop to endure” indicate the following important factors:

1. Profile diploma - a basic filter for choosing a psychologist. A psychologist without a diploma is not a psychologist, but a person from the street. And although the diploma itself does not guarantee that a person studied well or has passed a modern training program, this is a mandatory requirement.
2. Accessibility and comfort - look for a psychologist with whom you can deal with in a convenient format and at a convenient time. Feel free to look for a psychologist according to the criteria of sex, gender and age, if it is important for you. The price of sessions should also be affordable: it does not mean better. Help is also free: in a crisis center, support group, or by phone of trust.
3. There are different methods of therapy. Some of them are better than others for working with certain conditions-for example, dialectical and behavioral therapy for a borderline personality disorder. If you do not understand the methods yet and do not understand what it is right for you, the authors of the book recommend at least check whether it is considered a universally recognized and evidence -based method in which the specialist you like work.

The conversations took place on Skype. What exactly they talked about, Kolmykova no longer remembers, but she had the feeling that they were leaving aside from her problems - for example, in discussing dreams. “Now I will ask the education, the approach in which the psychologist works, and then I was still very green,” she admits. After several sessions, she decided that Bondar was not suitable for her, and was about to stop therapy when they had a misunderstanding due to the transfer and payment of the session. Kolmykova says that Bondar asked to postpone the meeting, which means that the client should not pay anything. Bondar counted exactly the opposite - and asked Marina to pay for the session (she cost about 1000 rubles). Kolmykova refused and said that the next meeting was not necessary.

After some time, in January 2017, Kolmykova suddenly found a post about herself in a public Daria Bondar. Next to her photograph, the psychologist wrote the text that the girl wanted to “dilute her on the grandmothers” (this is the formulation of Kolmykova, the exact text of the post “The cold” could not be restored). “I was very, very stunned. I was pounding, it became bad, ”recalls Marina. “I remember, I threw off the screenshots of that correspondence about the transfer of [meeting] in the commentary, but Daria deleted them, and I came to her PM, wrote something bad like“ Well, you’re rubbing ”.”

Almost simultaneously, Bondar laid out a screenshot of correspondence with another client. She sent her photos to the psychologist and asked if she had the potential of the photographer and whether it is possible to start her public based on these photos. “When you understand that you are in complete trap,” Bondar joked: the client’s question implied that she would express a personal opinion (this is unacceptable in therapy), and put her in an awkward position. In the comments, she said that the client left her "to study esotericism and clean the aura."

Now Bondar explains that at that time she was still studying as a psychologist at the Moscow Gestalt Institute, and practiced only eight months. She admits that she got angry with Kolmykov and wrote a post on emotions. Two days later, having received a lot of negative comments, Bondar deleted the post - and two weeks later she wrote a personal message to Kolmykova with an apology.

With another client, everything turned out not so simple. “The devil pulled me to lay out this screenshot. I didn’t think that she was reading me, ”Bondar recalls. -She wrote to me in the comments something from the series: “Daria, you’re completely fucking there, but you quickly remove it.” I deleted her comment, she came to me in a personal with accusations, I said that three months have passed already after the completion of therapy, I did what I want in my public, there is no deanon. In general, Hamovato answered, said: “Go to the feminists.” And the shit rushed through the pipes. "

And indeed: the girl wrote in several feminist communities on VKontakte, after which, according to the psychologist, she began to threaten her that her address would be publicized. In addition, activists complained about her to teachers. “I was called to the carpet, reported, they said urgently to apologize. I apologized, ”Bondar recalls. - And after that, our group drove through the brains of ethics and positioning for two days. Forced to read all ethical codes. I read. "

Now Bondar regrets that she brought her negative emotions to the public and conflict with former clients. “Then I used my public to share wild situations and cases from practice,” she says. “But the cases should be decorated differently, it should not be screenshots with an Ober.” She still pays for those mistakes: if you look for it on the Internet, articles on Life.ru and on the website of the Zvezda television channel, reviews on the forums, posts in social networks immediately come up. Some of the clients scare away some of the clients.

Since 2017, Bondar has passed retraining courses on clinical psychology and several short-term courses, for example, family and cognitive-behavioral therapy. According to her, now in social networks she can lay out a funny phrase from sessions like “to mourn the loss of relations, I first turned on Naruto, and after that, the singer Maxim” and tell the case from practice, but takes care of anonymity as much as possible. “Emotions must be expressed in another place, at least in a personal diary,” Bondar concludes. “The main thing is that no one can see.”

The so -called therapists

In social networks and on reviews of reviews, you can find a lot of stories about the unethical behavior of psychologists; There are even special groups for them. Someone is faced with discrimination, someone with depreciation, someone with practices who harm more than help. Almost always we are talking about the situation “Word against the Word”, since communication is one on one; Moreover, psychologists themselves are rarely ready to comment on customer claims.

“Cold” did not include several stories related to claims to the behavior of specialists, in this material, since we could not verify them and get comments on psychologists. In one of these cases, the girl said that she lost confidence in therapy after she told the psychologist that she had suffered from violence in the family in childhood. According to her, he first invited her to think about how it could be “beneficial” to her, and then said that women were often to blame for violence. “The psychologist has power, roughly speaking, to heal or destroy you, because he knows your most vulnerable places,” the interlocutor of “cold” explains. - It would seem that these are just a word. But even a few words can harm a person who has survived such things as household violence. Therefore, I think, it is very bad that in our country there is no clear licensing of the work of psychologists. ”

There really is no regulation of psychological and psychotherapeutic assistance in Russia - and representatives of the professional community themselves admit that this is wrong.

An attempt to change something was last made recently. In October 2022, the Duma Committee on Family, Women and Children sent the text of the bill on psychological assistance for “discussion” in the community and gave it two weeks.

The bill proposes to introduce state control for psychologists: to create a “commission on psychological assistance”, which will be appointed by the “authorized state body”. This commission will approve the standards of assistance and the state policy to ensure psychological assistance. It is also proposed to establish a “all -Russian professional organization”, which will conduct a register of psychologists, and the “central certification commission”, which will conduct exams and issue certificates to psychologists.

The main claims of the professional community to the document are that such a state control structure is fraught with corruption. In addition, deputies did not take into account that in Russia there are at least 15 approaches to psychotherapy, which cannot be reduced to a single standard. Союз практических психологов предложил обязать психологов состоять в зарегистрированном профессиональном общественном объединении (например, по разным подходам) или саморегулируемой организации (СРО), а также завести единый реестр практикующих психологов. По такому же принципу, пишет Би-би-си, в России регулируется деятельность коллекторов и микрофинансистов. Вице-спикер Госдумы Анна Кузнецова в ноябре 2022 года заявляла , что законопроект находится на «финальной стадии», но пока на рассмотрение его так и не внесли.

Соосновательница Коллегии по этике в психологии и психотерапии Наталья Кисельникова, которая работала над правками к законопроекту как приглашенный эксперт, рассказывает, что в западных странах есть два основных способа контроля за лицензиями психолога. Где-то ее можно получить, пройдя обучение по программе, одобренной профессиональными ассоциациями. Где-то ассоциации проводят сертификацию сами.

Кисельникова не верит, что в России закон поможет лишить неэтичных и непрофессиональных психологов работы. «Так называемые терапевты, которые спят с клиентками, очень хорошо приспосабливаются: заплатят кому надо, сдадут экзамен, получат лицензию и продолжат делать то же самое», — говорит она. Соосновательница Alter Ольга Китаина добавляет, что принятие закона не гарантирует, что люди обязательно пойдут к психологу с лицензией, потому что они все равно часто идут к тем, кто пользуется у них авторитетом, кому они доверяют. А назвать себя можно не психотерапевтом, а коучем, консультантом — и продолжать работать дальше.

По словам Кисельниковой, самое эффективное направление работы в этом смысле — просвещение клиентов и терапевтов: чтобы одни лучше понимали, как все устроено, а другие больше задумывались, что они делают.

Пока внешнего регулирования нет, психологи иногда сами занимаются разбирательствами с коллегами, нарушающими этику.

Механизм морального оправдания

В ноябре 2022 года друзья скинули Елене Хромовой пост из телеграм-канала психолога Дмитрия Дюкова. Он рассказывал, что выяснил, что у одного психолога, который модерирует профессиональный телеграм-чат Synapsus, нет профильного образования, — к тому же он общается с клиентами анонимно, не сообщая свою фамилию. Вскоре выяснилось, что речь идет о Дмитрии «Небо» Крюкове.

Чат Synapsus, как следует из его описания, предназначен для «консультирования по проблемам, предположительно, психиатрического плана». Дюков описывает его как «дружественное сообщество, без пяти минут клинику на общественных началах». В чате состоят почти 3,5 тысячи человек — как специалисты, так и клиенты. Как сказал «Холоду» Дмитрий Крюков, когда пять лет назад его сделали администратором чата, про диплом у него никто не спрашивал: «все знают цену» диплому. По его словам, для сообщества гораздо важнее были «успешные совместные ремиссии, хороший разбор кейсов и грамотные высказывания на протяжении пяти лет». (После постов Дюкова Крюкова из чата выгнали.)

Крюков признает, что отношения с обеими клиентками были «ошибкой» и что в обоих случаях он был неправ, однако оспаривает их рассказы. Он настаивает, что инициатором отношений с девушками был не он. На заявления Хромовой Крюков отвечает, что это способ отомстить после «плохого расставания», а про Селиванову говорит, что это она уволила его, чтобы «тусить вместе», но он близкого контакта не хотел, она обиделась и теперь говорит неправду.

По словам Крюкова, во всех случаях, когда он вступал с бывшими пациентками в отношения, он проводил «градуированную проверку смены ролей»: устраивал с ними «новое знакомство с особыми испытаниями осознанности и вербальности», а также проводил «проверки ожиданий, наблюдение за собой и выражением эмоций». Он перечисляет следующие условия, в которых возможны отношения с бывшими клиентами: терапия следовала определенному подходу (например, когнитивно-поведенческому) и прошла успешно, завершилась полгода назад или раньше, человек полиаморен и самостоятелен, у него есть «проверенная легкость других отношений». Также, по версии Крюкова, клиент должен инициировать отношения сам, а его влюбленность должна быть «полностью осознанной». Это не все критерии, которые психолог перечислил в разговоре с «Холодом»; он добавил, что «это должно быть эссе листов на десять как минимум, а лучше — книга на 300 страниц».

И Селиванова, и Хромова сказали «Холоду», что не понимают, о чем говорит Крюков, и не помнят никаких подобных «проверок» и «испытаний».

Крюков добавляет, что пункт о «сближении» через полгода встречается в ряде этических кодексов — например, в кодексе American Mental Health Counselors Association (AMHCA) вообще нет никаких требований по времени, по истечении которого можно вступать в сексуальные отношения с клиентами. «[Американская ассоциация психологов] говорит: год-два, и, как и [у меня], “при особых условиях”», — продолжает Крюков. В кодексе этой ассоциации действительно есть пункт о сексуальных отношениях с бывшими клиентами: они возможны минимум через два года и только при «самых необычных обстоятельствах». В эту ассоциацию входит 133 тысячи специалистов; у AMHCA в 2015 году было 7 тысяч членов.

Про еще одну бывшую клиентку, которая первой подняла вопрос о его образовании, Крюков говорит, что она «сложный человек»: по его версии, до этого она угрозами добивалась отношений с другим психологом, а потом жаловалась на него в чатах (клиентка сказала «Холоду», что Крюков некорректно описал эту ситуацию). Дюков, по мнению Крюкова, раскачал кампанию против него из личной неприязни и в рамках недобросовестной конкуренции, а за год до этого угрожал ему: кто-то отправил Крюкову его геопозицию в телеграме и сказал оглядываться; психолог уверен, что автором сообщения был Дюков (тот это отрицает).

Самого Дюкова в 2020 году тоже обвиняли в неэтичном поведении после того, как он написал в том же телеграм-канале пост о том, что к нему на прием в поисках «кинематографических приключений» иногда приходит «откровенное шмарье». Соосновательница Коллегии по этике в психологии и психотерапии Наталья Кисельникова считает, что такие высказывания нарушают принцип уважения к клиенту и его эмоциональную безопасность: кто-то мог узнать в них себя и потерять доверие к психотерапии или к миру вообще.

По словам Крюкова, из примерно 400 клиентов за семь лет практики романтические отношения у него были с тремя. Под близостью психолог подразумевает «нежность и признания в любви». С Селивановой, как он считает, «близости» у него не было.

Наталья Кисельникова говорит, что в зависимости от подхода отношения с бывшими клиентами (не только романтические, но и дружеские, деловые) допускаются через годы, а не месяцы, а в некоторых подходах они запрещены на всю жизнь. Объясняется это тем, что для клиента терапевт — эмоционально значимая фигура, которой трудно отказать из уважения или страха отвержения. Чтобы отношение к терапевту поменяло такую эмоциональную окраску, требуется не меньше двух-трех лет, говорит Кисельникова.

«Когда психотерапевт придумывает какие-то свои правила — это механизм морального оправдания, — продолжает она. — Ты просто не можешь оставаться в профессиональной позиции, а хочешь удовлетворить свои собственные потребности. Ты не думаешь о благе клиента, которым на самом деле должен руководствоваться».

Крюков подчеркивает, что у клиентов никогда не было к нему претензий по части терапии, — и действительно, и Александра Селиванова, и Елена Хромова оценивают его скорее положительно. «Одно время мне даже казалось, что он меня с того света вытащил, — говорит Селиванова. — Для неопытных и побитых жизнью людей Дима выглядел как спаситель».

По ее словам, тяжелее всего ей было объяснять окружающим, почему отношения с психологом — это неправильно. «От общих знакомых и даже от партнера я постоянно слышала: “Ну ты же сама согласилась! Ты же понимаешь, что сама виновата? Тебя же никто не заставлял”, — вспоминает Александра. — Если бы речь шла о равных субъектах, я бы и слова не сказала. Но в терапии есть дисбаланс информации».

По ее словам, Крюков регулярно «приносил» в их уже не терапевтические отношения рассуждения и выводы о том, «как она устроена», мог сказать: «Вы же понимаете, Саша довольно эмоциональный человек и может наговорить всякого». «Человек получил доступ к твоему очень глубокому материалу и теперь обращается с ним произвольно, общаясь с тобой и твоими близкими», — объясняет она и добавляет: когда твой бывший терапевт говорит тебе, что ты истеричка, ты невольно ему веришь.

Крюков сказал «Холоду», что такого «абсолютно точно не было». «Тут принципиальная проблема таких обвинений: пациент может говорить все что угодно, а мы не можем отвечать подробно, не раскрывая закрытой информации», — пояснил он. А потом добавил, что Александра — «аутичный чемпион по “Мафии” со склонностью к контролю, [которая] никогда ничего не “наговорит” без подробно продуманной цели».

В конце концов Александра Селиванова ушла из полиаморного сообщества, рассталась с партнером, практически полностью поменяла круг общения и переехала. «За пять лет я слишком много слышала “А что такого?”. Пожалуй, эта ситуация злит меня не тем, что он сделал, — это можно пережить, — говорит она. — Меня злит, что за это время никто не поинтересовался, есть ли у него диплом, что все его рекомендовали и никто его не остановил. Я уже не уверена, что словом можно кому-то помочь — но навредить точно можно».