Psychological rehabilitation of combatants with mental disorders and mental trauma

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Rivne Medical Academy

Kamianets-Podilskyi National Ivan OhiLenko University

Psychological rehabilitation of combatants with mental disorders and mental trauma

Kharchenko Yevhen Dr. in Medicine, Professor, Professor of

the Department of Physical Rehabilitation and Ergo-Therapy

Onufriieva Liana Dr. in Psychology, Professor,

Head of the Department of General and Applied Psychology

Rivne, Kamianets-Podilskyi



Annotation

psychologically somatic stress military

The purpose of this article is to introduce the concept of Psychologically somatic stress, to describe types of military stress, to show the principles of use the method of Positive Psychotherapy for psychological rehabilitation of combatants with mental disorders.

Methods of the research. The following theoretical methods of the research were used to solve the tasks formulated in the article: a categorical method, structural and functional methods, the methods of the analysis, systematization, modeling, generalization. The experimental method was the method of organizing empirical research. We also used the method of Positive Psychotherapy.

The results of the research. According to combatants we distinguish the following types of stress: Chronic constant (or prolonged) stress. It is determined by a constant (or prolonged) serious load on a person and causes increased neuropsychological and physiological tension of the body. Acute situational stress is caused by a certain event or phenomenon, as a result of which a person loses his/her mental balance. Constant physiological stress is associated with physical overloads of the body and the influence of various harmful environmental factors on it (uncomfortable temperature, high noise level, etc.). Psychological stress is a consequence of: violation of the psychological stability of the person (for example, affected self-esteem, negative reasons of war, etc.); psychological overload of the person (increased responsibility, large amount of war destroyed activity, etc.). The subtype of Psychological stress is the Emotional stress, that occurs when there is a threat, danger or fear. Informative stress is determined by information overload or information vacuum.

Conclusions. The solution of the problem by using the method of Positive Psychotherapy has to be in such a way, that torments, the patient must always go through five main stages: 1. Looking at the situation from a distance. 2. Careful study of each individual detail, without exception, all the nuances. 3. Situational agreements. 4. Verbalization. In Psychology, this is the formalization of feelings and emotions into verbal-logical forms. In simple words, this is a description of how a person feels when he/she is thinking about a problem. 5. Expanding boundaries, setting new goals and drawing up a plan of the action. The main goal of each session is to free a person from the burden with which he/she came. And you need to do it right now, at the current moment in time. Interestingly, according to this scheme, specialists in Positive Psychology build communication with absolutely all their clients, regardless of their problem.

Key words: psychological rehabilitation of combatants, mental disorders, mental trauma, chronic constant (or prolonged) stress, acute situational stress, constant physiological stress, psychological stress, violation of the psychological stability, psychological overload, emotional stress, informative stress.



Анотація

Психологічна реабілітація учасників бойових дій з психічними розладами та травмами

Харченко Євген

доктор медичних наук, професор, професор кафедри фізичної реабілітації і ерготерапії, Рівненська медична академія, м. Рівне (Україна)

Онуфрієва Ліана

доктор психологічних наук, професор, завідувач кафедри загальної та практичної психології, Кам'янець-Подільський національний університет імені Івана Огієнка, м. Кам'янець-Подільський (Україна)

Психологічна реабілітація учасників бойових дій з психічними розладами та травмами.

Метою статті є ознайомлення з поняттям психосоматичного стресу; опис видів військового стресу, показати принципи використання методу позитивної психотерапії для психологічної реабілітації учасників бойових дій із психічними розладами.

Методи дослідження. Для розв'язання поставлених завдань використовувалися такі теоретичні методи дослідження: категоріальний, структурно-функціональний, аналіз, систематизація, моделювання, узагальнення. Експериментальним методом є метод організації емпіричного дослідження. Також було використано метод Позитивної Психотерапії.

Результати дослідження. Ми виділяємо такі види стресу: хронічний стрес визначається постійним (чи тривалим) серйозним навантаженням на людину і викликає підвищену нервово-психологічну і фізіологічну напругу організму; гострий стрес викликається певною подією чи явищем, у результаті якого людина втрачає психічну рівновагу; фізіологічний стрес пов'язаний з фізичними перевантаженнями організму і впливом на нього різних шкідливих факторів навколишнього середовища (некомфортна температура, високий рівень шуму). Доведено, що психологічний стрес є наслідком: порушення психологічної стійкості особистості (наприклад, зачеплене самолюбство та ін.); психологічного перевантаження особистості (підвищена відповідальність, великий обсяг роботи та ін.). Показано, що різновидом психологічного стресу є емоційний стрес, що виникає при погрозі, небезпеці, образах. Зазначено, що інформаційний стрес визначається інформаційними перевантаженнями чи інформаційним вакуумом.

Висновки. Вирішення проблеми, яка мучить пацієнта, в позитивній психології завжди має пройти п'ять основних етапів: 1. Аналіз ситуації з боку, з певної відстані. 2. Ретельне опрацювання кожної окремої деталі, всіх без винятку нюансів. 3. Ситуаційна згода. 4. Вербалізація. У психології це - оформлення почуттів та емоцій у словесно-логічні форми. Простими словами, це - опис того, що відчуває людина, думаючи щодо цієї проблеми. 5. Розширення кордонів, постановка нових цілей та складання плану дій. Головна мета кожного сеансу - звільнити людину від вантажу, з яким вона прийшла до психотерапевта. Причому зробити це потрібно саме зараз, у цей момент часу. Цікаво, що за такою схемою фахівці з позитивної психології спілкуватимуться абсолютно зі всіма своїми клієнтами, незалежно від їхньої проблеми.

Ключові слова: психологічна реабілітація учасників бойових дій, психічні розлади, психічна травма, хронічний постійний (або тривалий) стрес, гострий ситуаційний стрес, постійний фізіологічний стрес, психологічний стрес, порушення психологічної стійкості, психологічне перевантаження, емоційний стрес, інформаційний стрес.



Introduction

For the first time, the psychological changes in people's person who experienced this or that extreme situation, global catastrophe (war, earthquake, flood, COVID-19, etc.) or changes in personal plan were described in the scientific literature (Chenguang, Zhaoqin, Fang, Yang, Jinxiu, Jing, Fuxiang, Delin, Minghui, Li, Jinli, Haixia, Yan, Jiuxin, Ling, Li, Zhixiang, Ling, Yanjie, Haixia, Feng, Kun, Yujing, Dongjing, Zheng, Yingxia & Lei, 2020; Chen, Zhou & dong, 2020; Mykhalchuk, Pelekh, Kharchenko, Ivashkevych Ed., Ivashkevych Er., Prymachok, Hupavtseva & Zukow, 2020). Such kind of psychological changes we call “soldier's heart syndrome” or “soldier's mental syndrome”.

Psychotraumatic factors affect not only the soldier's psyche, but also the entire body as a whole (Kraus, 2015). These factors influence the conditions of hostilities and they have not only a mental, but also a somatic side of their influences. The fear caused by the combat situation (Edwards, Lee & Esposito, 2019) is suppressed by great nervous tension. The achieved balance is disturbed by an additional influence, it is usually somatic by its nature (Epstein, Blake & Gonzalez, 2017).

Mental trauma is considered as one of the consequences of the impact of stress factors on a person, who is a participant in hostilities (Grunebaum, Oquendo, Burke, Ellis, Echavarria, Brodsky, Malone & Mann, 2003). There are different approaches to understand this phenomenon.

Based on various theories and practical studies, the content of mental trauma is defined by some scientists as:

- breakthrough of a hypothetical protective mechanism that protects the psyche from excessive stimuli (Choi, Chau, Tsang, Tso, Chiu, Tong, Lee Ng Tak, Wai Fu, Lee Kam, Lam, Yu Wai, Lai Jak & Sik, 2003);

- the result of a large and intense irritation from which it is impossible to get rid of or which cannot be processed in a normal way (Onufriieva & Ivashkevych Ed., 2021);

- an experience in which the actual Ego is suppressed and it is a strong violation of the mediator function of the Ego (Brodsky, Oquendo, Ellis, Haas, Malone & Mann, 2001);

- changes in the perception of one's own invulnerability (Chan, Ng & Chan, 2003);

- the result of the interaction of a traumatic event, a person's perception and assessment of it, a person's mental reaction to this event (Corbitt, Malone, Haas & Mann, 1996);

- destruction of the idea that the surrounding world is not dangerous and it is filled with meanings, that one's own personality is worthy of respect, and other people are worthy of trust (Huang, Oquendo, Friedman, Greenhill, Brodsky, Malone, Khait & Mann, 2003);

- weakening of the activity or a change in the integrity of the individual barrier of mental adaptation, which is accompanied by a violation of “mental homeostasis” and a decrease by the level of adaptation (Mandell & Pherwani, 2003);

- the violation of psychological integrity having been formed in childhood (Mykhalchuk, Zlyvkov, Lukomska, Nabochuk & Khrystych, 2022);

- the result of the impact of psychotraumatic stimuli, the strength of which is determined by the significance of pathogenic information for this or that individual (Kris, 1952);

- violation of mental protection and the system of significant experiences (Mykhalchuk, Levchuk, Ivashkevych Er., Yasnohurska & Cherniakova, 2021).

Scientists (Tabachnikov, Mishyiev, Kharchenko, Osukhovskaya, Mykhalchuk, Zdoryk, Komplienko & Salden, 2021) proposed to classify mental trauma in terms of its intensity, significance for the individual, awareness and ability to overcome, degree of duration of influence of psycho-traumatic factors:

- massive (catastrophic), sudden, sharp, unexpected, stunning;

- situationally acute;

- prolonged situational situations that transform the conditions of many years of life (situations of deprivation);

- prolonged situational, leading to the perceived need for persistent mental overstrain (exhaustion).

So, the purpose of this article is to introduce the concept of Psychologically-somatic stress, to describe types of military stress, to show the principles of use the method of Positive Psychotherapy for psychological rehabilitation of combatants with mental disorders.



Methods of the research

The following theoretical methods of the research were used to solve the tasks formulated in the article: a categorical method, structural and functional methods, the methods of the analysis, systematization, modeling, generalization. The experimental method was the method of organizing empirical research. Also, we used the method of Positive Psychotherapy for psychological rehabilitation of combatants with mental disorders.

Results and their discussion

We should also note, that emotional stress is usually social in its origin, and different people's resistance to it is also different. Stress reactions to psychosocial difficulties are not so high, a consequence of the latter as an integrative response to their cognitive assessment and emotional arousal.

In turn, initially noting some non-specific response of the body to the influence of harmful factors, which is manifested in displaying the symptoms of the general adaptation syndrome of the person, the concept of stress is now applied to something else. Also, we've to emphasize, that in critical situations on stress there is even a kind of genre tradition of starting a review of studies listing such completely disparate phenomena, as the reaction to the influence of cold and criticism, hyperventilation of the lungs in different conditions of forced breathing and the joy of success, fatigue and humiliation. According to our observations, many considering stress factors are similar like everything that happens to a person, if he/she is not staying in the bed. Also, we observed, that even in the state of complete relaxation a sleeping combatant feels a certain stress, and he/she equates the absence of stress with the death. If we add to this that stress reactions are inherent to all living things, including plants, then this concept together with its simple derivatives (stressor, microand macro-stressor factors, positive and negative stressors) becomes the center of an almost cosmological system, which becomes, as we think, the basic, leading stimulus of life affirmation, creation and the person's development, the basis factor of all aspects of human life. In such a way, a stressor factor acts as a foundation for personal philosophical and ethical constructions of the psyche of the individual (Tabachnikov, Mishyiev, Drevitskaya, Kharchenko, Osukhovskaya, Mykhalchuk, Salden & Aymedov, 2021).

In our psychological researches on stress and stress factors, our persistent attempts are made to somehow limit the claims of this concept, subordinating it to traditional psychological problems and terminology. For this purpose, we'd introduce the concept of Psychologically-somatic stress, which, unlike the physiological highly stereotyped stress reaction to danger, is a reaction having been mediated by threat assessment and protective processes and circumstances. According to the results of our research, the essence of a stressful situation is the high loss of control, that is the lack of an adequate response to the given situation, when the consequences of failure have the aim to be respond, to be significant for the individual. Also, we believe, that stress should be called a special type of emetogenic situations, such as we've to use this term in relation to situations that are repeated or are chronic in their nature, and in this case the adaptation disorders may appear quickly. We also define mental stress as a state in which a person finds himself/herself in the real conditions that prevent his/her self-actualization and selfrealization.

Therefore, the main direction in the Developmental Psychology is displayed in the structure of the concept of stress. This concept is the denial of the lack of addressability of situations that generate stress. That is why, not some or any influences of the environment causes stress, but only that one, which are evaluated as threatening, fear, which disrupts adaptation, control and prevents self-actualization of the combatant.

Based on these facts, we can tell, that a small and short-term stress can affect a person without significant consequences, while a long and significant one puts the combatants' physiological and psychological functions out of balance, negatively affects the combatants' health, work capacity, work efficiency and relationships with others (in this case it is called distress).

In general, 95 militaries were participated in our research. The place of organizing this stage of the experiment was the Main Military Clinical Hospital (the Center), Kyiv, Ukraine. They were in the age 24-45 years old. At this stage all respondents were included into one experimental group. These militaries were sent for inpatient treatment by the military commissariats of Kyiv to resolve the issue of fitness for military service. All soldiers have been served in the army in the military zone of Ukraine in the south-east of Ukraine (Donetsk, Lugansk and Kherson regions). They all were included by us into experimental group, which was formed by the help of method of randomization. This stage of the experiment was organized in February-May, 2023.

We have followed the main ethical standards of providing the empirical research (we've obtained the informed consent of potential participants in the experiment to voluntarily participation in the research). Ethical principles were followed in the process of conducting the empirical research: the principle of voluntary consent; the principle of minimizing risks for participants; the principle of confidentiality; the principle of informing participants about the content of the research; the principle of mandatory documentation of the stages and the results of the research; the principle of reliability of methodical instruments of the research having been conducted; the principle of validity of research data processing.

According to combatants we distinguish the following types of military stress:

Chronic constant (or prolonged) stress. It is determined by a constant (or prolonged) serious load on a person and causes increased neuropsychological and physiological tension of the body.

This Chronic constant (or prolonged) stress is shown on Fig. 1.



Fig. 1 Chronic constant (or prolonged) stress - Acute situational stress is caused by a certain event or phenomenon, as a result of which a person loses his/her mental balance.

Constant physiological stress. It is associated with physical overloads of the body and the influence of various harmful environmental factors on it (uncomfortable temperature, high noise level, etc.).

On Fig. 3 we showed the image of combatant with Constant physiological stress.



Fig. 3 Constant physiological stress

-- Psychological stress is a consequence of:

• violation of the psychological stability of the person (for example, affected self-esteem, negative reasons of war, etc.);

• psychological overload of the person (increased responsibility, large amount of war destroyed activity, etc.).

A subtype of Psychological stress is Emotional stress, that occurs when there is a threat, danger or fear.

Psychological stress is displayed by us on Fig. 4.

Fig. 4 Psychological stress

Informative stress, which is determined by information overload or information vacuum.

The image of Informative stress is on Fig. 5.

We proved, that the names of cluster emotions of the lexicalsemantic field “fear” of combatants because of the events of War on the territory of Ukraine acted as a kind of core elements, turning it into high ordered collection of conceptually related synonymous groups of lexemes. Among them, the main synonymous series stands out, which forms the basis of the logical structure of the nominative space, since it most adequately reflects its main conceptual category. The lexeme “fear” is generic in relation to other synonymous units, a stylistically neutral unit that is used to define emotions of fear in various parts of the language, reflects the most generalized meaning and is characterized as the most frequent in use in texts compared to other units close in their meaning.

Fig. 5 Informative stress

For psychological rehabilitation of combatants with mental disorders we proposed to use the method of Positive Psychotherapy. Positive Psychotherapy gained recognition not so long ago, but has already managed to gain popularity among psychologists and psychotherapists. All thanks to the fact that it offers to solve the problems of patients right now, and not later, when the causes are discovered, or after some or many years. How does it work in practice? Is this therapy deservedly popular? These questions we'll decide in our article.

Positive Psychotherapy is a direction in Psychology that focuses on solving problems using the innate and acquired abilities of a person. It is used not only in Psychology, but also in Psychiatry in cases where there is a great need for the treatment of behavioral and personality disorders.

The founder of the current direction is the Iranian professor, Doctor of Medical Sciences and a specialist in the field of Psychology, Psychotherapy and Neurology Nossrat Pezeshkian. Peseschkian's Psychotherapy was promoted in Germany in the late 60s of the last century. But Positive Psychotherapy received its recognition only in 1996, when the European Association for Psychotherapy declared it as the official direction. Twelve years later, in 2008, the World Council for Psychotherapy did the same (Peseschkian, 2003).

To understand the essence of Positive Psychotherapy of N. Peseschkian (2003), it is enough to read carefully the meaning of the word from which this title “Positive Psychotherapy” comes from. This direction works with the problem that a person has at the current time and requires an immediate solution. According to Nossrat Pezeshkian, the methods having been used by psychologists are not always effective. And all positive because precious time is wasted. First of all, the specialist looks for the causes of the problem, then tries to eliminate the factors provoking its development, and only after these actions begins the fight against the difficulty itself. During this time, it can not only intensify, but also go into a chronic, neglected form.

The main objectives of Positive Psychotherapy are: treatment of personality and behavioral disorders; prevention of deviant (deviating from generally accepted norms) behavior and social maladaptation of very young children and adolescents; development of intercultural consciousness, which include the study of national traditions that influence the behavior of combatants with mental disorders. Another task is to study the interaction of Positive Psychotherapy with other psychotherapeutic areas.

Positive Psychotherapy is based on three principles: balance, hope, self-help and mutual help. Let's analyze each of them in more detail.

The principle of balance. Here we are talking about a differential analysis of personal psychodynamics. As we stated above, Psychotherapy works with the innate and acquired abilities of the person. Problems are arisen when the first are not identified, and the second ones, lying completely on the surface, are not applied. The main task of the psychotherapist is to find, separate from each other and make both of them work (Murphy, Hall & Hall, 2003).

The principle of hope. It happens that a specialist refuses to work with a patient because a psychotherapist does not have the necessary skills to solve his/her problem. In the case of Positive

Psychotherapy, a specialist simply does not have the right to do so. Even if the situation is running to the point of impossibility, he/she must behave as if after a couple of sessions the person will be absolutely healthy. In this case, it is recommended to focus on the inner strength of the patient himself/herself (Onufriieva, Chaikovska, Kobets, Pavelkiv & Melnychuk, 2020).

The principle of self-help and mutual assistance. It implies harmonization, adaptation and development of any personality in the shortest possible time. At first, the therapist works directly with the patient and his/her problems. And then a psychotherapist gives him/her a plan of activity on how to help not only himself/herself, but also the people around him/her. The latter includes not only family members, but also the activity with colleagues, neighbors, just acquaintances (Mykhalchuk, Pelekh, Kharchenko, Ivashkevych Ed., Zukow, Ivashkevych Er. & Yatsjuryk, 2023).

These are just some of the tools which are used by Positive Psychotherapy. In fact, there are many more. Positive Psychotherapy of N. Peseschkian (2003) relies on the innate and acquired abilities of a person. And it's not just some talents and super abilities. Rather, it refers to the need for knowledge and love. The ability to know is considered the intellectual essence of a man. According to our research, the left hemisphere of the brain is responsible for it. It has two interesting features: It is more strongly developed among mathematicians, physicists and those ones who are somehow connected with the exact sciences. In priority it is for people living in North America and Western Europe.

Let's look by the example of how this ability is used in Positive Psychotherapy sessions. Suppose the patient is a man who has problems in the family. He is asked to answer a number of basic questions. Here are some of them: “What is the reason for constant quarrels and scandals?”, “Doesn't your wife take care of the house and children?”, “Or maybe she does not make time for the kids?” “Is this the only reason for dissatisfaction?”, “Are there any positive aspects in your family life?”, “What outweighs: disadvantages or advantages?” By giving the last answer, the patient will see a complete picture of what is happening in his family. It turns out that already at the first session, he will understand how he should behave further, is it worth fighting for the relationship or it is better to leave?

The second ability we pointed out was the ability to love. We'd like to say, it is not connected with the intellectual sphere. This is the emotional component of the human personality. To a greater extent, it is inherent according to representatives of creative and humanitarian professions, as well as those ones who live in the East or in the South America. If this ability is predominant for this patient, it is pointless to ask him/her rational questions. Trying to answer them, they will get even more confused. Therefore, psychotherapists use metaphors and parables. So, for example, if an artist came for help, as an example, he can give a damaged canvas or paint that has dried up. This will help him understand the situation correctly and draw conclusions.

According to Peseschkian's theory, there are people the abilities of whom are mixed. So, for example, an Oriental may be a pragmatic mathematician or a prim Englishman, who is an artist. How shall we be in this case? Here, specialists choose the dominant part of their personality for work, trying to avoid internal conflicts.

Exercises of Positive Psychotherapy will be especially effective in a case of those people who like to exaggerate problems, “to make an elephant out of a fly”. Encourages you to see positive in everything that happens around. Yes, sometimes it is difficult, but nothing is impossible, especially when you understand what it is for. Imagine that you suddenly become ill in the middle of a working day. It would seem, what good can be in this situation? Any ailment is a signal from the body that something is wrong with it. So, you have the opportunity to undergo an examination and in time to identify its cause. The problem was before, but, you see, rarely does anyone regularly goes to the hospital and undergoes a medical examination. But the sooner you turn to a qualified specialist and start treatment, the less consequences (often irreversible) will be.

Also, in our experiment we used the exercise “An ideal day”. This exercise is shown to those combatants who have not received joy from the life for a long time, who have forgotten what happiness and peace are, and who are mired in problems and, as a result of all this, fell into depression. It is recommended to do it a couple of times a week. So, take a blank sheet of paper and a pen. Write on it as much detail as it is possible how you would like to live tomorrow. Don't miss a single detail. Write in your plan what you want to eat for breakfast, whom to call, what TV show to watch or what book to read, where to go and whom to meet. And then try to live the day as you wrote as accurately as you can.

The exercise “Positive labels” gives to combatants excellent results, although it seems too difficult. You need to clear the space around you of labels with negative connotations. What does it mean? For example, your neighbor is not old and fat, but wise over the years and with appetizing forms. The boss is not a tyrant, but a person who simply has a rather interesting and difficult character. At first, you can repeat these statements out loud, and then move on to mental formulations.

The next exercise is “A clew”. Don't worry, you won't have to knit here. The ball needs to be untangled. Too often we lump everything together. And then it seems that there are more and more problems, and there is not enough strength to fight them. Take several sheets of paper and write a different difficulty on each of them. Let's say one has problems at work, the other person has problems in the family, the third one has a lack of time for activities with children, etc. Paint them as detailed as possible, but in no case do not mix. Proceed to the solution in the same way.

Nowadays, Positive Psychotherapy has become widespread. And there is a logical explanation for this; we mean its advantages. There are several of them:

1. Focus on the problem, not on its manifestations and symptoms. To help the patient, you will need no more than 20 sessions, if we talk about the work of a psychologist, and no more than 50 of them, if we talk about a psychotherapist. A great example is Gestalt Psychology. Where it helps in 6 months, Positive Psychotherapy copes in one and a half. The specialist does not spend much time looking for the right tools for the job. Almost all methods of resolving internal conflicts are applicable.

2. Positive Psychotherapy is suitable for representatives of all nationalities, whether they are strict Germans or sensitive residents of the East. The patient will not only be a listener. He is actively involved into the process of solving his/her own problem.

3. The psychotherapist perceives a person as an integral system, a formed personality, and does not work with its separate parts, for example, emotions or thoughts.

4. The activity is based on the use of illustrative examples, parables and metaphors, which greatly simplifies it and makes it more understandable.

5. Another undoubted advantage is the activity for the future, despite the use of the principle of “here and now”. The patient does not only solve the problem, but also receives instructions on how to behave correctly in the future.



Conclusions

The solution of the problem by using the method of Positive Psychotherapy has to be in such a way, that torments the patient must always go through five main stages:

1. Looking at the situation from a distance.

2. Careful study of each individual detail, without exception, all the nuances. 3. Situational agreements.

3. Verbalization. In Psychology, this is the formalization of feelings and emotions into verbal-logical forms. In simple words, this is a description of how a person feels when he/she is thinking about a problem.

4. Expanding boundaries, setting new goals and drawing up a plan of the action. The main goal of each session is to free a person from the burden with which he/she came. And you need to do it right now, at the current moment in time. Interestingly, according to this scheme, specialists in Positive Psychology build communication with absolutely all their clients, regardless of their problem.

As for the methods, there are dozens of them in the arsenal of psychotherapists. And each time they apply the most effective methods in a particular case. The methods can be: visualization; questioning; questions and answers; pronunciation; stories, parables; metaphors.

Sometimes patients solve their problems after seeing themselves in examples of similar situations. One of the benefits of Positive Psychotherapy of N. Peseschkian (2003) is the ability to use some of the techniques and exercises on your own. They will help a specialist to cope with excessive emotional and physical stress, internal disagreements and complexes, obsessions.



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3. Chenguang S., Zhaoqin W., Fang Z., Yang Y., Jinxiu Li, Jing Y., Fuxiang W., Delin Li, Minghui Y., Li X., Jinli W., Haixia X., Yan Y., Jiuxin Qu., Ling Q., Li Ch., Zhixiang Xu, Ling P., Yanjie Li, Haixia Zh., Feng Ch., Kun H., Yujing J., Dongjing Liu, Zheng Zh., Yingxia Liu, Lei Liu. Treatment of 5 Critically Ill Patients With COVID-19 With Convalescent Plasma. JAMA-Journal of the American Medical Association. 2020. Vol. 323, No 16. P. 1582-1589. DOI: 10.1001/jama.2020.4783. Chen N., Zhou M., Dong X. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet. 2020. Vol. 395. P. 507-513. DOI: 10/1016/ S0140-6736(20)30211-7.

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6. Edwards F., Lee H., Esposito M. Risk of being killed by police use of force in the United States by age, race-ethnicity, and sex. Proceedings of the National Academy of Sciences of the United States of America. 2019. Vol. 116, No 34. P. 16793-16798. DOI: 10.1073/pnas.1821204116.

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8. Grunebaum M.F., Oquendo M.A., Burke A.K., Ellis S.P., Echavarria G., Brodsky B.S., Malone K.M., Mann J.J. Clinical impact of a 2-week psychotropic medication washout in unipolar depressed inpatients. Journal of affective disorders. 2003. Vol. 75, No 3. P. 291-296. DOI: 10.1016/ s0165-0327(02)00168-4.

9. Huang Yung-yu, Oquendo M.A., Friedman Jill M.H., Greenhill L.L., Brodsky B., Malone K.M., Khait V., Mann J.J. Substance abuse disorder and major depression are associated with the human 5-HT1B receptor gene (HTR1B) G861C polymorphism. International Journal of Neuropsychopharmacology. 2003. Vol. 28, No 1. P. 163-169. DOI: 10.1038/ sj.npp.1300000.

10. Kraus K. Bildung von Lehrerinnen und Lehrern: Herausforderungen in Schule, Hochschule und Gesellschaft. Berlin; Toronto: Budrich UniPress, 2015. P. 145.

11. Kris E. Psychoanalytic Explorations in Art. New-York: International Universities Press, 1952. 358 p.

12. Mandell B., Pherwani S. Relationship between emotional intelligence and transformational leadership style: a gender comparison. Journal of Business and Psychology. 2003. Vol. 17, No 3. P. 387-404.

13. Mykhalchuk N., Levchuk P., Ivashkevych Er., Yasnohurska L., Cherniakova O. Psycholinguistic specifics of understanding by Ukrainian students the principles of nomination of linguocultural models “clothing” in English and Ukrainian. Psycholinguistics. Психолінгвістика. Психолингвистика. 2021. Vol. 29, No 2. P. 195-237. ПереяславХмельницький: ФОП Домбровська Я.М. DOI: https://doi. org/10.31470/2309-1797-2021-29-2-195-237

14. Mykhalchuk N., Pelekh Yu., Kharchenko Ye., Ivashkevych Ed., Ivashkevych Er., Prymachok L., Hupavtseva N., Zukow W. The empirical research of the professional reliability of 550 doctors during the COVID-19 pandemic in Ukraine (March-June, 2020). Balneo Research Journal. 2020. Vol. 11, No 3. P. 393-404. DOI: http://dx.doi. org/10.12680/balne.

15. Mykhalchuk N., Pelekh Yu., Kharchenko Ye., Ivashkevych Ed., Zukow W., Ivashkevych Er., Yatsjuryk A. Suicidal behavior as a result of maladjustment of servicemen to the conditions of military service in Ukraine. European Journal of Clinical and Experimental Medicine. 2023. Vol. 21, No 1. P. 90-107. doi: 10.15584/ejcem.2023.1.12.

16. Mykhalchuk N., Zlyvkov V., Lukomska S., Nabochuk A., Khrystych N. Psycholinguistic paradigm of the Medical staff - Patients communicative interaction in the conditions of COVID-19 in Ukraine and Scotland. PSYCHOLINGUISTICS. 2022. Vol. 31, No 1. P. 92-117. URL: https://doi.org/10.31470/2309-1797-2022-31-1-92-117.

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21. Tabachnikov S., Mishyiev V., Kharchenko Ye., Osukhovskaya E., Mykhalchuk N., Zdoryk I., Komplienko I., Salden V. Early diagnostics of mental and behavioral disorders of children and adolescents who use psychoactive substances. Психиатрия, психотерапия и клиническая психология. 2021. Вып. 12(1). С. 64-76. DOI: 10.34883/PI.2021.12.1.006.

22. Tabachnikov S., Mishyiev V., Drevitskaya O., Kharchenko Ye., Osukhovskaya E., Mykhalchuk N., Salden V., Aymedov C. Characteristics of Clinical Symptoms in Psychotic Disorders of Combatants. Психиатрия, психотерапия и клиническая психология. 2021. Вып. 12(2). С. 220230. DOI: 10.34883/PI.2021.12.2.003

References

1. Brodsky, B.S., Oquendo, M., Ellis, S.P., Haas, G.L., Malone, K.M., & Mann, J.J. (2001). The relationship of childhood abuse to impulsivity and suicidal behavior in adults with major depression. The American Journal of Psychiatry, 158(11), 1871-1877. DOI: 10.1176/appi.ajp.158.11.1871.

2. Chan, J.W.M., Ng, C.K., & Chan, Y.H. (2003). Short term outcome and risk factors for adverse clinical outcomes in adults with severe acute respiratory syndrome (SARS). Thorax, 58, 686-89.

3. Chenguang, S., Zhaoqin, W., Fang, Z., Yang, Y., Jinxiu, Li, Jing, Y., Fuxiang, W., Delin, Li, Minghui, Y., Li, X., Jinli, W., Haixia, X., Yan, Y., Jiuxin, Qu., Ling, Q., Li, Ch., Zhixiang, Xu, Ling, P., Yanjie, Li, Haixia, Zh., Feng, Ch., Kun, H., Yujing, J., Dongjing, Liu, Zheng, Zh., Yingxia, Liu, & Lei, Liu (2020). Treatment of 5 Critically Ill Patients with COVID-19 With Convalescent Plasma. JAMA-Journal of the American Medical Association, 323 (16), 1582-1589. DOI: 10.1001/ jama.2020.4783.

4. Chen, N., Zhou, M., & Dong, X. (2020). Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet, 395, 507-13. DOI: 10/1016/ S0140-6736(20)30211-7.

5. Choi, K.W., Chau, T.N., Tsang, O., Tso, E., Chiu, M.C., Tong, W.L., Lee Po, O., Ng Tak, K., Wai Fu, Ng, Lee Kam, Ch., Lam, W., Yu Wai, Ch., Lai Jak, Y., & Sik, T. (2003). Outcomes and prognostic factors in 267 patients with severe acute respiratory syndrome in Hong Kong. Ann Intern Med., 139, 715-23. DOI: 10.7326/0003-4819-139-9-200311040-00005.

6. Corbitt, E.M., Malone, K.M., Haas, G.L., & Mann, J.J. (1996). Suicidal behavior in patients with major depression and comorbid personality disorders. Journal of affective disorders, 39(1), 61-72. DOI: 10.1016/01650327(96)00023-7.

7. Edwards, F., Lee, H., & Esposito, M. (2019). Risk of being killed by police use of force in the United States by age, race-ethnicity, and sex. Proceedings of the National Academy of Sciences of the United States of America, 116 (34), 16793-16798. DOI: 10.1073/pnas.1821204116.

8. Epstein, R., Blake, J.J., & Gonzalez, T. (2017). Girlhood interrupted: the erasure of black girls' childhood. Washington, DC: Georgetown Law Center on Poverty and Inequality. Retrieved from https://www.law. georgetown.edu/poverty-inequality-center/wp-content/uploads/ sites/14/2017/08/girlhood-interrupted.pdf.tab.

9. Grunebaum, M.F., Oquendo, M.A., Burke, A.K., Ellis, S.P., Echavarria, G., Brodsky, B.S., Malone, K.M., & Mann, J.J. (2003). Clinical impact of a 2-week psychotropic medication washout in unipolar depressed inpatients. Journal of affective disorders, 75(3), 291-296. DOI: 10.1016/ s0165-0327(02)00168-4.

10. Huang, Yung-yu, Oquendo, M.A., Friedman, Jill M.H., Greenhill, L.L., Brodsky, B., Malone, K.M., Khait, V., & Mann, J.J. (2003). Substance abuse disorder and major depression are associated with the human 5-HT1B receptor gene (HTR1B) G861C polymorphism. International Journal of Neuropsychopharmacology, 28(1), 163-169. DOI: 10.1038/ sj.npp.1300000.

11. Kraus, K. (2015). Bildung von Lehrerinnen und Lehrern: Herausforderungen in Schule, Hochschule und Gesellschaft. Berlin; Toronto: Budrich UniPress [in German].

12. Kris, E. (1952). Psychoanalytic Explorations in Art. New-York: International Universities Press.

13. Mandell, B., & Pherwani, S. (2003). Relationship between emotional intelligence and transformational leadership style: a gender comparison. Journal of Business and Psychology, 17(3), 387-404.

14. Mykhalchuk, Nataliia, Levchuk, Pavlo, Ivashkevych, Ernest, Yasnohurska, Liudmyla, & Cherniakova, Olena (2021). Psycholinguistic specifics of understanding by Ukrainian students the principles of nomination of linguocultural models “clothing” in English and Ukrainian. Psycholinguistics. Psykholinhvistyka. Psikholingvistika - Psycholinguistics. Psycholinguistics. Psycholinguistics, 29(2), 195-237. Pereiaslav-Khmelnytskyi: FOP Dombrovska Ya.M. DOI: https://doi.org/10.31470/23091797-2021-29-2-195-237

15. Mykhalchuk, Nataliia, Pelekh, Yurii, Kharchenko, Yevhen, Ivashkevych, Eduard, Ivashkevych, Ernest, Prymachok, Lyudmyla, Hupavtseva, Nataliia, & Zukow, Walery (2020). The empirical research of the professional reliability of 550 doctors during the COVID-19 pandemic in Ukraine (March-June, 2020). Balneo Research Journal, 11(3), 393404. DOI: http://dx.doi.org/10.12680/balne.

16. Mykhalchuk, Nataliia, Pelekh, Yurii, Kharchenko, Yevhen, Ivashkevych, Eduard, Zukow, Walery, Ivashkevych, Ernest, & Yatsjuryk, Alla (2023). Suicidal behavior as a result of maladjustment of servicemen to theconditions of military service in Ukraine. European Journal of Clinical and Experimental Medicine, 21(1), 90-107. doi: 10.15584/ ejcem.2023.1.12

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