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The history of the formation and development of pathopsychology. Development of ideas about pathopsychology in the pre-revolutionary period

15.09.2020

Chapter I

TO THE HISTORY OF DEVELOPMENT
DOMESTIC PATHOPSYCHOLOGY
(The chapter was written jointly with V.I.Belozertseva)

Domestic pathopsychology has a different history of development than modern clinical psychology in the West. However, they were born simultaneously, at the beginning of the 20th century, and were brought to life by the demands of psychiatric practice and the achievements of psychological science.

Until the end of the XIX century. most psychiatrists in the world did not use the data of psychology: the futility of its speculative introspective provisions for the needs of the clinic was obvious. In psychiatric journals 60s-80s. of the last century, many works were published on the anatomy and physiology of the nervous system, and there were virtually no psychological articles.

Interest in psychology on the part of leading psychoneurologists arose in connection with a radical turn in its development - the organization in 1879 by W. Wundt in Leipzig of the world's first experimental psychological laboratory. The introduction of the methods of natural science into psychology tore it out of the bosom of idealistic philosophy. Psychology became an independent science. And the further development of psychiatry was unthinkable outside the union with experimental psychology. "It is no longer possible for a psychiatrist to neglect the provisions of modern psychology, which is based on experiment, and not on speculation," wrote VM Bekhterev [27, 595]. "Let us leave the work of artists to reproduce the inner world of the mentally ill, to recreate their emotional experiences, which some of them (Dostoevsky, Garshin, etc.) achieve much better than doctors ..." [31, 11].

At large psychiatric clinics at the end of the 19th century. psychological laboratories began to be organized - E. Kraepelin in Germany (1879), P. Janet in France (1890). Experimental psychological laboratories were also opened at psychiatric clinics in Russia - the second in Europe laboratory of V.M.Bekhterev in Kazan (1885), then in St. Petersburg, the laboratory of S.S.Korsakov in Moscow (1886), V.F. Chizh in Yuryev , I. A. Sikorsky in Kiev, P. I. Kovalevsky in Kharkov. A number of laboratories have been established in the USA and England.

Experimental psychological methods for studying disturbed psyche were developed in the laboratories. At the same time, to compare the results, the psyche of healthy people was studied. Since in Russia the official psychological science stubbornly adhered to the introspective method, remaining in the mainstream of philosophical knowledge, psychiatrists were the first experimental psychologists. In oral speeches and on the pages of the press, they substantiated the need to turn psychology into an experimental science, proved the inconsistency of speculative speculative constructions: “Science must be accurate and cannot be content with analogy, assumptions ... and even more so it cannot put up with the products of fantasy and creativity on the spot reality "[26,398].

At the beginning of the XX century. researchers of mental disorders announce the isolation of a special branch of knowledge - pathological psychology... In the literature of those years, there is still an undifferentiated use of the terms "pathopsychology" and "psychopathology". Thus, A. Gregor (1910) writes: "Experimental psychopathology studies the performance of mental functions under abnormal conditions created by a painful process underlying mental illness" [211, 3]. "Special conditions of research, and even more special formulation of questions given by the needs of a psychiatric clinic, led to the formation of an independent discipline - experimental psychopathologycontacting, but not merging with ... clinical psychiatry, general and individual psychology, "wrote P. M. Zinoviev [70, 6]," the scientific discipline that studies the mental life of mentally ill people is called psychopathology or pathological psychology ... "[140, 75].

The confusion of the concepts of "pathopsychology" and "psychopathology" occurred due to the lack of a clear differentiation of the tasks of psychology and psychiatry during the period of initial accumulation of factual material in specific studies of mental anomalies, especially since researchers, as a rule, combined both a psychiatrist and a psychologist in one person.

The clearest idea of \u200b\u200bthe subject and tasks of pathopsychology at the dawn of its formation was contained in the works of V.M.Bekhterev: "The latest advances in psychiatry, owing largely to the clinical study of mental disorders at the patient's bedside, served as the basis for a special department of knowledge known as pathological psychology (italics mine. - B. 3.), which has already led to the solution of many psychological problems and from which, no doubt, even more in this respect can be expected in the future "[23, 12-13]. "objective psychology", the scientist defined its subject: "... the study of abnormal manifestations of the mental sphere, since they illuminate the tasks of the psychology of normal persons" [26, 8] - Deviations and modifications of normal manifestations of mental activity, according to V. M. Bekhterev, are subject to the same basic laws as a healthy psyche.Thus, VM Bekhterev no longer equated the concepts of “pathopsychology” and “psychopathology.” In the Psychoneurological Institute he organized, courses of general psychopathology and pathological psychology were taught at the same time, i.e. they were different disciplines.

At the very origins of the emerging branch of psychology, many domestic and foreign scientists noted that its significance goes beyond the science applied to psychiatry.

Mental disorders were viewed as an experiment of nature, affecting for the most part complex mental phenomena, to which experimental psychology had no approach. Thus, psychology received a new tool of knowledge. “Disease turns into a subtle instrument of analysis,” wrote T. Ribot. “It makes experiments for us that are unrealizable in any other way” [156, 61].

In one of the first generalizing works on pathopsychology, "Psychopathology as Applied to Psychology," the Swiss psychiatrist G. Störring held the idea that a change in an element of mental life as a result of illness makes it possible to judge its significance and place in complex mental phenomena. Pathological material contributes to the formulation of new problems in psychology, in addition, pathopsychological phenomena can serve as a criterion for evaluating psychological theories.

In the preface to the Russian translation of the work of G. Storring, V. M. Bekhterev noted: "Due to a more convex picture of pathological manifestations of mental activity, the relationships between individual elements of complex mental processes often appear much brighter and more prominent than in a normal state. For example, in pathological cases it is better the constituent elements of personality consciousness are clarified, the meaning in the mental life of mood and the sensitive sphere in general appears more clearly, the factors determining the processes of memory, associations and judgments, etc., are more fully clarified. In view of this, it is natural that modern psychologists more and more often turn to psychopathology for clarification of many controversial issues "[195, 1].

AF Lazursky expressed similar thoughts: "The data obtained by the pathology of the soul made it necessary to revise, and in many cases to undergo a thorough processing, many important departments of normal psychology." There appeared "an opportunity to examine the mental properties of a person as if through a magnifying glass, making it clear to us such details, the existence of which in normal subjects can only be guessed at" [108, 664, 665].

Thus, studies of mental disorders in their very origins were considered by domestic and foreign scientists in the mainstream of psychological knowledge. At the same time, the great importance of experimental psychological research for solving the problems of psychiatry was recognized. Thus, in connection with the studies of mental disorders by E. Kraepelin and his collaborators, V. Henri pointed out that experimental psychology provides methods that allow one to notice insignificant changes in the state of the patient's mental functions, "follow the course of the disease step by step," observing positive or negative the impact of treatments. Physicians usually see only large changes that do not give the opportunity to finely regulate the treatment process [216,41].

We will not discuss the ways of development of pathopsychology abroad. Let us note only the significant contribution to its formation of the studies of the school of E. Kraepelin and the appearance in the 1920s. of our century of works on medical psychology by well-known foreign psychiatrists: "Medical Psychology" E. Kretschmer, which treats the problems of development and mental disorders from the unacceptable for us positions of constitutionalism, and "Medical Psychology" by P. Janet, devoted mainly to issues of psychotherapy. *

* The history of the formation and development of foreign and domestic pathopsychology has not been sufficiently studied and is presented in our literature.

If progressive psychiatrists stood at the origins of foreign pathopsychology, then later this branch developed and develops under the influence of ideas from various directions of bourgeois psychology - behaviorism, psychoanalysis, humanistic and existential psychology. Of course, one cannot deny the positive significance, for example, for the practice of psychotherapy, the ideas of K. Rogers, G. Allport, A. Maslow. However, the theoretical provisions of these directions are methodologically untenable; in the practice of foreign pathopsychology, the main emphasis is not on experiment, but on the measurement and correlation of individual characteristics, personality traits; the practical psychological service is influenced by the ideas of the so-called "antipsychiatry" and "community psychology".

Developed domestic pathopsychology from the very beginning was distinguished by strong natural science traditions. The formation of its principles and research methods was influenced by the work of IM Sechenov "Reflexes of the Brain" (1863), which made a "gap in the wall" dividing physiology and psychology. I.M.Sechenov himself attached great importance to the convergence of psychology and psychiatry. In a letter to MA Bokova, the father of Russian physiology announced his intention to engage in psychological experiments and develop medical psychology, which he lovingly called his "swan song" [171, 239]. But circumstances did not allow him to carry out his intentions.

The successor of I.M.Sechenov on this path was V.M.Bekhterev, a psychiatrist by training, the founder of materialistically oriented experimental psychology and the founder of the pathopsychological trend in Russia. As a representative of the reflex concept, he considered the only scientific objective method for the study of mental activity, which requires, if possible, to cover the entire set of facts of the external manifestation of neuropsychics and related conditions ... "[28, 592].

To disassociate himself from introspectionism, V.M.Bekhterev refused to use psychological terminology. The conceptual apparatus of the theory he developed creates the impression that the school of V.M.Bekhterev was concerned exclusively with physiology. * However, the design of the research was aimed mainly at analyzing the performance of experimental tasks, and not at the features of neurodynamics. "Objective psychology" V. M. Bekhterev broke with traditional functionalism and proposed to experimentally investigate various types of activity: how the patient is identified with impressions, the definition of inconsistencies in pictures and stories, the combination of verbal symbols and external impressions, replenishment of syllables and words when they are omitted in the text , determination of similarities and differences between objects, the formation of a conclusion from two premises, etc.

* "Impression" (perception), "consolidation", or "fixation of traces" (memorization), "revival of traces" (recollection), "identification of traces" (recognition), "concentration" (attention), "combination of traces" (associations) , "general tone", or "mood" (feelings), etc. [26, 589 ].

But in the course of the struggle with subjective-idealistic psychology, V. M. Bekhterev, who had not mastered dialectical materialism, came to the creation of "reflexology", in which he mechanically split real activity: he absolutized its external manifestations and ignored the mental image. From the activity, its motivational component was emasculated, which made it possible to see the subject of activity in a person.

It should be noted that despite this, in the specific works of the Bekhterev school, the theoretical departure from psychological terminology and the corresponding analysis was not always carried out. As for pathopsychological studies, most of them were carried out in the pre-reflexological period of V. M. Bekhterev's work, when such a task was not at all posed.

The range of pathopsychological research can be judged by the doctoral dissertations carried out under the guidance of V. M. Bekhterev: L. S. Pavlovskaya. Experimental psychological studies on patients "with increasing paralytic dementia (1907); MI Astvatsaturov. Clinical and experimental psychological studies of speech function (1908); KN Zavadovsky. The nature of associations in patients with chronic primary insanity (1909) ; A. V. Ilyin. On the processes of concentration (attention) in mentally ill mentally ill (1909); L. G. Gutman. Experimental psychological research in manic-melancholic psychosis (1909); V. V. Abramov. Objective psychological study of creativity and other intellectual functions in the mentally ill (1911), etc.

Representatives of the school of V.M.Bekhterev have developed many methods of experimental psychological research of the mentally ill. Some of them (the method of comparing concepts, defining concepts) are among the most used in Soviet psychology.

The requirements for the techniques formulated by V.M.Bekhterev and S.D. Vladychko have retained their significance for modern science: simplicity (for solving experimental problems, the subjects should not have special knowledge and skills) and portability (the possibility of research directly at the patient's bedside, outside the laboratory environment ).

The works of the Bekhterev school reflect rich concrete material on disorders of perception and memory, mental activity, imagination, attention and mental performance. The experimental results were compared with the characteristics of the patient's behavior outside the experimental situation. The case histories, written from the standpoint of objective psychology, contain information valuable for psychological analysis about disorders of the personality, consciousness and self-consciousness, and the emotional-volitional sphere. They are presented in dynamics, which allows you to see the conditions and stages of development of a mental defect, which are manifested in the real life of a person.

Some pathopsychological studies of the school are of interest as a historical fact of the "activity" approach to mental phenomena. Thus, in the multifaceted studies of V. M. Bekhterev's collaborators, associations are not a mechanical cohesion of ideas, but the result of activity, depending on its structure and dynamics. Or, for example, speech is analyzed in a system of holistic behavior; its features in the experimental conversation are compared with the patient's speech in other circumstances; it is shown that similar speech reactions can have a different nature, the absence or perversion of the speech reaction is possible not only because of mental disability, but also as an expression of negativism, "involuntary but conscious desire of patients to evade external influence on their will" [16, 290 ]. All this objective material may well be analyzed in line with the modern theory of activity.

The main principles of pathopsychological research in the school of V.M.Bekhterev were: the use of a set of methods, a qualitative analysis of mental disorders, a personal approach, correlation of the research results with the data of healthy persons of the corresponding age, gender, education.

The use of a set of techniques - observing the subject during the experiment, taking into account the peculiarities of his behavior outside the experimental situation, combining various experimental techniques for studying the same pathological phenomena - contributed to obtaining rich objective material.

The principle of qualitative analysis, put forward in the period of the enthusiasm of many researchers by measuring methods (the approach to mental disorders as a quantitative decrease in certain abilities), has become traditional in Russian pathopsychology. But the theoretical platform of the scientist, especially during the development of reflexology, limited the analysis to the flow of external features of activity. And the recorded objective material was not brought to a truly psychological analysis.

The valuable and fruitful principle of the personal approach was also put forward by VM Bekhterev during the period of functionalism dominance in the world of experimental psychology: “The personality of the patient and its attitude to the experiment is not left unattended by the experimenter. ... Everything that can be given by objective observation of the patient , starting with facial expressions and ending with statements and behavior of the patient, must be taken into account ... evaluated in connection with all conditions of the experiment, not excluding those immediately preceding the experiment "[28, 593]. But the "objective method" of VM Bekhterev contradicted the possibilities of this principle, and the analysis remained incomplete.

KI Povarnin, a representative of the V.M.Bekhterev school, wrote that the patient's attitude to the experimental problem is reflected in the results of objective research: “If a normal subject meets the experimenter halfway in his aspirations, then the mentally ill can treat the experience completely differently: he can be careless to the work offered to him, performs it somehow due to complete indifference to the interests of experience or latent unwillingness, or distracting delirium and hallucinations; he, finally, can completely abandon experience due to suspicion, etc. " [148, 33]. In this regard, the question was raised about the skillful individual approach of the experimenter to the patient, such that would encourage participation in the experiment.

The views of K.I. Povarnin and other representatives of the school of V.M.Bekhterev were greatly influenced by the head of the psychological laboratory of the Psychoneurological Institute A.F. Lazursky. As a student and collaborator of V.M.Bekhterev, he became the organizer of his own psychological school. In the preface to AF Lazursky's book "General and Experimental Psychology", LS Vygotsky wrote that its author was one of those researchers who were on the path of transforming empirical psychology into scientific. AF Lazursky himself worked mainly on the issues of individual and educational psychology, but ideas from these branches were transferred to pathopsychology. So, K.I. Povarnin pointed out the need to take into account the individual characteristics of patients, since sometimes defects are found where, in fact, individual characteristics are sharply expressed. For example, poor memorization is possible not due to illness, but as a result of poor auditory memory, as can be seen from memorizing visually perceived. This idea enriched the principle of correlating the results of research of sick and healthy.

A natural experiment developed by A.F. Lazursky for the needs of educational psychology was introduced into the clinic. It was used in the course of organizing the leisure time of patients, their activities and entertainment - for a special purpose, calculating tasks, rebuses, riddles, tasks to fill in letters, syllables, etc., were missing in the text.

Thus, pathopsychology already in its origins had all the signs necessary to establish its scientific independence as a branch of psychological science: the subject of research is mental disorders; methods - the entire arsenal of psychological methods; the conceptual apparatus is the apparatus of psychological science. Another thing is what kind of content was put into the concept of the psyche by representatives of various psychological trends. In the school of V.M.Bekhterev, broad development prospects were outlined, theoretical and applied aspects of the emerging industry were identified.

Communication with psychiatry was carried out through participation in the recreation of the psychopathological syndrome characteristic of various mental illnesses. Experimental studies were used in solving problems of differential diagnosis and in monitoring the dynamics of mental disorders during treatment. They helped to penetrate the mechanisms of mental illness. So, VM Bekhterev experimentally proved that in the appearance and localization of hallucinations in patients, their orienting activity plays a role - anxious listening, scrutiny; demonstrated the relationship of hallucinations with illusions.

At the school of V. M. Bekhterev, the development of the foundations of psycho-reflex therapy began. "By analogy with the physical method of strengthening a sick organism," wrote A. V. Ilyin, "psychological experience will make it possible to find a way, if not even for relative recovery, then at least for maintaining the patient's dying psyche" [76, 480] ... As a method of treatment of hysterical anesthesia and paralysis, obsessive states and pathological drives, the "education" of combination-motor reflexes, which supplanted pathological reflexes, was used; work was carried out on raising mental activity through a certain dosage of mental labor in the form of reading and taking notes and other forms of mental activities of adults. This kind of therapy merged with curative pedagogy, but psychological methods proper played a very modest role in it. The specific participation of psychologists in the construction of general principles and the creation of specific methodological methods of psychotherapeutic influence begins to take shape in Soviet pathopsychology only in our time.

Pathopsychological methods were used in pediatric and forensic examinations. VM Bekhterev and NM Shchelovanov wrote that the data of pathological psychology make it possible to almost accurately recognize mentally incompetent schoolchildren in order to single them out in special institutions for the retarded.

The practice of forensic medical examination gave rise to the need for research at the intersection of pathological and individual psychology, which had not only practical, but also theoretical value. Research at the intersection of pathopsychology with social psychology was also planned. "The influence of patients on each other and the wide area of \u200b\u200bnormal suggestibility and imitation among healthy people are extremely interesting questions for both the psychiatrist and the psychologist; this issue deserves full attention of experimental psychology, collective psychology, sociology, pedagogy and criminal anthropology" [7, 758 ]. He has a practical interest in setting up cases in schools, hospitals, in the fight against neuroses and psychosis.

It is interesting that in the school of V. M. Bekhterev the problem of the relationship between the development and disintegration of the psyche was outlined, which found a solution much later, on the theoretical basis of the works of L. S. Vygotsky (B. V. Zeigarnik. B. S. Bratus, M. A. Kareva, S. Ya. Rubinstein, V.V. Lebedinsky). So, M. Marzhetskiy wrote about the tempting of comparing the data obtained "by observation and experiments on children, with the data obtained in the work on the mentally ill" [129, 733]. Such work was carried out by L. S. Pavlovskaya, showing the heterogeneity of the "disintegration" in two groups of patients - idiots and with juvenile dementia - and the qualitative difference in their solutions to experimental problems in comparison with the solution of problems beyond their powers by children of the fourth year of life ".

VM Bekhterev did not consider the study of the psyche of the mentally ill as the key to understanding the inner world of the healthy. From the norm - to pathology, in order to restore the patient's neuropsychic health - this should be the way of the psychiatrist's thoughts. Therefore, both in the practice of training a neuropathologist and psychiatrist, and in scientific psychiatric searches of the school of V.M.Bekhterev, the psychology of a normal person occupied an honorable place.

KI Povarnin expressed valuable thoughts about the importance of general psychological training: “Researchers-doctors often consider it possible to begin experimental psychological research of the mentally ill, without bothering to get familiar even with the basics of normal psychology. ... With such an attitude to psychological research, it is difficult to expect from them with satisfactory results ... After all, the mental life of a person is the most complex object of study in all nature and requires a skillful and careful approach armed with psychological knowledge "[148, 38-39].

Insufficient psychological preparation can lead to gross mistakes - a simplified understanding of mental phenomena, incorrect conclusions. A complex psychological reality, in which all the components are fused together, the experimenter must skillfully reorganize, bringing to the fore the phenomenon under study. Knowledge of psychology is necessary both when choosing a method of research and when analyzing the results.

In addition to theoretical knowledge, researchers need practical training: "Skill in work, the ability to approach the subject, the systematic conduct of the experiment, an infinite number of trifles that are overlooked in theoretical presentation, but extremely important for the case, can be learned only in practice" [148, 42]. It is necessary to be able to keep a protocol, register results, distribute the sequence in time and duration of experiments, etc. KI Povarnin noted that "science cannot get rid of works that discredit the experimental psychological method" until insufficiently trained experimenters are engaged in research.

Versatile specific research and the development of elementary theoretical foundations allow us to consider the contribution of the school of V.M.Bekhterev to pathopsychology as the starting point for the formation of this industry in Russia. That is why VM Bekhterev and his collaborators are given so much attention in this book.

The second major center of domestic psychiatry, in which experimental psychology developed, was the psychiatric clinic of S. S. Korsakov, organized in 1887 at the medical faculty of Moscow University. The psychological laboratory of the clinic was headed by A.A. Tokarsky. He edited the "Notes of the Psychological Laboratory", a significant content of which was the research of students.

Like all representatives of progressive trends in psychiatry, S. S. Korsakov was of the opinion that only knowledge of the foundations of psychological science makes it possible to correctly understand the disintegration of the mental activity of a mentally ill person. It is no coincidence that he began reading a course in psychiatry with a presentation of the foundations of psychology. Similar traditions were followed by the followers of S. S. Korsakov: V. P. Serbsky, V. A. Gilyarovsky and others. They believed that psychological training is necessary for a doctor of any specialty. S. S. Korsakov even applied in 1889 with a petition for the establishment of a special department of psychology at the medical faculty. However, it did not receive support from the university administration.

S. S. Korsakov and his collaborators were the organizers and participants of the Moscow Psychological Society. S. S. Korsakov himself was the chairman of this society. The works that came out of his clinic made a valuable contribution to psychological science - to the understanding of the mechanisms of memory and its disorders, mechanisms and disorders of thinking. Thus, the world famous "Korsakov syndrome" gave new ideas about the temporal structure of human memory, laid the foundations for dividing the types of memory into long-term and short-term. In his work "On the Psychology of Microcephaly," S. S. Korsakov wrote about the absence of a "guiding function of the mind" in idiots, which makes human actions meaningful and expedient. Analysis of the structure of dementia in the work of AA Tokarsky "On stupidity" led to the idea that the disorders of the intellectual activity of patients are not reduced to the disintegration of individual abilities, but represent complex forms of disorders of all purposeful mental activity.

A number of meetings of the Moscow Society of Psychologists were devoted to familiarization with the methods of psychological research, with works on experimental psychological diagnostics of mental illness. Great interest was aroused by the book by A. N. Bernstein "Clinical Methods of Psychological Research of the Mentally Ill" and "Atlas for Experimental Psychological Research of Personality" by FG \u200b\u200bRybakov.

GI Rossolimo's work "Psychological Profiles. A Method for Quantitative Research of Psychological Processes in Normal and Pathological Conditions" was widely known in Russia and abroad. It attempted to transform psychology into an exact science - it proposed a certain system of examination and assessment on a 10-point scale of mental processes. As a result, an individual curve (profile) was obtained that characterizes the level of the "primary", innate, and "secondary", acquired, mind. These were the first attempts at test tests, and G.I. Rossolimo, with his positive aspirations, was one of the founders of pedology in Russia, the methodological and practical inconsistency of which was revealed in the 30s. and received a critical conclusion in the decree of the Central Committee of the All-Union Communist Party of Bolsheviks dated July 4, 1936.

As a rule, the leading psychoneurologists of pre-revolutionary Russia were the conductors of the advanced ideas of psychology and contributed to its development in the scientific and organizational direction. They were members of scientific psychological societies, editors and authors of psychological journals.

After the Great October Socialist Revolution, it was at the neuropsychiatric congresses that the first reports of the Soviet psychologists who advocated the construction of Marxist psychology, K.N. Vygotsky spoke for the first time at the II Congress, raising his voice against the mechanistic emasculation of the psychology of the mental image.

This situation largely determined the nature of pathopsychological research and the ways of their further development. The close connection with clinical practice and the tendency to theoretically comprehend the obtained facts saved pathopsychologists already at that time from naked empiricism and speculative constructions, which are still characteristic of pathopsychology in many foreign countries. The development of pathopsychology proceeded in line with the general development of psychology as a science based on the foundations of Marxist-Leninist philosophy.

The development of pathopsychology as a special area of \u200b\u200bknowledge was greatly influenced by the ideas of the outstanding Soviet psychologist L. S. Vygotsky: 1) the human brain has different principles of organization than the brain of an animal; 2) the development of higher mental functions is not predetermined by the morphological structure of the brain, they arise not as a result of the maturation of brain structures alone, but are formed in life by appropriating the experience of mankind in the process of communication, training, education; 3) the defeat of the same zones of the cortex has a different meaning at different stages of mental development.

The theoretical ideas of L.S.Vygotsky, which were further developed in the works of his students and collaborators A.R. Luria, A.N. Leontyev, P. Ya.Gal'perin, L.I.Bozhovich, A.V. Zaporozhets, largely determined path of pathopsychological and neuropsychological research in our country.

LS Vygotsky himself headed the pathopsychological laboratory at the Moscow branch of the VIEM on the basis of the clinic. S. S. Korsakov, in which the psychologists G. V. Birenbaum, B. V. Zeigarnik and others worked. Experimental studies of the psychology of mental retardation served as material for L. S. Vygotsky to construct a theory of the connection between the cognitive and motivational spheres in a fundamental discussion with K. Levin (on the connection between intellect and affect).

Experimental research under the leadership of L. S. Vygotsky laid the foundation for a multifaceted study of the decay of thinking by B.V. Zeigarnik and her collaborators in the pathopsychological laboratory of the Institute of Psychiatry of the RSFSR Ministry of Health and Moscow State University. There is no need to further describe the development of Soviet psychology in historical terms, since the substantive characteristics of its achievements are presented in the corresponding chapters of the book. Let's name only the main centers in which pathopsychological studies were carried out.

This is a neuropsychiatric institute named after I. V.M.Bekhterev and Leningrad State University, where for several decades VN Myasishchev directed the research on pathopsychology. In accordance with the traditions of the school of V.M.Bekhterev, on a new methodological basis, in line with the theory of relations of V.N.Myasishchev, research was carried out in different areas of medical psychology. These studies continued the best traditions of the school of V. M. Bekhterev - a holistic approach to personality and intransigence to functionalism: "The psychology of impersonal processes should be replaced by the psychology of an active personality, or personality in activity" [135, 11].

A number of works were devoted to the violation of the structure of the labor activity of patients, the study of the influence of the attitude of patients to work on their performance. On the basis of these studies, V.N.Myasishchev put forward the position that impaired performance should be considered as the main manifestation of a person's mental illness and that the indicator of performance serves as one of the criteria for the mental state of the patient. The works of the Leningrad school of pathopsychologists of this period have not yet lost their relevance, both in content and in experimental methods.

Pathopsychological studies of disorders of cognitive activity and motivational sphere have been widely developed in the laboratory of the Central Institute of Psychiatry of the Ministry of Health of the RSFSR on the basis of the V.I. P. B. Gannushkina (B. V. Zeigarnik, S. Ya. Rubinshtein, T. I. Tepenitsyna, Yu. F. Polyakov, V. V. Nikolaeva). Much work is being done on pathopsychology at the Center for Mental Health of the USSR Academy of Medical Sciences (Yu. F. Polyakov, T. K. Meleshko, V. P. Kritskaya, N. V. Kurek, etc.).

The social aspect of pathopsychological research is presented in the psychological laboratory of the Central Scientific Research Institute for the Expertise of Working Ability and Labor Organization of Disabled People, created for the first time in the world in the USSR (V.M.Kogan, E.A.Korobkova, I.N.Dukelskaya, etc.).

In line with the theory of D.N.Uznadze, psychologists and psychiatrists of Georgia have conducted and continue to conduct studies of set disorders in various forms of mental illness.

Since 1949, at the initiative of S.L. Rubinstein, a course on pathopsychology began to be taught at the Moscow State University. MV Lomonosov at the psychological department of the philosophy faculty. Currently, such courses have been introduced into the curricula of all faculties or departments of psychology at universities in the country.

In recent years, the importance of pathopsychology in psychocorrectional work has grown, which is carried out in various types of psychological services: psychocorrection and prevention in the somatic clinic and clinic of neuroses, outpatient departments of crisis states, "helplines", "Family service", etc. Pathopsychologists take part in group psychocorrection (Psychoneurological Institute named after V.M.Bekhterev, Clinic of neuroses, a number of psychiatric hospitals, etc.).

The network of laboratories is expanding to restore both individual impaired functions and the ability to work of sick people. The participation of psychologists is now becoming not only necessary, but often a leading factor both in diagnostic work and in the field of prevention and psychocorrection of mental disorders.

Pathopsychological research in children's psychoneurological institutions has received special development. Techniques are being developed to facilitate the early diagnosis of mental retardation; an analysis of complex pictures of underdevelopment in childhood is carried out in order to search for additional differential diagnostic signs and symptoms; using the position of L. S. Vygotsky about the "zone of proximal development", pathopsychologists are developing methods of "teaching experiment" aimed at identifying prognostically important signs of children's learning ability (S. Ya. Rubinshtein, V. V. Lebedinsky, A. Ya. Ivanova, E. . S. Mandrusova and others). Methods of game psychocorrection are being developed (A.S. Spivakovskaya, I.F.Rapokhina, R.A. Kharitonov, L.M. Khripkova). The role of pathopsychologists in the field of labor, forensic psychiatric and forensic psychological examinations has significantly increased ...

The rapid growth of research and practical work in the field of experimental pathopsychology contributes to the creation of sections in scientific societies of psychologists that unite and coordinate research in the field of pathopsychology. At the all-Union congresses of the country's psychologists, reports of pathopsychologists were widely presented, which concentrated around the following problems: 1) the importance of pathopsychology for the theory of general psychology; 2) problems of psychocorrection; 3) pathology of cognitive activity and personality. Similar symposia were organized at international congresses of psychologists (1966 - Moscow, 1969 - London, 1972 - Tokyo, 1982 - Leipzig).

Thus, at present, an applied field of psychology is developing, which has its own subject and methods - experimental pathopsychology.

The history of pathopsychology is associated with the development of psychiatry, neurology and experimental psychology.

At the end of the XIX century. psychology began to gradually lose the character of a speculative science, and the methods of natural science began to be used in its research. The experimental methods of W. Wundt and his students penetrated into psychiatric clinics - the clinic of E. Kraepelin (1879), the largest psychiatric clinic in France in Salpetrieres (1890), where P. Janet held the position of head of the laboratory for more than 50 years; experimental psychological laboratories were also opened in psychiatric clinics in Russia - in the laboratory of V.M.Bekhterev in Kazan (1886), then in the laboratory of V.F.Chizh in Yuryev, I.A.Sikorsky in Kiev, etc.

Pathopsychology as an independent branch of psychological science began to form at the beginning of the 20th century. Thus, in 1904, VM \u200b\u200bBekhterev writes that the latest advances in psychiatry were largely due to the clinical study of the patient's mental disorders and formed the basis of a special section of knowledge - pathological psychology; she has already helped solve many psychological problems, and is likely to provide even more help in the future.

It was in the works of V.M.Bekhterev that the clearest ideas about the subject and tasks of pathopsychology at the initial stages of its formation were contained, namely, the study of abnormal manifestations of the mental sphere, since they illuminate the tasks facing the psychology of normal people. The Psychoneurological Institute, organized by V.M.Bekhterev, taught courses in general psychopathology and pathological psychology. In the literature of those years, it is designated as "pathological psychology" (VM Bekhterev, 1907).

In one of the first generalizing works on pathopsychology, "Psychopathology as applied to psychology," the Swiss psychiatrist G. Sterring wrote that a change as a result of illness of a particular component of mental life makes it possible to find out in which processes it takes part and what significance it has for phenomena , which include. Pathological material contributes to the formulation of new problems in general psychology, thereby contributing to its development; in addition, pathological phenomena can serve as a criterion for evaluating psychological theories.

Thus, at the very origins of the new branch of psychological science, when specific material had not yet been sufficiently accumulated, scientists already realized its importance as a science applied to psychiatry. In the preface to the Russian edition of the work of G. Sterring (1903), V.M.Bekhterev expressed the idea that pathological manifestations of mental activity are deviations and modifications of normal manifestations of mental activity, subject to the same laws.

In the 20s. XX century works on medical psychology of famous foreign psychiatrists appear: "Medical Psychology" by E. Kretschmer, which treats the problems of decay and development from the standpoint of constitutionalism, and "Medical Psychology" by P. Janet, in which the author dwells on the problems of psychotherapy.

The development of Russian pathopsychology was distinguished by the presence of strong natural science traditions. IM Sechenov attached great importance to the convergence of psychology and psychiatry. In a letter to M. A. Bokova in 1876, he announced that he was starting to create medical psychology - his "swan song" - and stated the fact that psychology was becoming the basis of psychiatry. The scientist - in particular, his work "Reflexes of the Brain" (1863) - had a significant impact on the formation of its principles and methods. However, the founder of the pathopsychological trend in Russia was not I.M.Sechenov, but V.M.Bekhterev, who organized extensive experimental psychological studies of mental disorders.

The representative of the reflex concept V.M.Bekhterev expelled introspection from the sphere of science, declaring the objective method to be the only scientific method, which was his merit during the period of dominance of subjective-idealistic psychology. But, as you know, the logic of the fight against introspective psychology led V.M.Bekhterev to abandon not only the use of psychological terminology, but also from attempts to penetrate the subjective world, to the creation of reflexology, and this could not but affect the pathopsychological studies of his students and employees: the reflexological principle deprived the study of the actual psychological analysis of objective manifestations of the psyche. Therefore, it is rather the protocol records of the works of the school of V.M.Bekhterev that are of interest, and not the analysis itself: an objective study required, if possible, to cover the entire set of factors associated with the external manifestation of neuropsychics, as well as the conditions accompanying them.

In addition, most of the pathological studies were carried out in the pre-reflex period of V. M. Bekhterev's work, in the laboratory and clinic of mental and nervous diseases of the Military Medical Academy in St. Petersburg.

In the works of the school of V. M. Bekhterev, rich concrete material was obtained about the features of associative activity, thinking, speech, attention, mental performance in different categories of patients in comparison with healthy people of the corresponding age, sex and education; this material is of interest as a historical fact of the "activity" approach to mental phenomena.

Avoiding one's own psychological analysis actually contradicted the principle of the personal approach put forward by V.M.Bekhterev, according to which during the experiment the patient's personality and his attitude to the experiment are taken into account, the smallest details are taken into account - starting with facial expressions and ending with the patient's remarks and behavior. This contradiction led to the fact that, contrary to the principles of reflexology, psychological analysis penetrated into the specific studies of representatives of the school of V.M.Bekhterev. An example is the work of MI Astvatsaturov, published in 1907, "On the manifestation of negativism in speech." The patient's speech in this study is analyzed in the system of holistic behavior, the features of speech in the experimental conversation are compared with the patient's speech in other circumstances, it is emphasized that similar speech reactions can have a different nature.

The principle of a qualitative analysis of disorders of psychological activity, adopted at the school of V.M.Bekhterev, has become a tradition in Russian psychology.

V.M.Bekhterev, S.D.Vladychko, V. Ya.Anifimov and other representatives of the school developed many methods of experimental psychological research of the mentally ill, some of them (the method of comparing concepts, defining concepts) were among the most used in Soviet pathopsychology ...

The requirements for the methods formulated by V.M.Bekhterev and S.D. Vladychko have retained their significance for modern science:

o simplicity (for solving experimental problems, the subjects should not have special knowledge and skills);
o portability (the possibility of research directly at the patient's bedside, outside the laboratory setting);
o preliminary testing of the technique on a large number of healthy people of appropriate age, gender, education.

A prominent role in determining the direction of Russian experimental psychology was played by V.M.Bekhterev's student A.F. Lazursky, head of the psychological laboratory at the Psychoneurological Institute founded by V.M.Bekhterev, organizer of his own psychological school. In the preface to AF Lazursky's book "General and Experimental Psychology", LS Vygotsky wrote that AF Lazursky was one of those researchers who were on the path of transforming empirical psychology into scientific.

The scientist made a great contribution to the development of the methodology of pathopsychology. A natural experiment developed by him for the needs of educational psychology was introduced into the clinic. It was used in organizing the leisure time of patients, their occupations and work.

A significant stage in the development of pathopsychology was the work of GI Rossolimo "Psychological profiles. A method for quantitative research of psychological processes in normal and pathological states" (1910), which was widely known in Russia and abroad. This was one of the first attempts at test research: a system of examining mental processes and assessing them on a 10-point scale was proposed. This was another step towards the transformation of pathopsychology into an exact science, although later the proposed approach turned out to be insufficiently consistent for solving the problems of pathopsychological research.

The second center in which clinical psychology developed was the psychiatric clinic of S. S. Korsakov in Moscow. In this clinic in 1886, the second psychological laboratory in Russia was organized, which was headed by

A.A. Tokarsky. Like all representatives of progressive trends in psychiatry, S. S. Korsakov was of the opinion that knowledge of the foundations of psychological science makes it possible to correctly understand the disintegration of the mental activity of a mentally ill person.

The works of the school of S. S. Korsakov contain provisions that make a valuable contribution to the theory of psychological science. So, AA Tokarsky's article "On stupidity" contains an interesting analysis of the structure of dementia, leads to the idea that intellectual disabilities of patients are not reduced to the disintegration of individual abilities, that we are talking about complex forms of violations of all purposeful mental activity.

In 1911, a book by A. N. Bernstein was published, which was devoted to the description of the methods of experimental psychological research; in the same year, F. Ye. Rybakov published his Atlas for the Experimental Psychological Study of Personality. Thus, by the 20s. XX century a new area of \u200b\u200bknowledge began to form - experimental pathopsychology.

Pathopsychology studies the patterns of mental disorders in comparison with the course of mental processes in the norm.

Pathopsychology is a section that investigates mental disorders using experimental methods.

Psychopathology is a section of clinical psychiatry that is devoted to the description of mental symptoms and syndromes (conversation and observation).

In terms of its goals and practical tasks, pathopsychology is aimed at providing specific practical assistance to clinicians dealing with the problems of mental disorders in various mental disorders.

Pathopsychology, like any other branch of psychology, studying the psyche, has its own specifics, since its subject is not just the psyche, but the psyche, disturbed by one or another mental disorder. The most complete and accurate definition of the subject of pathopsychology was given by BV Zeigarnik: “Pathopsychology as a psychological discipline proceeds from the laws of development and structure of the psyche in the norm. She studies the patterns of the decay of mental activity and personality traits in comparison with the patterns of formation and course of mental processes in the norm, she studies the patterns of distortion of the reflective activity of the brain.

Pathopsychology, considering mental disorders, qualifies psychopathological phenomena in the concepts of modern psychology, using a categorical apparatus common to all branches of psychology. Pathopsychology, being a branch of psychology, uses the entire arsenal of methods accumulated by psychological science, and among them the experiment takes the leading place. Due to the specifics of the subject and the practical tasks it solves, we can say that pathopsychology is an experimental science. In pathopsychology, a great deal of experience has been accumulated in the experimental study of the psyche of patients, and this experience is very useful for psychopathology.

The modern systematic approach to the study of mental disorders requires their comprehensive consideration, therefore, the data of clinical analysis should be supplemented by data from pathopsychological research. Therefore, in recent years, a tendency towards convergence of the practice of researching mental disorders in psychology and psychopathology has become increasingly clear: clinicians are increasingly using experimental psychological research methods, and in pathopsychology (and clinical psychology in general) a significant role is given to the descriptive approach.

Pathopsychological examination is aimed at solving the following tasks:

Dif. Diagnosis of mental illness (observation, conversation, anamnesis ...) diagnosis has extremely serious consequences for the individual.

Differential methods Diagnostics: in 99% based on the results of experimental methods aimed at studying cognitive processes. Personality questionnaires and questionnaires are extremely rare (lie, suffer from cognitive disorders). Sometimes projective techniques are used

Assessment of the severity of cognitive and emotional disorders.
Assessment of the dynamics of cognitive and emotional disorders during treatment and rehabilitation.
Solving problems of forensic psychological and medical labor expertise.

2. The history of the development of pathopsychology

The history of pathopsychology is associated with the development of psychiatry, neurology and experimental psychology.

At the end of the XIX century. psychology began to gradually lose the character of a speculative science, and the methods of natural science began to be used in its research. The experimental methods of W. Wundt and his students penetrated into psychiatric clinics - the clinic of E. Kraepelin, the largest psychiatric clinic in France in Salpetrieres, where P. Janet held the position of head of the laboratory for more than 50 years; experimental psychological laboratories were also opened in psychiatric clinics in Russia - in the laboratory of V.M.Bekhterev in Kazan, then in the laboratory of V.F.Cyzh in Yuryev, I.A. Sikorsky in Kiev, etc.

The development of Russian pathopsychology was distinguished by the presence of strong natural science traditions. IM Sechenov attached great importance to the convergence of psychology and psychiatry. However, the founder of the pathopsychological trend in Russia was not I.M.Sechenov, but V.M.Bekhterev, who organized extensive experimental psychological studies of mental disorders.

The representative of the reflex concept V.M.Bekhterev expelled introspection from the sphere of science, declaring the objective method to be the only scientific method.

In the works of the school of V.M.Bekhterev, rich concrete material was obtained about the features of associative activity, thinking, speech, attention, mental performance in different categories of patients in comparison with healthy people of the corresponding age, gender and education.

The principle of a qualitative analysis of disorders of psychological activity, adopted at the school of V.M.Bekhterev, has become a tradition in Russian psychology.

The requirements for the methods formulated by V.M.Bekhterev and S.D. Vladychko have retained their significance for modern science:

Simplicity (for solving experimental problems, the subjects should not have special knowledge or skills);

Portability (the possibility of research directly at the patient's bedside, outside the laboratory setting);

Preliminary testing of the technique on a large number of healthy people of the corresponding age, gender, education.

A significant stage in the development of pathopsychology was the work of GI Rossolimo "Psychological profiles. The method of quantitative research of psychological processes in normal and pathological states", which is widely known in Russia and abroad. This was one of the first attempts at test research: a system was proposed for examining mental processes and assessing them on a 10-point scale

Development of ideas about pathopsychology in the post-revolutionary period

An important role in the formation of pathopsychology as a specific area of \u200b\u200bknowledge was played by L.S.Vygotsky's ideas about object-related activity, which were later developed in general psychology by his students and collaborators: A.N. Leontiev, A.R. Luria, P. Ya. Galperin , L. I. Bozhovich, A. V. Zaporozhets and others.

L. S. Vygotsky expressed theses that:

The human brain has different principles of organization than the brain of an animal;

The development of higher mental functions is not predetermined by the morphological structure of the brain alone; mental processes do not arise as a result of just the maturation of brain structures, they are formed in vivo as a result of training, education, communication and appropriation of the experience of mankind;

The defeat of the same areas of the cortex has different meanings at different stages of mental development.

L. S. Vygotsky, with his experimental research, laid the foundation for the study of the disintegration of thinking.

Following the tradition of B. M. Bekhterev, V. N. Myasishchev strove for a combination of psychiatry and psychology and the introduction of objective methods of researching patients in psychiatric clinics. Methods of objective registration of emotional components of human mental activity were developed; as an objective indicator, we used the human electrocutaneous characteristic (ECC), recorded with a galvanometer.

A number of works were devoted to the analysis of the structure of the labor activity of patients. On the basis of these studies, V.N.Myasishchev put forward the thesis that impaired performance should be considered as the main manifestation of a person's mental illness and that the indicator of performance is one of the criteria for the mental state of a patient.

During the Great Patriotic War, pathopsychologists got involved in rehabilitation work in a neurosurgical hospital. Disorders of mental activity and their restoration are the subject of pathopsychological studies.

The data of S. Ya.Rubinstein, B.V. Zeigarnik, A.R. Luria on the structure of reading, writing, and thinking disorders in patients with vascular pathology, Alzheimer's disease, and the consequences of brain trauma made it possible to substantiate the following point of view: mental illness proceeds according to biological patterns that cannot repeat the patterns of development. Even in cases where the disease affects the youngest, specifically human parts of the brain, the psyche of a sick person does not acquire the structure of the child's psyche at an early stage of his development. The fact that the patient is unable to think and reason at a high level indicates the loss of complex forms of behavior and cognition, but does not mean a return to the stage of childhood. That is, the disintegration of the psyche is not a negative of its development. Different types of pathology lead to qualitatively different decay patterns.

The most important ideas of L. S. Vygotsky were developed in the works of A. N. Leontiev, who was especially thoroughly involved in the development of the problem of activity. He formulated the following basic principle: internal mental activity arises in the process of internalization of external practical activity and has the same structure as practical activity. Thus, by studying practical activity, we learn the patterns of mental activity. This provision played a huge role in the development of the methodology of pathological psychology. BV Zeigarnik repeatedly pointed out that it is possible to understand the patterns of mental disorders only by studying the patient's practical activities, and to correct mental disorders - by managing the organization of practical activities.

Another theory that played an important role in the development of pathopsychology is V. N. Myasishchev's theory of relations, according to which a person's personality is a system of relationships with the world around him. These complex relationships are expressed in his mental activity. Human relations in a developed form are a system of individual, selective, conscious personality ties with various aspects of objective reality.

Mental illness changes and destroys the existing system of relationships, and violations in the system of personality relationships, in turn, can lead to illness. It was through such contradictory attitudes that V.N.Myasishchev considered neuroses.

Development of ideas about pathopsychology in the modern period

One of the leading problems in the field of pathopsychology is the problem of the decay of cognitive activity. Work in this area is carried out in different directions: changes in the personality component in the structure of disorders of cognitive processes are being investigated, the question of the relationship between disorders of cognitive processes and the process of updating knowledge is being developed. Another line of research is aimed at the psychological analysis of personality disorders observed in a psychiatric clinic.

Recently, pathopsychological research has expanded significantly in experimental practice: forensic psychiatric and labor.

The problem of labor and social rehabilitation is now attracting the attention of representatives of various specialties; the network of laboratories is expanding to restore both individual functional disorders and the working capacity of sick people. The involvement of psychologists is becoming not only necessary, but often a leading factor in both the recovery field and the prevention of mental illness.

Pathopsychological research in children's psychoneurological institutions has received special development. Techniques are being developed to facilitate the early diagnosis of mental retardation; analysis of complex pictures of dementia and underdevelopment in childhood is carried out in order to search for additional differential diagnostic signs and symptoms; on the basis of LS Vygotsky's position on the zone of proximal development, a number of teaching experiment techniques are being developed aimed at identifying prognostically important signs of children's learning ability (psychological laboratory of neuropsychiatric hospital No. 6).

Along with research work, a lot of work is being done to develop and test research methods. The growth of research and practical work in the field of experimental pathopsychology manifests itself in the fact that in scientific societies of both psychologists and psychiatrists and neuropathologists there are sections that unite and coordinate research in the field of pathopsychology. At the all-Union congresses of psychologists, reports of pathopsychologists were widely presented, which concentrated around the following problems:

The importance of pathopsychology for the theory of general psychology;

Compensation problem;

The problem of the pathopsychology of thinking and personality.

An important role in the development of pathopsychological research in different years was played by M. M. Kabanov, Yu. F. Polyakov, V. V. Nikolaeva, V. M. Kogan. Pathopsychological research in children's psychoneurological institutions has received special development. Methods are being developed that contribute to the early diagnosis of intellectual disorders, the identification of additional differential diagnostic signs of mental illness in children, methods of psychocorrectional work (S. Ya. Rubinstein, V.V. Lebedinsky, I. L. Korobeinikov, A. Ya. Ivanova, A. S. Spivakovskaya).

3. The main problems that hinder the development of domestic pathopsychology at the present stage

An outdated psychodiagnostic tool (developed in the 30-60s of the XX century). extreme conservatism of the psychiatric system
Lack of integration with foreign clinical psychology: methodological and ideological differences
Lack of implementation of modern cognitive sciences in neurophysiology (?)

In large psychiatric clinics of the Old and New World at the end of the 19th century. psychological laboratories began to be organized - E. Kraepelin in Germany (1879), P. Janet in France (1890). Experimental psychological laboratories were also opened in psychiatric clinics in Russia - the second in Europe laboratory of V.M.Bekhterev in Kazan (1885), then in St. Petersburg, S.S.Korsakov's laboratory in Moscow (1886), I.A. Sikorsky in Kiev , P. I. Kovalevsky in Kharkov. A number of laboratories have been organized in the USA and England.

Experimental psychological methods were developed in the laboratories for studying disorders of mental processes in people who have suffered from certain diseases. At the same time, to compare the results, the mental characteristics of healthy people were studied. Since in Russia the official psychological science stubbornly adhered to the introspective method, remaining in the mainstream of philosophical knowledge, psychiatrists were the first experimental psychologists.

At the beginning XX in. researchers of mental activity report on the isolation of a special branch of knowledge - pathological psychology. At this stage, scientists do not yet distinguish between the concepts of "pathopsychology and" psychopathology. Thus, A. Gregor (1910) writes: "Experimental psychopathology studies the performance of mental functions under abnormal conditions created by the painful process underlying mental illness."

The confusion of these terms occurred due to the lack of a clear differentiation of the tasks of psychology and psychiatry during the period of initial accumulation of factual material, in specific studies of mental anomalies, especially since the researchers, as a rule, combined both a psychiatrist and a psychologist in one person.

The clearest idea of \u200b\u200bthe subject and tasks of pathopsychology at the dawn of its formation was contained in the works of V.M.Bekhterev: “The latest advances in psychiatry, owing to a large extent to the clinical study of mental disorders at the patient's bedside, served as the basis for a special department of knowledge known as pathological psychology, which has already led to the resolution of many psychological problems. " Calling pathological psychology among the branches of "objective psychology", the scientist defined its subject: "... the study of abnormal manifestations of the mental sphere, since they illuminate the tasks of the psychology of normal persons." Deviations and modifications of normal manifestations of mental activity, according to V.M.Bekhterev, are subject to the same basic laws as a healthy psyche. Thus, VM Bekhterev no longer equated the concepts of "pathopsychology" and "psychopathology". In the Psychoneurological Institute, which he organized, courses in general psychopathology and pathological psychology were taught at the same time, that is, different disciplines were behind them.

At the very origins of the emerging new branch of psychology, many domestic and foreign scientists noted that its significance goes beyond the limits of science applied to psychiatry.

At the same time, mental disorders were considered as an experiment of nature, affecting mostly complex mental phenomena that at this stage were not studied by the methods of psychology. At this time, experimental work was born on clinical materials. - “The disease turns into a subtle instrument of analysis,” wrote T. Ribot. "She makes experiments for us that are not feasible in any other way."

In one of the first generalizing works on pathopsychology, "Psychopathology as Applied to Psychology," the Swiss psychiatrist G. Störring held the idea that a change in an element of mental life as a result of illness makes it possible to judge its significance and place in complex mental phenomena. Pathological material contributes to the formulation of new problems in psychology. In addition, pathopsychological phenomena can serve as a criterion for evaluating psychological theories.

Thus, studies of mental disorders in their very origins were considered by domestic and foreign scientists in the mainstream of psychological knowledge. At the same time, the great importance of experimental psychological research for solving the problems of psychiatry was recognized. Thus, in connection with the studies of mental disorders by E. Kraepelin and his collaborators, V. Henri pointed out that experimental psychology provides methods that make it possible to notice insignificant changes in the state of the patient's mental functions, "follow the progress of the disease step by step," observing positive or negative the impact of treatments. Doctors usually see only large changes that do not give the opportunity to finely regulate the treatment process.

In the 20s. In the twentieth century, the works of famous foreign psychiatrists appeared: "Medical Psychology" by E. Kretschmer and "Medical Psychology" by P. Janet, which are an attempt to systematize the accumulated knowledge in pathopsychology.

Subsequently, a new field of psychological science developed under the influence of various directions at the junction of medicine and psychology.

The development of Russian pathopsychology from the very beginning was distinguished by natural science traditions. The formation of its principles and methods of research was influenced by the work of IM Sechenov "Reflexes of the Brain" (1863), which made a "breach in the wall" dividing physiology and psychology. I.M.Sechenov himself attached great importance to the fusion of psychology and psychiatry.

The successor of I.M.Sechenov on this path was V.M.Bekhterev, a psychiatrist by training, the founder of materialistically oriented experimental psychology and the founder of the pathopsychological trend in Russia. As a representative of the reflex concept, he considered the only scientific objective method for the study of mental activity, which requires, if possible, to cover "the entire set of facts of the external manifestation of neuropsychics and related conditions ...".

To disassociate himself from introspectionism, V.M.Bekhterev refused to use psychological terminology. The conceptual apparatus of the theory he developed creates the impression that the school of V.M.Bekhterev was exclusively concerned with physiology. However, the design of the research was aimed mainly at analyzing the performance of experimental tasks, and not at the features of neurodynamics. But in the course of the struggle against subjective-idealistic psychology, V. M. Bekhterev, who had not mastered dialectical materialism, came to the creation of "reflexology", in which he mechanically split real activity: he absolutized its external manifestations and ignored the mental image. From the activity, its motivational component was emasculated, which made it possible to see a subject of activity in a person.

Representatives of the school of V.M.Bekhterev have developed many methods of experimental psychological research of the mentally ill. Some of them (the method of comparing concepts, definitions of concepts) are among the most used in Russian psychology. The works of this school reflect rich concrete material about disorders of perception and memory, mental activity, imagination, attention and mental performance.

The requirements for the methods formulated by V.M.Bekhterev and S.D. Vladychko have retained their significance for modern science: simplicity (for solving experimental problems, the subjects should not have special knowledge and skills) and portability (the possibility of research directly at the patient's bedside, outside the laboratory environment ).

The main principles of psychological research in the clinic at the school of V.M.Bekhterev were: the use of a set of methods, a qualitative analysis of mental disorders, an individual approach, correlation of the research results with the data of healthy persons of the corresponding age, gender, education.

The use of a set of techniques - observing the subject during the experiment, taking into account the peculiarities of his behavior, combining various experimental techniques for studying the same pathological phenomena - contributed to obtaining a rich objective material.

The principle of qualitative analysis, put forward in the period of the enthusiasm of many researchers by measuring methods (the approach to mental disorders as a quantitative decrease in certain abilities), has become traditional in Russian pathopsychology. But the theoretical platform of the scientist, especially during the development of reflexology, limited the analysis to the flow of external features of activity. And the recorded objective material was not brought to a truly psychological analysis.

However, some researchers, for example, K.I. Povarnin, pointed to the need to take into account the individual characteristics of patients, since sometimes they find defects where, in fact, individual characteristics are sharply expressed. So, poor memorization is possible not due to illness, but as a result of poor auditory memory, as can be seen from memorizing visually perceived. This idea enriched the principle of correlating the results of the study of sick and healthy.

A natural experiment developed by A.F. Lazursky for the needs of educational psychology was introduced into the clinic. It was used in the course of organizing the leisure time of patients, their activities and entertainment - for a special purpose, calculating tasks, rebuses, riddles, tasks to fill in letters, syllables, etc., were missing in the text.

Thus, pathopsychology already in its origins had all the signs necessary to establish its scientific independence as a branch of psychological science: the subject of research is mental disorders; methods - the entire arsenal of psychological methods; the conceptual apparatus is the apparatus of psychological science. Another thing is what kind of content was put into the concept of the psyche by representatives of various psychological trends. In the school of V. M. Bekhterev, broad development prospects were outlined, theoretical and applied aspects of a new psychological direction were outlined.

The connection with psychiatry was carried out by researchers when recreating the psychopathological syndrome characteristic of various mental illnesses. Experimental studies were used to solve the problems of differential diagnosis and to monitor the dynamics of the patient's condition during treatment. This helped to penetrate the mechanisms of mental disorder. So, VM Bekhterev experimentally proved that in the appearance and localization of hallucinations in patients, their orienting activity plays a role - anxious listening, gazing; and also demonstrated the similarity of hallucinations with illusions.

Pathopsychological methods have been used in pediatric and forensic examinations. VM Bekhterev and NM Shchelovanov wrote that the data of pathological psychology make it possible to almost accurately recognize mentally incompetent schoolchildren in order to single them out in special institutions for the mentally retarded.

The practice of forensic medical examination gave rise to the need for research at the intersection of pathological and individual psychology, which had not only practical, but also theoretical value. Research at the intersection of pathopsychology with social psychology was also planned. “The influence of patients on each other and the wide area of \u200b\u200bnormal suggestibility and imitation among healthy people are extremely interesting questions for both the psychiatrist and the psychologist; this issue deserves the full attention of experimental psychology, collective psychology, sociology, pedagogy and criminal anthropology, ”wrote K.S. Aghajanyants, a leading researcher in the study of the induction of mental illness.

Also in the school of V.M.Bekhterev, the problem of the relationship between the development and disintegration of the psyche was outlined, which was resolved much later, on the theoretical foundation of the works of L. S. Vygotsky, B. V. Zeigarnik, B. S. Bratus, M. A. Karev, S. Ya. Rubinstein and V.V. Lebedinsky.

The second major center of domestic psychiatry, in which experimental pathopsychology developed, was the psychiatric clinic of S. S. Korsakov, organized in 1887 at the medical faculty of Moscow University. The psychological laboratory of the clinic, headed by A.A. Tokarsky, made a valuable contribution to understanding the mechanisms of memory and its disorders, mechanisms and disorders of thinking. And the description of the manifestations of the so-called "Korsakov's syndrome" made it possible to form new ideas about the temporal structure of human memory, laid the foundations for the classification of such types of memory as long-term and short-term.

S. S. Korsakov and his staff were the organizers and participants of the Moscow Psychological Society, a number of meetings of which were devoted to familiarization with the methods of experimental psychological diagnosis of mental illness.

The works of G. I. Rossolimo “Psychological profiles. The method of quantitative research of psychological processes in normal and pathological states "and A. N. Bernshtein" Clinical methods of psychological research of the mentally ill. " These were the first attempts at testing.

The formation of pathopsychology as a special area of \u200b\u200bknowledge was greatly influenced by the ideas of the outstanding psychologist L. S. Vygotsky: 1) the human brain has different principles of organization than the brain of an animal; 2) the development of higher mental functions is not predetermined by the morphological structure of the brain, they arise not as a result of the maturation of brain structures alone, but are formed in life by appropriating the experience of mankind in the process of communication, training, education; 3) the defeat of the same areas of the cortex has a different meaning at different stages of mental development.

The theoretical ideas of L.S.Vygotsky, which were further developed in the works of his students and collaborators A.R. Luria, A.N. Leontyev, P. Ya.Gal'perin, L.I.Bozhovich, A.V. Zaporozhets, largely determined path of pathopsychological and neuropsychological research in our country.

Pathopsychological research in children's psychoneurological institutions has received special development. Methods have been developed to facilitate the early diagnosis of mental retardation; analysis of complex pictures of underdevelopment in childhood is carried out in order to search for additional differential diagnostic signs and symptoms; using the position of L.S. Kharitonov, L.M. Khripkova). The role of pathopsychologists in the field of labor, forensic psychiatric and forensic psychological expertise has significantly increased.

The rapid growth of research and practical work in the field of experimental pathopsychology contributes to the creation of sections in scientific societies of psychologists that unite and coordinate research in the field of pathopsychology.

A few words about the Soviet, ambiguous period for the formation and development of pathopsychology, its relationship with medical psychology. The decree of the Central Committee of the CPSU (b) "On pedological perversions in the system of the People's Commissariat for Education", issued in 1936, for 40 years, if not stopped, then significantly distorted the development of psychology and its various fields both in scientific and practical activities. This period, which ended with Gorbachev's liberalization and perestroika in the second half of the 1980s, was replete with indiscriminate criticism of various trends and schools of Western psychology, primarily the psychometric approach in psychodiagnostics. The state ban on the use of tests was combined with a careful permission to use "domestic tests" in pathopsychology (S. Ya. Rubinshtein, 1971) and non-standardized "tests" in neuropsychology (A.R. Luria, 1973). On the pages of medical and psychological literature, a stormy polemic unfolded regarding the content of the concepts of "medical psychology" and "pathopsychology", attempts were made to replace the development of a broader direction, to which medical or clinical psychology belongs, to one of its sections with methodological "truncation" of the subject, goals and tasks. At the same time, it was noted that “Russian pathopsychology is original, has a higher degree of development in comparison with other sections of psychology” (BD Karvasarsky, 1982).

Pathopsychology developed rapidly during the Great Patriotic War due to the rich empirical material accumulated in the course of neuropsychological and pathopsychological studies, observations of wounded soldiers with local lesions of the cerebral cortex.

Most researchers at present believe that the most developed areas of medical or clinical psychology, which includes several sections, are pathopsychology, which arose at the intersection of psychology, psychopathology and psychiatry, of which B.V. Zeigarnik (1971, 1986), S. Ya. Rubinstein (1976), Yu.F. Polyakov (1974), as well as neuropsychology, which was formed on the basis of psychology, neurology and neurosurgery (A.R. Luria, 1962-1977, E.D. Chomskaya, 1976, L.S. Tsvetkova, 1982, etc.).

A promising direction in pathopsychology is the direction, the purpose of which is the development of pathopsychological syndromes, i.e. identifying disorders in the structure of mental activity and establishing the degree of changes in mental processes (intellectual, perceptual, mnestic, etc.). An example is the research of Yu.F. Polyakov and his staff. They relate to the violations of the actualization of information from past experience revealed in patients with schizophrenia, which results in a restructuring of perceptual and other mental processes, which has a pathogenetic significance in the formation of mental disorders in this disease.

The development of pathopsychology as an applied psychological science, which began in a psychiatric clinic, has now expanded and turned out to be useful for the needs of therapeutic, surgical and other clinics, in psychotherapeutic practice, professional hygiene, etc.

test questions

Why were the first studies in the mainstream of Russian pathopsychology carried out by psychiatrists and not psychologists?

What scientific disciplines are most associated with pathopsychology in the process of its formation?

Which major pathopsychologists do you know?

In which medical institutions is the work of a pathopsychologist useful?

The data obtained in research within this discipline are of great theoretical and practical importance. Let us consider in more detail the basics of pathopsychology.

general characteristics

In the modern scientific environment, there is some confusion of different concepts, incorrect use of certain terms. In this regard, the need to separate pathopsychology and psychopathology is natural. The latter is considered a branch of medical science. It is focused on the study of diseases of the mental system. Within the framework of this discipline, various kinds of violations and their mechanisms are studied. Pathopsychology is based on the patterns of structure and development of the psyche in the norm. She examines and compares the decay of personality traits with the normal course of processes. Thus, both of these sciences have similar research objects, but different subjects.

Tasks

Pathopsychology is a science aimed at obtaining additional information about the patient's condition. In particular, his cognitive activity, emotional-volitional sphere, personality as a whole are subject to research. This information is needed when making a diagnosis. Experimental methods of pathopsychology make it possible to identify many signs of disorders, to establish their structure and connection with each other.

Another important task, which is solved within the discipline, is to conduct research for examination (judicial, military, labor). In the process of such a procedure, a specialist can establish the structure of violations and their relationship with the intact aspects of the activity of the psyche or carry out differential diagnostics. This research is fraught with certain difficulties. They are primarily due to the patient's interest. In this regard, the patient can underestimate the manifestations of violations, exacerbate them or even simulate them in order to avoid responsibility or to obtain disability. Another task that pathopsychology solves is the study of changes under the influence of therapy. In such cases, similar sets of techniques are used. With repeated research with their help, the dynamics of the state is established, the effectiveness of treatment is determined.

Additional functions

In recent years, experimental pathopsychology has begun to be applied to solve two additional problems. The first is related to rehabilitation measures. During their implementation, specialists pay great attention to the detection of the intact sides of the patient's personality and psyche. In addition, the patient's social environment, the nature of relationships with other people, educational and work attitudes are studied. The purpose of such a study is to develop recommendations that would facilitate faster rehabilitation. The second independent function of specialists is their participation in psychotherapeutic activities. Here, however, it is worth noting that the issue of doctor's participation in them is not sufficiently regulated at the legislative level.

Development of science

As an independent branch, pathopsychology began to form at the beginning of the 20th century. The most clear ideas about the subject of science are reflected in the works of Bekhterev. In his opinion, pathopsychology is the process of studying abnormal manifestations at the initial stages of the formation of a system. Various courses were taught at the institute organized by Bekhterev. At the same time, a clear line was immediately drawn dividing pathopsychology and psychopathology.

Domestic figures

From the very beginning, the development of the industry has been based on strong natural science traditions. The formation of principles and techniques was carried out under the influence of the works of Sechenov. He attached particular importance to the relationship between psychology and psychiatry. Bekhterev became Sechenov's successor on this path. He is considered the founder of the pathopsychological branch in psychological science. Representatives of his school developed many of the mentally ill. They are still widely used in the discipline today. The main principles of the study were also formulated:

Pediatric pathopsychology

Before the works of Zeigarnik appeared in science, it was believed that in a number of neurotic diseases, the patient's behavior begins to move to a lower level, which reflects a certain stage of the child's development. Based on this concept, many scientists have tried to identify the correspondence between the process of personality breakdown and a specific stage of childhood. For example, Kretschmer brought the thinking of the schizophrenic closer to adolescent development. In 1966, at the 8th International Congress, Ajuriaguerra (a Swiss scientist) defended the opinion of a layer-by-layer mental decay from higher to lower forms. Such conclusions were based on a number of observations:

Luria, Zeigarnik, Rubinstein: pathopsychology and biological laws

The data of these researchers concerned reading and writing in patients with vascular diseases, Alzheimer's disease, and brain injuries. Based on the information received, a new point of view was substantiated. It consisted in the fact that the flow is influenced by biological laws. They cannot repeat the principles and stages of development. Even when young, specific brain regions are affected by the disease, the patient's psyche does not acquire the structure of a child's at an early stage of development. The fact that the patient is not able to reason and think at a high level indicates the loss of complex forms of cognition and behavior. But this does not mean that he returns to the childhood stage.

Myasishchev's theory

She also played an important role in the development of pathopsychology. According to the theory, the human personality is presented as a system of the person's relationship with the outside world. Such interactions are characterized by a complex structure and are expressed in mental activity. The disease changes and destroys the formed system of relationships. These disorders, in turn, can provoke illness. Through such contradictions, Myasishchev investigated psychoses.

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