Таким обра-
зом, обычное <одномерное> предсказание исхода лече-
ния, столь часто применяемое в психотерапии, не
только не учитывает сложности человеческой индиви-
дуальности, но и умаляет способность врача постичь
эту сложность и опираться на нее в ходе терапии.
Использование процедуры предсказания индивиду-
альных решеток пациентов и сравнение этого предска-
зания с реальными результатами позволили выявить
источники конкретных ошибок психотерапевтов даже в
тех случаях, когда в целом предсказания оказывались
правильными, что даст возможность в будущем эмпири-
чески выявлять <горячие точки> терапии, до сих пор
поддававшиеся лишь ad hoc интерпретации психоанали-
тиков.
Матрицы <идеального результата психотерапии>
Эти матрицы позволили выявить пациентов, оправ-
давших ожидания психотерапевтов и не оправдавших
таких ожиданий, что уже само по себе достаточно
интересно. В пяти случаях из восьми решетки, запол-
ненные пациентами в ходе повторного тестирования,
коррелировали с решетками <идеального результата
психотерапии>. Анализ же тех матриц <идеального
результата психотерапии>, в которых нашли свое отра-
жение нереалистичные ожидания психотерапевтов, дал
возможность увидеть то, каким образом <идеализирует-
ся идеальное>. Может быть, психотерапию наряду с
политикой следует считать искусством учета всех воз-
можностей. В некоторых случаях несоответствие меж-
ду решеткой <идеального результата> и решеткой,
заполненной пациентом, свидетельствовало не о неуда-
че лечения, а о том, что пациентом был найден
альтернативный способ решения проблемы, не учтен-
ный психотерапевтом, но впоследствии как самим паци-
ентом, так и психотерапевтом признанный удовлетвори-
тельным (вспомним пациента X.).
Поэтому в тех случаях, когда был достигнут идеаль-
ный, по мнению психотерапевтов, результат, его следу-
ет интерпретировать не в терминах <правильности> или
<абсолютности предсказаний>, но в более релятивист-
ских терминах, как показатель совпадения ожиданий
психотерапевтов с реальным результатом.
Образно говоря, в данном случае мы имеем тот
<материал, из которого сделаны предсказания>,-
интуитивные догадки, которые проверяются будущими
событиями и заставляют по-новому оценить наши зна-
ния на данный момент. Диапазон качества таких дога-
док чрезвычайно широк-от смутных и неточных
высказываний, сделанных, что называется, вслепую, до
удивительно точных, обоснованных предсказаний. Не-
предсказуемым является лишь то, насколько точным
будет данное конкретное предсказание. Отсюда, кста-
ти, следует, что предсказание, сделанное с целью
лучшего контроля поведения, имеет меньше шансов на
успех по сравнению с предсказанием, цель которого-
лучше понять другого человека.
Выводы для дальнейших исследований
Во-первых, при разборе недостатков использованной
методики в дальнейших исследованиях при повторном
тестировании следует не только использовать ранее
выявленные кокструкты, но и снова повторять процеду-
ры выявления, чтобы включить в исследование вновь
возникшие конструкты. Это даст дополнительные све-
дения для сравнения результатов двух тестирований и
не нозполяет упустить из виду то качественно новое,
что появилось в феноменальном мире пациентов в
результате терапии.
Во-вторых, <Я-концепцию> лучше исследовать, ис-
пользуя представление о себе в качестве элемента, а не
конструкта.
В-третьих, как отмечалось при критике теории
концептуальной структуры, предложенной Маклуф-
Норрис и ее коллегами (148), для того чтобы оконча-
тельно изгнать из психологии представление о том, что
решетки выявляют стабильные личностные черты и что
с их помощью можно классифицировать испытуемых
по диагностическим категориям, необходимо провести
исследование, в котором решетки (наряду с беседой)
заполнялись бы пациентами периодически через каж-
дые 2-3 месяца. Весьма заманчиво также изучить
диапазон и виды изменений, происходящих с системой
конструктов с течением времени. Это дало бы возмож-
ность разработать более чувствительные индексы изме-
нений, чем те, которые используются при проведении
единственного повторного тестирования через год после
первого.
В заключение хочу сказать следующее. Я думала,
что мне удалось сделать данное исследование подлинно
рефлексивным, так как в число обследуемых наряду с
пациентами были включены и психотерапевты. Потом я
поняла, что забыла включить в это число себя. Неуже-
ли подлинная рефлексивность-недостижимый мираж?
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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29
зом, обычное <одномерное> предсказание исхода лече-
ния, столь часто применяемое в психотерапии, не
только не учитывает сложности человеческой индиви-
дуальности, но и умаляет способность врача постичь
эту сложность и опираться на нее в ходе терапии.
Использование процедуры предсказания индивиду-
альных решеток пациентов и сравнение этого предска-
зания с реальными результатами позволили выявить
источники конкретных ошибок психотерапевтов даже в
тех случаях, когда в целом предсказания оказывались
правильными, что даст возможность в будущем эмпири-
чески выявлять <горячие точки> терапии, до сих пор
поддававшиеся лишь ad hoc интерпретации психоанали-
тиков.
Матрицы <идеального результата психотерапии>
Эти матрицы позволили выявить пациентов, оправ-
давших ожидания психотерапевтов и не оправдавших
таких ожиданий, что уже само по себе достаточно
интересно. В пяти случаях из восьми решетки, запол-
ненные пациентами в ходе повторного тестирования,
коррелировали с решетками <идеального результата
психотерапии>. Анализ же тех матриц <идеального
результата психотерапии>, в которых нашли свое отра-
жение нереалистичные ожидания психотерапевтов, дал
возможность увидеть то, каким образом <идеализирует-
ся идеальное>. Может быть, психотерапию наряду с
политикой следует считать искусством учета всех воз-
можностей. В некоторых случаях несоответствие меж-
ду решеткой <идеального результата> и решеткой,
заполненной пациентом, свидетельствовало не о неуда-
че лечения, а о том, что пациентом был найден
альтернативный способ решения проблемы, не учтен-
ный психотерапевтом, но впоследствии как самим паци-
ентом, так и психотерапевтом признанный удовлетвори-
тельным (вспомним пациента X.).
Поэтому в тех случаях, когда был достигнут идеаль-
ный, по мнению психотерапевтов, результат, его следу-
ет интерпретировать не в терминах <правильности> или
<абсолютности предсказаний>, но в более релятивист-
ских терминах, как показатель совпадения ожиданий
психотерапевтов с реальным результатом.
Образно говоря, в данном случае мы имеем тот
<материал, из которого сделаны предсказания>,-
интуитивные догадки, которые проверяются будущими
событиями и заставляют по-новому оценить наши зна-
ния на данный момент. Диапазон качества таких дога-
док чрезвычайно широк-от смутных и неточных
высказываний, сделанных, что называется, вслепую, до
удивительно точных, обоснованных предсказаний. Не-
предсказуемым является лишь то, насколько точным
будет данное конкретное предсказание. Отсюда, кста-
ти, следует, что предсказание, сделанное с целью
лучшего контроля поведения, имеет меньше шансов на
успех по сравнению с предсказанием, цель которого-
лучше понять другого человека.
Выводы для дальнейших исследований
Во-первых, при разборе недостатков использованной
методики в дальнейших исследованиях при повторном
тестировании следует не только использовать ранее
выявленные кокструкты, но и снова повторять процеду-
ры выявления, чтобы включить в исследование вновь
возникшие конструкты. Это даст дополнительные све-
дения для сравнения результатов двух тестирований и
не нозполяет упустить из виду то качественно новое,
что появилось в феноменальном мире пациентов в
результате терапии.
Во-вторых, <Я-концепцию> лучше исследовать, ис-
пользуя представление о себе в качестве элемента, а не
конструкта.
В-третьих, как отмечалось при критике теории
концептуальной структуры, предложенной Маклуф-
Норрис и ее коллегами (148), для того чтобы оконча-
тельно изгнать из психологии представление о том, что
решетки выявляют стабильные личностные черты и что
с их помощью можно классифицировать испытуемых
по диагностическим категориям, необходимо провести
исследование, в котором решетки (наряду с беседой)
заполнялись бы пациентами периодически через каж-
дые 2-3 месяца. Весьма заманчиво также изучить
диапазон и виды изменений, происходящих с системой
конструктов с течением времени. Это дало бы возмож-
ность разработать более чувствительные индексы изме-
нений, чем те, которые используются при проведении
единственного повторного тестирования через год после
первого.
В заключение хочу сказать следующее. Я думала,
что мне удалось сделать данное исследование подлинно
рефлексивным, так как в число обследуемых наряду с
пациентами были включены и психотерапевты. Потом я
поняла, что забыла включить в это число себя. Неуже-
ли подлинная рефлексивность-недостижимый мираж?
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