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Year : 2020  |  Volume : 62  |  Issue : 9  |  Page : 414-419
The self-coping method in online psychological aid at COVID-19 pandemic


1 Republican Scientific and Practical Center of Mental Health, Kazakh National Medical University, Almaty, Kazakhstan
2 Department of Communication Skills, Clinical Psychology and Psychotherapy, Almaty, Kazakhstan

Click here for correspondence address and email

Date of Submission31-Aug-2020
Date of Decision04-Sep-2020
Date of Acceptance10-Sep-2020
Date of Web Publication28-Sep-2020
 

   Abstract 


Background: Today pandemic has set challenges for psychologists and psychotherapists in providing online first psychological aid to the community.
Aim: At such moments, society especially needs psychological support, which should be feasible, short-term, and effective.
Settings and Design: A method of self-coping, based on the concepts of behavioral and cognitive psychology. The following principles underlie the method: a person can cope with his/her conditions; the accumulation of unconscious feelings, sensations, images leads to the development of problem states; self-awareness of them through the conscious observation leads to their attenuation and extinction.
Materials and Methods: The method consists of five steps. The first step is the differentiation of feelings, sensations, and appropriate images. The second stage is the observation of one's condition related to images. In the third stage, the client observes spontaneous images and related feelings and sensations. The fourth step involves observing spontaneous images. Fifth stage: A client obtains skills of ecological behavior: A person expresses feelings but does not exhibit them in a destructive way. The Add-on tools help at jam up issues.
Results: The pre-pandemic experience of using this method has shown high efficiency, comprehensibility, and simplicity. The method has proven its usefulness in online consulting, positively perceived by clients, who note its ease of understanding, training, and use.
Conclusion: The method has shown an efficacy during the pandemic and suggested to be effective in various conditions (obsessive/anxiety disorders, eating disorders, alcohol abuse, etc.)

Keywords: short-term psychotherapy, self-coping, emotion control, psychological disorders

How to cite this article:
Nurmagambetova S, Assimov M. The self-coping method in online psychological aid at COVID-19 pandemic. Indian J Psychiatry 2020;62, Suppl S3:414-9

How to cite this URL:
Nurmagambetova S, Assimov M. The self-coping method in online psychological aid at COVID-19 pandemic. Indian J Psychiatry [serial online] 2020 [cited 2022 Nov 28];62, Suppl S3:414-9. Available from: https://www.indianjpsychiatry.org/text.asp?2020/62/9/414/296506




Today, pandemic has set challenges for psychologists and psychotherapists in providing online first psychological aid to community. People in the best case are working remotely at home; in the worst one, they are losing their jobs and money. Children are forced to study online with a system of education that is not very prepared for this. Older people (the most vulnerable) have become isolated in most families. Along with a lengthy stay in a limited space, existing conflicts are becoming harder and more painful, and new ones appear. At the same time, everyone is under pressure from a continuous flow of information – not always reliable, contradictory, often with a charge of panic moods. At such moments, society especially needs psychological support, which should be provided in any conditions, with any challenges. It is important to have simple short-term methods that would help people to cope with emotions of anxiety, fear, and anger that arise in unusual living conditions and lead to dramatic consequences.

Self-coping is a short-term method of psychotherapy (psychocorrection). It does not require a long time as the psychoanalysis and a deep immersion in the past; in fact, it focuses on the current condition of a person. At the same time, it differs from behavioral psychotherapy in that it works with images, assuming that any behavior is first formed through the images. It also differs from the symbolic drama in that it binds every actual image with feelings and sensations. Moreover, in contrast to the symbolic drama, preference is not given to symbols, but to the current state, which the client should experience in specific images. In contrast to gestalt psychology and body-oriented psychotherapy, the method of self-coping operates with a certain set of feelings and sensations associated with the corresponding images, which need to be experienced in a cyclic sequence.

Based on all heritage mentioned above, we have developed a new method of self-coping. The name may be perceived as much of a muchness, because coping alone means capability to handle the stress. The prefix “self” is designed to emphasize once again the use of the inner potential of a person to find the resources to cope not only with stress, but also with excessive (abnormal) anxiety, panic attacks, dependence on nicotine, and other conditions. Of course, this intervention is one of tools in the arsenal of skills and knowledge of a doctor, a psychologist, and a psychotherapist.

The self-coping is both a method and a result of personal hygiene. Constant and regular personal hygiene using this method will improve communication, reduce the risk of conflicts in relationships, avoid many psychosomatic diseases, and, in general, behave in a meaningful way. The most important concept underlying the method is the emotional literacy or emotional intelligence.[1] If people are aware of emotions, they can make emotions work for the benefit of themselves and others around, and not against themselves. It is crucial to learn how to control and handle complex emotional situations, otherwise, they often lead to struggle, lies that hurt other people. Self-coping is the most effective way to control our internal state, the components of which are feelings, images, and sensations.

Images determine our actions and behavior styles. Any reaction, behavior style, conscious, or unconscious, is formed first in images. Everyone experiences different kinds of images: when we go to work, we have the images of the supposed actions, which in everyday life are called “plans” or “desires.” At the same time, we not only plan certain actions, phrases, reactions, but also the results of certain actions or reactions, we suppose negative or positive consequences in our mental images. On the other hand, images do not exist on their own. Each image has a certain emotional (sensory) coloring. Imagining a meeting with a pleasant person, creating a number of proposed actions, phrases, and outcomes, we experience a sense of joy. Moreover, in contrast, anticipated unpleasant expectations in the form of images can cause anxiety, irritation, anger, or fear. Each image is associated not only with emotions but also with body sensations. For example, anxiety (as well as joy and other emotions) can cause sensations such as the heartbeat, fever, and cold in some part of the body. This is a natural interconnection of images, emotions, and sensations in reactions to both external stimuli and internal mental and physiological processes that determine our condition as a whole, whether we feel good or bad.

In the actual situation, feelings and sensations are becoming stronger and accelerate the dynamic of images (excitement develops into anxiety and anxiety into fear). More prominent feelings cause more pronounced images and sensations. A person tries to control himself to suppress (repression) and thereby further enhances the current state, and it becomes problematic.

A certain condition is a combination of images, feelings, and sensations in their interconnection, interdependence, and constant changeability.

One of the conditions for the ability to control these interconnected and interdependent mental functions is the ability to realize, hence to cope.

By consciously distinguishing images, emotions, and sensations, monitoring their interconnections and mutual interference, experiencing unsuccessful or undesirable forms of behavior in images, emotions, and sensations, a person has an option to choose appropriate behavior in a real situation.

Our attitude to the external situation is determined by the internal reaction, developing of a certain state (appropriate emotion, sensation, and image). This state driven by the image often does not coincide with the real situation, and there is an internal conflict, an attempt to push out or avoid this situation, that finally emerges as a big problem. The self-coping allows to recognize the discrepancy between the internal state versus real situation and make a decision toward the real situation.

The culminating idea of the method is taking responsibility – “how I behave – this is my problem, how you behave – this is your problem.” When people realize that the cause of their problems is a distorted perception of external situations in images, I then take responsibility. Moreover, when people take responsibility, the reaction and the behavior come from choosing the best option, more acceptable to the external real situation – “I either manifest my feelings, or express them consciously.”

Basic principles of the self-coping method are as follows:

  1. Human behavior depends on the mental state (state of mind)
  2. Emerging behavioral problems are the result of incapability to cope with the mental state
  3. Mind/Soul is manifested by states, for example, weakness, fatigue, drowsiness, and hunger
  4. The mental state consists of the feelings, the sensations, and images
  5. The main tool of self-coping is the ability to consciously observe one's internal state (introspection) and be able to verbalize it
  6. The formula of self-coping: I see (differentiated conscious perception of emotions, sensations, and images in a single connection, this is one cycle) – I realize (awareness of the process of changing states, whether we like it or not, a cycle changes, thereby changing states) – I control, when we consciously experience different states through images and corresponding emotions and sensations
  7. Responsibility for one's behavior: The reason for the behavior is the internal state, the state of your mind at the moment, and not the environment (people or situation), this is just a trigger
  8. Each person is capable of self-improvement, learning to realize and bear responsibility for his behavior and life.


There are two areas of application of the method:

  1. Psychohygienic direction is necessary for the formation of a new strategy of behavior in stressful situations. It helps to cope with difficult life situations that cause states of loneliness, resentment, unhappy love, thoughts about not willing to live, get drunk, use a drug, etc.[2],[3],[4]
  2. Psychocorrectional or psychotherapeutic direction: This is the work with specific conditions that clients/patients are seeking a psychologist/psychotherapist. The method can be used independently or in combination with other psychotherapeutic and therapeutic methods. It is used for the following disorders: neurotic disorders, addictive disorders (at rehabilitation phase), and sexual disorders and also in internal medicine, problems of relationships, choice, and decision-making. Contraindications include severe life-threatening conditions, psychotic disorders, and severe cognitive impairment. It can be used in individual and group format.


The method consists of five stages:

  • The 1st stage: Differentiation of the state: Awareness of components of the mental state: feelings (emotions), sensations, and images
  • The 2nd stage: Predetermined images with closed eyes: Consistent observation of the mental state through working with the images
  • The 3rd stage: Spontaneous images with closed eyes: Sequential observation of changes in the mental state through work with spontaneous images
  • The 4th stage: Free images with open eyes: Consistent observation of the mental state through working with free images
  • The 5th stage: Ecological behavior as a result of mental state management (expression of thoughts and emotions).


The 1st stage: The goal is to differentiate feelings, sensations, and images. Recognizing mental state and capability to describe it in an understandable language will help to better understand and regulate the behavior. A person is always in a certain mental state. Such conditions such as fatigue, anxiety, hopelessness, jealousy, love, happiness, hunger, rivalry, and fear are known. Conditions follow one after another so quickly that sometimes a person does not notice how they change or may experience several different conditions at once. In this case, it is necessary to highlight the current-leading state. Mental states arise independently of our will. People often do not recognize them. Usually, we try to control them, i.e., suppress them, following external circumstances (moral, cultural, or situational). According to this method, in order to realize one's state, it is necessary to learn to identify the three components using special exercises: feeling, sensation, and image [Figure 1].
Figure 1: A simple way to memorize 9 basic emotions

Click here to view


Sensation is the body language through which the body transmits signals of our needs or the effects of the external environment. Often, people do not recognize sensations and notice them only when the body “screams” about itself, for example, a headache, burning behind the sternum, and heaviness in the legs. However, a sensation exists always, for example, heaviness, lightness, cold, heat, dryness, and constriction. It is important to read the signals of the body at every moment of time, namely, bodily sensations. They can be a clue and give information about our mental state.

Feelings (emotions) are the language of the experiences of our mind (conditional projection of feelings in the chest). According to this method, we distinguish 11 human emotions. For ease of memorization, we projected them as follows in the palm of a person [Figure 1].

The term “calmness” in this method refers to a group of feelings and is used when it is difficult to single out one or another feeling that is not very pronounced (excitement, irritation, and sadness) or changes quickly, since feelings are insufficiently recognized and it is difficult to determine the dominant one. At the same time, a person's calm is relative (absolute calmness in life is impossible).

The third component of the mental state is an image. The image here is a unit of thought, like a film shot. Depending on the content, the image can be observed as clear or understandable, home, nature, and objects, and as obscure-incomprehensible blurry images, darkness, zigzags, flashes, stripes, and lights. People think through images. An image is the cause of experienced feelings and sensations. When protective phenomena operate (repression, avoidance, etc.), the images play the role of “curtains” that hide what a person do not will to be aware toward actual problems.

It is important to understand what our mind is, to know general concepts. The mind can be seen through its components and then manage it. The components are feelings, sensations, and images. Everything that we do not lead directs us. However, in order to lead, it is needed to understand.

The 2nd stage: The goal is to watch the mental state through the “model of cyclic (continuous) dynamics of feelings–sensations–images.” Closed eyes and stipulated images serve to develop the skill of conscious observation of a change in one's mental state, since stipulated images are neutral, consistent (more often), and understandable, and closed eyes contribute to better concentration on one's internal processes. This can happen until the automated skill is developed. However, in some cases, the change of images does not occur, that is, a person gets stuck on one image. For example, often, the image of darkness does not change in patients of oncological clinics. Such obstacles that have arisen in the natural change of images, as well as the feelings and sensations associated with them, are called slipping. The reason for the slip is fear and anxiety of emerging images. This could be compared with driving a car. A person is a driver; a car is driver's internal state; images are naturally changeable pictures in a car window; driver's emotions are gas; sensations are a brake. Slipping – a phenomenon when your car is broken and does not drive. Ask the client what happened? Compare this to a car breakdown, and the client needs to find out what has broken in his state of mind. If a person stays in stuck with a certain emotion or image, three kinds of dialogue could be applied: response through acting out; making a compromise; acceptance.

An example:

  • Therapist (T): Close your eyes, imagine a river. Hold this image and describe what you see, what you feel and sense in the body
  • Client (C): I see the river. It's wide. Feeling is excitement. Sensation is tightness of the chest.


    • T: Go further along the river. What do you see?
    • C: Reed grows along the river, the river narrows
    • T: What do you feel and sense?
    • C: I feel anxiety, I sense a heartbeat, it becomes more frequent
    • T: What is the reason for the heartbeat?
    • C: The reeds that grow along the river are tall and dense
    • T: Let's move on. What do you see?
    • C: I went through the reeds
    • T: An image?
    • C: An open place, only a wide river, the grass is green
    • T: How do you feel? What is your sensation?
    • C: Calmness and relaxation
    • T: Go on. What do you see?
    • C: The river flows smoothly further and does not narrow, and does not expand. Green grass grows
    • T: Feeling and sensation?
    • C: Calm. Lightness in the legs
    • T: Go on
    • C: The river flows smoothly, straight
    • T: Feeling and sensation?
    • C: Calm. Lightness in the chest.


The 3rd stage: This is a consistent observation of changes in mental state through work with spontaneous images with person's closed eyes. This is an important stage, when a person is developing the ability to observe his unique internal state, which spontaneously arises in “closed eyes.” It is good to better focus on feelings, sensations, and images. The outcome of this stage is a person can do this with open eyes. It means that a person is prepared to the next stage. It is important that a psychologist (psychotherapist) during three stages helps a person to understand his problem state and repeatedly talks with him about it (craving to eat, craving alcohol, drugs, reluctance to eat, panic attacks, etc.). Immersion in a problem state is for client's training how to deal with it. The emerging feelings, sensations, and images within a problem situation are absolutely spontaneous and create unpredictability of the content. Moreover, even when working with one problem situation in different sessions, different spontaneously arising feelings, sensations, and images form spontaneously arising, replacing each other mental states.

The 4th stage is presenting the management of the mental state through working with free images with the person's open eyes. The goal is to watch the mental state through the “model of cyclic (continuous) dynamics of emotions–sensations–images.” At this stage, work is based on the same rules and principles as at the previous one. A person can monitor the dynamic change of mental states in time, see the components of his mind, and verbalize, forming a meaning and understanding about himself. Then, the understanding of how to live with it, the desire to manage your mental states comes. In this case, the patient does not need to apply special techniques to concentrate on his condition, knocking him out of the usual and everyday routine. The patient learns to do this in real time, without changing the current behavior style.



State management formula is See = Realize = Manage. See: to recognize signals of your body-sensations, to understand what feeling has arisen at the moment, and to recognize and watch images that arise on response to the corresponding emotion and sensation. Realize: Be aware of and realize the pattern of cycle changes. Jamming and slipping are a problem that needs to be dealt. Manage: Do not control, do not fight, but allow yourself to observe “emotions–images–sensations,” accepting a continuous dynamic change of mental states.

This step reflects the difference between management and control and explains the formula of self-coping. As is already known, the mental state has three components that must be clearly and precisely differentiated. Since the change of images and the corresponding feelings and sensations is a continuous process, it is important to consciously observe their change. The images should be allowed to arise spontaneously, then to see them, to observe them, as something very natural and spontaneous. Moreover, it is important to realize what feelings and sensations you experience with the arising images.

Exercise “Snow” (“philosophy of the method”) lasts from 3 to 10 min. The therapist gives instructions:

“Take a comfortable position on the chair. Put your hands with your palms open on top of your knees, or rest your elbows on your hips. Ensure a comfortable hand position so that your hands can be held long enough. Imagine that you have loose soft snow on your hands. Look at him and do not close your eyes! Your task is to observe what is happening with the snow on your palms.”

After completing the exercise, talk with the client about the work done. Ideally, there is a consistent observation of “melting snow” in the palm, at the end the client experiences the feeling of “warmth,” the sensation of “joy,” the image of “red palms.” This exercise is not always possible to carry out to the end, and this indicates that the client is not in control of his condition, but displaces/avoids undesired reactions.

The 5th stage: Eco-friendly behavior is the person's ability to express, i.e., verbalize feelings (emotions) and thoughts to himself or an opponent, rather than demonstrating feelings (screaming, crying, quitting at work, leaving school, etc.), thus expressing your feelings and emotions without harming himself and others. It is crucial a person to form his speech in a difficult or conflict situation, while showing an assertive (independent) behavior model, bear responsibility for his behavior, and express his feelings and thoughts in a socially acceptable manner. The goal is to train people on ecological behavior in real life situations. It means a respectful attitude toward personal boundaries, compliance with the okay principle - all people are equal and significant for each other. We recognize our right and the right of others to express their opinions and make their own decisions in any situations. Ecological behavior refers to the skill of expressing one's state in an environmentally friendly way, forming a model of assertive behavior, and expressing one's thoughts and feelings in a socially acceptable pattern.

In various life situations, our behavior manifests itself as a result of accumulated emotions or unjustified expectations. However, a person does not have to accumulate his feelings and keep them in himself, this leads to an overabundance of energy that cannot be controlled (understand restraint by this). Sooner or later, it will splash out in the most inappropriate place or situation. To prevent this, a person needs to realize his emotions to experience and release them in a civilized manner (internally) and then express (externally). In everyday life, we often manifest our emotions through our behavior – we shout, take offense, cry or drink alcohol, “react psychosomatically” (high blood pressure, gastritis, allergies, etc.).[5] Manifestation, not expression, is seen in creativity, work, and study. Being unable to cope with problematic states, people abandon work, study, cannot create, receiving satisfaction. If people understand what kind of mental images makes them react through scream, tears, being obsessed with sweets, drinking alcohol, people then realize why they are doing this, that an existing actual situation is not a real cause of their feelings.[6] Therefore, we can manage our condition, experiencing subsequent images, feelings, and sensations. Having experienced in this way our undesirable states, we can then express them in communication, showing separately feelings and separately relevant thoughts. Changing the external locus of control to the internal one, people take responsibility for their own conditions and behavioral reactions.

Principles of eco-behavior:

  1. Express only the feeling and thoughts, not mentioning out loud about sensations
  2. To express feelings means not to “infect” other people with your emotion
  3. When a person expresses his/her thoughts, he only talk about him/herself and in no case criticize other person's behavior
  4. It is important to use words “I think” and “I feel” before uttering a statement; the sequence of their use does not matter
  5. Your expression should not be emotional, but that does not mean that you are a robot.


Eco-(friendly) behavior is the end result of self-coping model. People's reactions to others and to the environment are important. The formation of responsibility for one's behavior, the ability to realize one's feelings, images, and sensations, allows a person to understand their expected reactions and accordingly, to model them (coping strategies), which makes it possible to manage them and bear responsibility for their reactions and behavior.

The self-cope model works in medical patients, when they experience physically unpleasant sensations, followed by feelings, images that could not be handled by patients. The method is applicable as one of the tools of short-term therapy, when it is necessary to quickly return the patient to a resource state, without deep immersion. This method is an affordable and high quality tool for working with children. It is important for business trainers to constantly improve the quality of work with staff, their communication skills. This method allows you to maximize your potential and activate internal resources. The ability to control your feelings helps not to transfer them to others, thereby improving communication. This method explains why we do not use enough internal potential, suppressing our feelings. As a result of this, our feelings are not realized to the maximum and do not work for us. Moreover, if we learn and teach others to control their feelings through understanding the nature of feelings, we then will better understand and interact with each other. Indeed, the realization that anxiety and irritability in one way or another is connected with our images helps to learn to control your feelings and to manifest them without “infecting” others. In this case, we have the eco-friendly behavior.

The prepandemic experience of using this method has shown high efficiency and its comprehensibility and simplicity. The method has proven its usefulness in online consulting, positively perceived by clients, who note its ease of understanding, training, and use.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

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Steiner C. Emotional Literacy: Intelligence with a Heart. Kyiv:Interservice; 2016 (in Russian).  Back to cited text no. 1
    
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Snyder CR, Ford CE, Harris RN. The effects of theoretical perspective on the analysis of coping with negative life events. In: Coping with Negative Life Events. New York: Plenum Press; 1987. p. 313.  Back to cited text no. 2
    
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Billings AG, Moos RH. Coping, stress, and social resources among adults with unipolar depression. J Pers Soc Psychol 1984;46:877-91.  Back to cited text no. 3
    
4.
Turner RJ, Roszel P. Psychosocial resources and the stress process. In: Stress and Mental Health. Contemporary Issues and Prospects for the Future. New York: Plenum Press; 1994. p. 179-210.  Back to cited text no. 4
    
5.
Ensel WM, Lin N. The life stress paradigm and psychological distress, J Health Soc Behav 1991;32:321-41.  Back to cited text no. 5
    
6.
Pearlin LI. The study of coping: An overview of problems and directions. In: The Social Context of Coping. New York: Plenum Press; 1991. p. 261-76.  Back to cited text no. 6
    

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Correspondence Address:
Dr. Saya Nurmagambetova
The Republican Mental Health Center, Almaty
Kazakhstan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/psychiatry.IndianJPsychiatry_1056_20

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