This is the name given to various thoughts, inclinations, fears, doubts, ideas that involuntarily invade the consciousness of the patient, who perfectly understands all their absurdity and at the same time cannot fight them. Obsessions are, as it were, imposed on a person; he cannot get rid of them by an effort of will.

Obsessive thoughts can occasionally appear in mentally healthy people. They are often associated with overwork, sometimes occur after a sleepless night and usually have the character of obsessive memories (a melody, a line from a poem, a number, a name, etc.).

Obsessive phenomena are conditionally divided into two groups:

1. abstract, or affectively neutral, i.e., occurring without affective reactions of obsession - obsessive account, fruitless sophistication, obsessive actions;
2. figurative or sensual obsessions that proceed with a pronounced affect - contrasting ideas (blasphemous thoughts, obsessive feelings of antipathy towards loved ones, obsessive inclinations), obsessive doubts, obsessive fears (phobias), etc.

obsessive account consists in an irresistible desire to count oncoming cars of a certain color, passers-by, luminous windows, one's own steps, etc.

intrusive thoughts ( fruitless sophistication) make a person constantly think, for example, about what would happen if the Earth turned out to be a cube in shape, where in this case the south or north would be, or how a person would move if he had not two, but four legs .

obsessive actions expressed in involuntary, automatic performance of any movements. For example, while reading, a person mechanically twists a lock of hair around his finger or bites a pencil, or automatically eats sweets lying on the table one after another.

Abstract obsessions, especially obsessive actions, are often found not only in patients, but also in mentally perfectly healthy people.

haunting memories are manifested in the constant involuntary recollection of some unpleasant, compromising fact from the life of the patient. This actualization is always accompanied by negatively colored emotions.

Contrasting obsessions include, as already indicated, blasphemous thoughts, feelings of antipathy and obsessive desires.

blasphemous thoughts- these are obsessive, cynical, offensive ideas about certain persons, religious and political figures, other people, to whom the patient actually treats with great respect or even reverence. For example, during a church service, a deeply religious person has an irresistible desire to shout an insult at God or the angels. Or during a meeting of freshmen with the rector of the institute, one student has an irresistible desire to shout that the rector is a fool. This desire was so intense that the student, holding his mouth shut, rushed out of the assembly hall like a bullet. Blasphemous thoughts are always accompanied by a pronounced affect, they are extremely painful for patients. It should be emphasized, however, that blasphemous thoughts, like all contrasting obsessions, are never realized.

An obsessive feeling of antipathy lies in the fact that the patient, in addition to his desire, has a painfully irresistible feeling of acute hostility and hatred for the closest and most beloved people, for example, to his mother or his own child. These obsessions proceed with a particularly pronounced affect of fear.

obsessive attraction are expressed in the patient's acute desire to hit a person he respects, gouge out the eyes of his boss, spit in the face of the first comer, urinate in front of everyone.

The patient always understands the absurdity and painfulness of these drives and always actively struggles with their realization. These obsessions proceed with marked fear and anxiety.

obsessive doubts- an extremely unpleasant painful feeling that the patient experiences, doubting the completeness of this or that action. Thus, a doctor who writes out a prescription to a patient for a long time cannot get rid of his doubts, which constantly gnaw at him, whether he indicated the correct dose in the prescription, whether this dose will be lethal, etc. People with obsessive doubts, leaving home, repeatedly return to check whether the gas or light is turned off, whether the tap in the bathroom is well closed, whether the door is tightly closed, etc. Despite numerous checks, the tension of doubts is not reduced.

Mastering representations- this is the acceptance of the improbable for reality, contrary to consciousness. At the height of the development of mastering ideas, a critical attitude towards them and awareness of their morbidity disappear, which brings such disorders closer to overvalued ideas or delusions.

Obsessive fears (phobias)- a painful and extremely intense experience of a feeling of fear of certain circumstances or phenomena with a critical attitude and attempts to fight this feeling. There are quite a few phobias. The most common are:

• Agoraphobia is an obsessive fear of open spaces (squares, streets).
• Acrophobia (hypsophobia) - obsessive fear of heights, depths. Algophobia is an obsessive fear of pain.
• Anthropophobia is an obsessive fear of contact with people in general, regardless of gender or age.
• Astrophobia is an obsessive fear of thunder (lightning).
• Vertigophobia is an obsessive fear of dizziness.
• Vomitophobia is the obsessive fear of vomiting.
• Heliophobia is an obsessive fear of sunlight.
• Hematophobia is an obsessive fear of blood.
• Hydrophobia is an obsessive fear of water.
• Gynecophobia is an obsessive fear of contact with women.
• Dentophobia is an obsessive fear of dentists, dental chairs and tools.
• Zoophobia is the obsessive fear of contact with animals.
• Kaitophobia is an obsessive fear of change of scenery.
• Claustrophobia is an obsessive fear of closed spaces, premises (apartment, elevator, etc.).
• Xenoscopyphobia is the obsessive fear of the gaze of others.
• Mysophobia is the obsessive fear of pollution.
• Necrophobia is an obsessive fear of the dead, corpses.
• Nyctophobia is an obsessive fear of the dark.
• Nosophobia - obsessive fear of getting sick
• Oxyphobia is an obsessive fear of sharp objects.
• Perophobia is the obsessive fear of priests.
• Pettophobia is an obsessive fear of society.
• Sityophobia (octophobia) is an obsessive fear of eating.
• Siderodromophobia is the obsessive fear of riding a train.
• Thanatophobia is an obsessive fear of death.
• Triskaidekphobia is an obsessive fear of the number 13.
• Taphephobia is the obsessive fear of being buried alive.
• Urophobia is an obsessive fear of an irresistible urge to urinate.
• Phobophobia is an obsessive fear of fear in a person who has ever experienced an episode of obsessive fear, this is the fear of a repetition of a phobia.
• Chromatophobia is an obsessive fear of bright colors. There are many other, lesser known phobias (there are more than 350 types in total).

Phobias are always accompanied by pronounced vegetative reactions up to the onset of panic states. Then, at the height of fear, a critical attitude towards phobias may disappear for some time, which complicates the differential diagnosis of obsessions from delusional ideas.

Patient I., 34 years old, suffering from irritable bowel syndrome (psychogenic diarrhea + psychogenic pain in the colon), for a long time suspected that his problems with stool were caused by colon cancer (carcinophobia) or syphilitic lesions (syphilophobia), or AIDS (spidophobia). ). Regarding suspected diseases, he was repeatedly examined in the relevant medical institutions, despite the negative results of the tests, he did not believe the doctors. He was treated by clairvoyants, healers, who willingly confirmed his suspicions, as long as he was able to pay. Once in the sanatorium department of the psychiatric hospital, every day he asked that the medicine be drawn into a disposable syringe in his presence, as he was terribly afraid of contracting AIDS through a syringe.

rituals- obsessive actions that the patient consciously develops as a necessary protection (a kind of spell) from a dominant obsession. These actions, which have the meaning of a spell, are performed, despite a critical attitude towards obsessions, in order to protect against this or that imaginary misfortune.

For example, with agoraphobia, the patient performs one action before leaving the house - in a certain order he rearranges books on the table or turns several times around an axis, or makes several jumps. When reading, a person regularly skips the tenth page, because this is the age of his child, while skipping the corresponding page "protects" the child from illness and death.

Rituals can be expressed in the reproduction by the patient aloud, in a whisper, or even mentally of any melody, well-known saying or poem, etc. Characteristically, after performing such an obligatory rite (ritual), relative calm sets in, and the patient can temporarily overcome the dominant obsession. In other words, a ritual is a secondary obsession consciously developed by the patient as a method of dealing with the main obsessions. Since rituals are compulsive in their content, the patient is usually unable to overcome the need to perform them. Sometimes rituals take on the character of being done (phenomena of mental automatism) or catatonic stereotypes.

Obsessive states cannot be attributed only to the pathology of thinking, since with them, especially with figurative obsessions, emotional disorders in the form of fear and anxious fears are also significantly expressed. In this regard, let us recall that at one time S.S. Korsakov, and before him J. Morel, argued that both the intellectual and emotional spheres suffer in obsessive states.

Obsessive states differ from overvalued and delusional ideas in that the patient is critical of his obsessions, regarding them as something alien to his personality. Also, and this is extremely important, he is always trying to fight his obsessions.

Obsessive ideas can sometimes develop into delusional ideas, or at least be the source of the latter (V.P. Osipov). In contrast to delirium, obsessions are usually of a non-permanent nature, appearing sporadically, as if by seizures.

Obsessive states are often found in neuroses (especially in obsessive-compulsive disorder), psychopathy of the inhibited circle, affective disorders (mainly in depressions) and in some psychoses (for example, in neurosis-like schizophrenia).

Thoughts are wicked. Thoughts that contradict the moral and ethical properties of the individual, the patient's ideas about ideals, worldview, attitude towards loved ones, etc. Because of this, they are extremely painfully experienced, depriming the patient.

• Agony- Agony (Greek) - such a condition of the patient, in which there are true symptoms of imminent death. The word "agony", which means the struggle with death, is not always apt, because sometimes death is presented to you...
• Marochetti, Mikhail Petrovich- Marochetti, Mikhail Petrovich (1783-1860) - doctor of medicine, was a doctor in St. Petersburg. theater school. In his Op. about hydrophobia ("Observations sur l" hydrophobie ", St. Petersburg, 1821) tried to prove that after a bite ...
• SOCIOREADAPTATION- SOCIOREAADAPTATION (English social readaptation) - the end result of the process of social rehabilitation, which determines the quality of life of a patient after a serious illness. S. is not limited to labor ...
• EUTHANASIA (from the Greek. to her- EUTHANASIA (from the Greek. she feels good and Thanatos, the god of death) satisfaction of the patient's request to hasten his death to. l. actions or means, incl. cessation of artificial measures to maintain life...
• BILO- BILO is an ethno-specific term that means a form of psychotherapy practiced in the folk medicine of Madagascar, aimed at harmonizing the self-esteem of a patient tormented by neurotic symptoms (s...
• Bibliotherapy- Bibliotherapy (biblio + Greek therapeia - care, care, treatment). A method of psychotherapy based on pedagogical and didactic principles. It is carried out with the help of books, primarily art ...
• Disease picture autoplastic- The disease is an autoplastic picture (Greek autos - itself, plastike - formation, formation). The sum of sensations, experiences and moods of the patient, together with his own imagin...
• Brave protection.- Delusional protection. Protective behavior of the patient, due to his delusional experiences. Includes the patient's actions directed against alleged enemies, collecting evidence of his innocence (...
• attraction.- Attraction. Psychological state, unconscious stage of need formation. The need presented in it either does not develop, fades away, or, becoming conscious, is realized in the form of a con...
• Gurevich-Golant-Ozeretskovsky violence syndrome- Gurevich-Golant-Ozeretskovsky syndrome of violent irresistible drives [Gurevich MO, 1925; Golant R.Ya., 1929; Ozeretskovsky D.S., 1950]. It is observed mainly in the chronic course of ...
• Dejerine directive psychotherapy- Dejerine directive psychotherapy. Psychotherapeutic method based on suggestion and education. Significant importance is attached to the emotional richness of psychotherapeutic ...
• Deactualization of delusions- Deactualization of delirium (des + lat. actualis - acting, effective). Temporary or long-term, persistent decrease in the significance of delirium, which has ceased to significantly affect the patient's actions. Often dream...
• Dubois rational psychotherapy— Dubois rational psychotherapy. is based on the effect on the patient of logical conviction in the waking state. It is carried out in the form of a dialogue between the patient and the doctor, during which ...
• Individual card of an outpatient.- Individual card of the outpatient. The main accounting and operational medical document filled out for an outpatient in outpatient departments of neuropsychiatric dispensaries and ...

Obsessive disorders, primarily obsessive fear, were described by ancient doctors. Hippocrates (5th century BC) gave clinical illustrations of such manifestations.

Doctors and philosophers of antiquity attributed fear (phobos) to the four main "passions" from which diseases originate. Zeno of China (336-264 BC) in his book On the Passions defined fear as the expectation of evil. To fear, he also ranked horror, timidity, shame, shock, fear, torment. Horror, according to Zeno, is fear, leading to stupor. Shame is the fear of dishonor. Shyness is the fear of taking action. Shock is the fear of an unfamiliar performance. Fear is fear from which the tongue is taken away. Anguish is the fear of the obscure. The main species were clinically described much later.

In the 30s of the XVIII century, F. Lepe (F. Leuret) described the fear of space. In 1783, Moritz published his observations of the obsessive fear of apoplexy. In more detail, some types of obsessive disorders are given by F. Pinel in one of the sections of his classification called "mania without delirium" (1818). B. Morel, considering these disorders as emotional pathological phenomena, designated them by the term "emotive delirium" (1866).

R. Kraft-Ebing in 1867 coined the term "obsessive representations" (Zwangsvorstellungen); in Russia, I. M. Balinsky proposed the concept of "obsessive states" (1858), which quickly entered the lexicon of Russian psychiatry. M. Falre-son (1866) and Legrand du Solle (1875) singled out painful states in the form of obsessive doubts with fear of touching various objects. Subsequently, descriptions of various obsessive disorders began to appear, for which various terms were introduced: idees fixes (fixed, fixed ideas), obsessions (siege, obsession), impulsions conscientes (conscious drives) and others. French psychiatrists often used the term "obsessions", in Germany the terms "anancasm", "anancastes" (from the Greek Ananke - the goddess of fate, fate) were established. Kurt Schneider believed that anankastic psychopaths more often than others show a tendency to reveal obsessions (1923).

The first scientific definition of obsessions was given by Karl Westphal: “... Under the name of obsessions one should mean such representations that appear in the content of the consciousness of a person suffering from them against and contrary to his desire, with the intellect unaffected in other respects and not being due to a special emotional or affective state; they cannot be eliminated, they interfere with the normal flow of ideas and disrupt it; the patient consistently recognizes them as unhealthy, alien thoughts and resists them in his healthy mind; the content of these representations can be very complex, often, even for the most part, it is meaningless, is not in any obvious relationship with the previous state of consciousness, but even to the sickest person it seems incomprehensible, as if flying to him from the air ”(1877).

The essence of this definition, exhaustive, but rather cumbersome, was subsequently not subjected to fundamental processing, although the question of the absence of any significant role of affects and emotions in the occurrence of obsessive disorders was considered debatable. V.P. Osipov considered this thesis of K. Westphal to be not entirely accurate, but nevertheless noted that the opinion of V. Griesinger and other competent scientists coincided with the opinion of K. Westphal. D. S. Ozeretskovsky (1950), who studied this problem quite thoroughly, defined obsessive states as pathological thoughts, memories, doubts, fears, drives, actions that arise independently and against the wishes of the patients, moreover, irresistibly and with great constancy. Subsequently, A. B. Snezhnevsky (1983) gave a clearer designation of obsessions, or obsessive-compulsive disorders.

The essence of obsessions lies in the forced, violent, irresistible emergence of thoughts, ideas, memories, doubts, fears, aspirations, actions, movements in patients with the realization of their pain, the presence of a critical attitude towards them and the fight against them.

In clinical practice, they are divided into those that are not associated with affective experiences (“abstract”, “abstract”, “indifferent”) and affective, sensually colored (A. B. Snezhnevsky, 1983). In the first group of "neutral" in relation to the affect of obsessive disorders, the most common phenomena of "obsessive sophistication" are described earlier than others. The author of their selection is W. Griesinger (1845), who also gave a special designation to such a phenomenon - Grubelsucht. The term "obsessive philosophizing" (or "futile philosophizing") was suggested to V. Griesinger by one of his patients, who constantly thought about various subjects that had no meaning and believed that he was developing "philosophizing of a completely empty nature." P. Janet (1903) called this disorder "mental chewing gum", and L. du Solle - "mental chewing gum" (1875).

V. P. Osipov (1923) gave vivid examples of this kind of obsessive disorder in the form of continuously arising questions: “why does the earth rotate in a certain direction, and not in the opposite direction? What would happen if she turned in the opposite direction? Would people live the same way or differently? Wouldn't they be different? What would they look like? Why is this scrap four-story? If it had three floors, would the same people live in it, would it belong to the same owner? Would it be the same color? Would he have been on the same street? S. S. Korsakov (1901) refers to a clinical example given by Legrand du Soll.

“Sick, 24 years old, famous artist, musician, intelligent, very punctual, enjoys an excellent reputation. When she is on the street, she is haunted by such thoughts: “Will someone fall from the window at my feet? Will it be a man or a woman? Will this man hurt himself, will he be killed to death? If he gets hurt, will he hurt his head or legs? Will there be blood on the sidewalk? If he immediately kills himself to death, how will I know? Should I call for help, or run, or say a prayer, what prayer to say? Will they blame me for this misfortune, will my students leave me? Will it be possible to prove my innocence? All these thoughts crowd her mind and greatly excite her. She feels herself trembling. She would like someone to reassure her with an encouraging word, but “so far no one suspects what is happening to her.”

In some cases, such questions or doubts concern some very insignificant phenomena. So, the French psychiatrist J. Bayarzhe (1846) tells about one patient.

“He developed a need to ask about all sorts of details about the beautiful women he met, if only by chance.This obsession has always been there. whenthe patient saw a beautiful lady anywhere, and he could not help but act according to the need; and on the other hand, it was connected, of course, with a mass of difficulties. Gradually, his situation became so difficult that he could not calmly take a few steps down the street. Then he came up with this method: he began to walk with his eyes closed, he was led by an escort. If the patient hears the rustle of a woman's dress, he immediately asks if the person he met is beautiful or not? Only after receiving the answer from the escort that the oncoming woman is ugly, the patient could calm down. So things went pretty well, but one night he was riding on the railway, suddenly he remembered that, being at the station, he did not find out whether the person who sold the tickets was beautiful. Then he woke up his companion, began to ask him whether that person was good or not? He, barely waking up, could not immediately figure it out and said: “I don’t remember.” This was enough to make the patient so excited that it was necessary to send a trusted person back to find out what the appearance of the saleswoman was, and the patient calmed down after he was told that she was ugly.

The described phenomena, as can be seen from the examples, are determined by the appearance in patients, against their will, of endless questions of random origin, these questions have no practical significance, they are often unsolvable, follow one after another, arise obsessively, in addition to desire. According to the figurative expression of F. Meschede (1872), such intrusive questions penetrate the patient's mind like screwing in an endless screw.

An obsessive count, or arrhythmomania, is an obsessive desire to accurately count and keep in mind the number of steps taken, the number of houses met along the way, poles on the street, passers-by men or women, the number of cars, the desire to add up their numbers, etc. Some patients decompose into syllables words and whole phrases, select individual words for them in such a way that an even or odd number of syllables is obtained.

Obsessive reproductions or reminiscences are designated by the term onomatomania. This phenomenon was described by M. Charcot (1887) and V. Magnan (1897). Pathology in such disorders is expressed in an obsessive desire to recall completely unnecessary terms, the names of heroes in works of art. In other cases, various words, definitions, comparisons are compulsively reproduced and recalled.

One patient, S. S. Korsakova (1901), sometimes in the middle of the night had to look in old newspapers for the name of a horse that had once won a prize - so strong was his obsessive thought associated with remembering names. He understood the absurdity of this, but did not calm down until he found the right name.

Contrasting ideas and blasphemous thoughts can also become obsessive. At the same time, ideas arise in the minds of patients that are opposite to their worldview, ethical attitudes. Against the will and desire of patients, thoughts of harming loved ones are imposed on them. Religious people have thoughts of a cynical content, obsessively attached to religious ideas, they run counter to their moral and religious attitudes. An example of "abstract" obsessions of unreal content is the following clinical observation by S. I. Konstorum (1936) and his co-authors.

“Sick G., 18 years old. There were no psychoses in the family. The patient himself at the age of 3, having received a long-desired toy, unexpectedly hit his mother on the head with it. From the age of 8 - pronounced phobias: fear of the death of loved ones, fears of certain streets, water, numbers, etc. At school, he brilliantly studied literature, poorly - in other subjects. In the pubertal period, peculiar thoughts and states began to pursue: he began to be afraid of fire (matches, a kerosene lamp) for fear of burning, burning his eyebrows, eyelashes. If I saw a person lighting a cigarette on the street, my mood would deteriorate for the whole day, I could not think of anything else, the whole meaning of life seemed to be lost. Recently, the fire of the patient worries less. After graduating from school, he suffered from pleurisy, at that time fear appeared when reading lying down - it seemed that eyebrows were pouring onto the book. It began to seem that eyebrows are everywhere - on the pillow, in bed. It was very annoying, spoiled the mood, threw me into a fever, and it was impossible to get up. At that time, a kerosene lamp was burning behind the wall, it seemed to him that he felt the heat radiate from it, felt how his eyelashes were burned, his eyebrows were crumbling. After discharge, he got a job as an instructor in a magazine, but he was afraid to be in the sun so as not to burn his eyebrows. The work was to his liking. I could easily cope with it if obsessive thoughts about shedding my eyebrows on book and paper did not interfere. Gradually, other obsessions appeared, associated with fears for their eyebrows. He began to be afraid to sit against the wall, as “eyebrows can stick to the wall.” He began to collect eyebrows from the tables, dresses and "set them in place." Soon he was forced to leave work. I rested at home for two months, did not read, did not write. Kerosene began to be afraid less. On vacation, he felt good, but the thought of shedding his eyebrows did not leave him. Wash the table many times a day to wash off "eyebrows from the face and hands." Soaked eyebrows so that they do not crumble from drying. When walking home from the station for 3 km, he covered his eyebrows with his hands so that they would not be burned by a kerosene lamp burning at home. He himself considered this abnormal, but he could not get rid of such fears. Soon he got a job again, in winter he wore a demi-season coat, since it seemed that eyebrows were on the winter one. Then he began to be afraid to enter the room, it seemed that there were eyebrows on the tables that would fly at him, which would force him to wash. I was afraid to touch the folder with my hand. In the future, there was a fear of getting into the eyes of glass. He left work, mostly lies at home, “struggles with thoughts”, but cannot get rid of them.

Obsessive doubts described by M. Falre (1866) and Legrand du Solle (1875) are close to obsessive fears. These are most often doubts about the correctness of their actions, the correctness and completeness of their actions. Patients doubt whether they locked the doors, put out the light, closed the windows. Omitting the letter, the patient begins to doubt whether he wrote the address correctly. In such cases, there are multiple checks of their actions, while using various methods to reduce the time of rechecks.

In some cases, doubts arise in the form of obsessive ideas in contrast. This is uncertainty about the correctness of the actions performed with a tendency to act in the opposite direction, realized on the basis of an internal conflict between equivalent, but either unattainable or incompatible desires, which is accompanied by an irresistible desire to free oneself from an unbearable situation of tension. Unlike re-control obsessions, in which "anxiety back" prevails, obsessive doubts by contrast are formed on the basis of actual anxiety, they extend to events occurring in the present. Doubts of contrasting content are formed as an isolated phenomenon without connection with any other phobias (B. A. Volel, 2002).

An example of obsessive doubts in contrast is, for example, the insolubility of the “love triangle” situation, since being with a beloved is accompanied by ideas about the inviolability of the family way of life, and, conversely, being in the family circle is accompanied by painful thoughts about the impossibility of parting with the object of affection.

S.A. Sukhanov (1905) gives an example from the clinic of obsessive doubts, describing one schoolboy who, having prepared his lessons for the next day, doubted whether he knew everything well; then he began, testing himself, again repeating what he had learned, doing this several times in the evening. Parents began to notice that he was preparing for lessons until the very night. When questioned, the son explained that he lacked confidence that everything was done as it should, he doubted himself all the time. This was the reason for going to the doctors and conducting special treatment.

A vivid case of this kind was described by V. A. Gilyarovskiy (1938). One of the patients he observed, who suffered from obsessive doubts, was treated for three years by the same psychiatrist and at the end of this period, having come to see him by a different route, he began to doubt whether he had gone to another doctor with the same surname and name. To reassure himself, he asked the doctor three times in a row to give his last name and three times to confirm that he was his patient and that he was treating him.

Especially often and in the most diverse form obsessive fears, or phobias, are encountered in practice. If simple phobias, according to G. Hoffmann (1922), are a purely passive experience of fear, then obsessive phobias are fear or a negative emotion in general, plus an active attempt to eliminate the latter. Obsessive fears most often have an affective component with elements of sensuality, imagery of experiences.

Earlier than others, fear of large open spaces, fear of squares, or "areal" fear, according to E. Kordes (1871), was described. Such patients are afraid to cross wide streets, squares (), as they fear that at this moment something fatal, irreparable may happen to them (they will fall under a car, it will become ill, and no one will be able to help). At the same time, panic, horror, discomfort in the body - palpitations, coldness, numbness of the limbs, etc. can develop. A similar fear can develop when entering enclosed spaces (claustrophobia) and in the thick of the crowd (anthropophobia). P. Janet (1903) proposed the term agoraphobia to designate all position phobias (agora-, claustro-, anthropo- and transport phobias). All these types of obsessive phobias can lead to the emergence of the so-called, which arise suddenly, are characterized by a vital fear, most often the fear of death (thanatophobia), generalized anxiety, sharp manifestations of the autonomic psychosyndrome with palpitations, heart rhythm disturbances, breathing difficulties (dyspnea), avoiding behavior.

Obsessive fears can be very diverse in terms of plot, content and manifestation. There are so many varieties that it is not possible to list them all. Almost every phenomenon of real life can cause a corresponding fear in patients. Suffice it to say that with the change of historical periods, phobic disorders change and “renew”, for example, even such a phenomenon of modern life as the fashion for buying Barbie dolls that has swept all countries has generated a fear of acquiring such a doll (barbiphobia). Yet the most persistent are fairly common phobias. So, many people are afraid to be on an elevated place, they develop a fear of heights (hypsophobia), others are afraid of loneliness (monophobia) or, conversely, being in public, fear of speaking in front of people (social phobia), many are afraid of injury, an incurable disease, infection with bacteria , viruses (nosophobia, carcinophobia, speedophobia, bacteriophobia, virusophobia), any pollution (mysophobia). The fear of sudden death (thanatophobia), the fear of being buried alive (taphephobia), the fear of sharp objects (oxyphobia), the fear of eating (sitophobia), the fear of going crazy (lyssophobia), the fear of blushing in public (ereitophobia), described by V.M. Bekhterev (1897) "obsessive smile" (fear that a smile will appear on the face at the wrong time and inopportunely). An obsessive disorder is also known, consisting in the fear of someone else's gaze, many patients suffer from a fear of not keeping gases in the company of other people (pettophobia). Finally, the fear may turn out to be total, all-encompassing (panphobia) or the fear of fear may develop (phobophobia).

Dysmorphophobia (E. Morselli, 1886) - fear of bodily changes with thoughts of imaginary external deformity. The frequent combination of ideas of physical handicap with ideas of attitude and depression of mood is typical. There is a tendency to dissimulation, the desire to "correct" a non-existent deficiency (, according to M. V. Korkina, 1969).

Intrusive actions. These disorders manifest themselves in different ways. In some cases, they are not accompanied by phobias, but sometimes they can develop along with fears, then they are called rituals.

Indifferent obsessive actions are movements made against desire, which cannot be restrained by an effort of will (A. B. Snezhnevsky, 1983). Unlike hyperkinesias, which are involuntary, obsessive movements are volitional, but habitual, it is difficult to get rid of them. Some people, for example, constantly bare their teeth, others touch their face with their hands, others move their tongues or move their shoulders in a special way, exhale noisily through their nostrils, snap their fingers, shake their legs, squint their eyes; patients can repeat any word or phrases unnecessarily - “you understand”, “so to speak”, etc. This also includes some forms of tics. Sometimes patients develop generalized tics with vocalization (Gilles de la Tourette's syndrome, 1885). Some types of pathological habitual actions (nail biting, nose picking, finger licking or sucking) are considered compulsive actions. However, they are related to obsessions only when they are accompanied by the experience of them as alien, painful, harmful. In other cases, these are pathological (bad) habits.

Rituals are obsessive movements, actions that occur in the presence of phobias, obsessive doubts and, first of all, have the meaning of protection, a special spell that protects against trouble, danger, everything that patients are afraid of. For example, in order to prevent misfortune, patients skip the thirteenth page while reading, in order to avoid sudden death they avoid black. Some people carry “protective” items in their pockets. One patient had to clap his hands three times before leaving the house, this “saved” him from a possible misfortune on the street. Rituals are as diverse as obsessive disorders in general. Performing an obsessive ritual (and ritual is nothing more than obsession against obsession) relieves the condition for a while.

Obsessive inclinations are characterized by the appearance, contrary to the wishes of the patient, of the desire to perform some meaningless, sometimes even dangerous action. Often such disorders manifest themselves in young mothers in a strong desire to harm their baby - to stab or throw it out of the window. In such cases, patients experience extremely strong emotional stress, the "struggle of motives" drives them to despair. Some are horrified when they imagine what will happen if they do what is being forced on them. Obsessive cravings, unlike impulsive ones, are usually not fulfilled.

A. Durer "Melancholy"

The correlation of spiritual illnesses and mental illnesses is one of the problems that both the clergy and lay representatives of the clergy constantly have to face in church life. But most often it is the priest who is the first person to whom a person with mental disorders turns for help.

three lives

At the beginning of the year, there was a wave of publications in the media about a series of suicides among teenagers. Around the same time, a priest approached me with a request to consult his spiritual daughter, a teenage girl who repeatedly mentioned suicide in conversations with her confessor. Masha (not her real name) came to the appointment with her mother, who was at a loss as to why the priest sent her daughter to a psychiatrist. Family members did not notice any changes in the daughter's condition. Masha successfully graduated from school and was preparing to enter the university. During our conversation, she not only confirmed the presence of suicidal thoughts, but also said that she opened the window several times to throw herself out of it. Masha skillfully hid her condition from relatives and friends and only spoke to her spiritual father about personal experiences. The father made a lot of efforts to persuade the girl to go to a psychiatrist. Masha had a severe depression that required hospitalization. If not for the efforts of the priest, she would certainly have joined the list of teenagers who committed suicide and left their relatives and friends in confusion and despair.

Around the same time, an ambulance received a call from a Moscow church. "Ambulance" to the young man called the priest. The young man for the purpose of "spiritual improvement" completely refused food and drank only water. In a state of extreme exhaustion, he was taken to the hospital, where he was in intensive care for ten days. It is noteworthy that the parents saw his condition, but did not take any measures. In both cases, the girl and the boy survived only because the priests recognized their mental disorder.

The third, tragic, case was also in Moscow. The priest, out of incompetence, forbade the young man who turned to him for help to take medicine, although he suffered a schizophrenic attack a few years ago. The patient committed suicide two weeks later.

The prevalence of mental illness and disorders in our society is quite high. Thus, about 15.5% of the population suffers from mental disorders, while about 7.5% are in need of psychiatric care. To a large extent, these statistics are influenced by alcoholism and drug addiction. In terms of suicide, our country ranks second in the world (23.5 cases per 100,000 population). According to official data, from 1980 to 2010, about a million Russian citizens committed suicide, which indicates a deep spiritual crisis in our society 1 .

Not surprisingly, people suffering from mental disorders seek help from the Church more often than anywhere else. On the one hand, most of them find spiritual support, meaning and purpose in life only in the temple. And on the other hand, which is no less important, many mental disorders during the period of exacerbation have a religious connotation. In addition, as noted by the doctor of medical sciences, Fr. Sergiy Filimonov, "today people come to the Church not out of good will to know God, but mainly to resolve the issue of getting out of crisis situations in life, including those associated with the development of mental illness in oneself or close relatives" 2 .

A new subject in the training of clergy

Today, in many dioceses, serious experience has been gained in cooperation between psychiatrists and priests, which began in the early 1990s. Then, with the blessing of the confessor of the Trinity-Sergius Lavra, Archimandrite Kirill (Pavlov), classes in pastoral psychiatry began at the Moscow Theological Seminary under the guidance of the abbot of the Lavra, Archimandrite Feognost (now Archbishop of Sergiev Posad). Father Theognost teaches pastoral theology, which included a cycle on pastoral psychiatry. Later, the course "Pastoral Psychiatry" at the Department of Pastoral Theology (since 2010 - the Department of Practical Theology) appeared at PSTGU on the initiative of Archpriest Vladimir Vorobyov and at the Sretensky Theological Seminary on the initiative of Archimandrite Tikhon (Shevkunov).

The first hospital church at the psychiatric clinic was consecrated on October 30, 1992 by His Holiness Patriarch Alexy II of Moscow and All Russia in honor of the icon of the Mother of God the Healer at the Scientific Center for Mental Health of the Russian Academy of Medical Sciences. Then, speaking to psychiatrists, His Holiness the Patriarch said: “Psychiatrists and scientists have been entrusted with the difficult and responsible mission of serving the cause of the spiritual health of the human souls entrusted to their care. Who came to the world of being poisoned by human sin in order to help those who need help, support and comfort.

For the first time, a special guide for priests in psychiatry based on the concept of a holistic Christian understanding of the human personality was developed by one of the recognized authorities of Russian psychiatry, the son of a priest in the Ryazan province, Professor Dmitry Evgenievich Melekhov (1899–1979). He wrote his concept of the course "Pastoral Psychiatry" for students of theological academies and seminaries in Soviet times. And although he failed to complete the book "Psychiatry and Questions of Spiritual Life" 3 , Melekhov formulated the basic principles of cooperation between a psychiatrist and a priest in the treatment and care of those suffering from mental ailments. This work was published in a typewritten edition shortly after the death of the author. Subsequently, it was included in the Handbook of the clergyman, and later in numerous collections.

One of the central problems of this book is the problem of the correlation in a person of bodily, mental and spiritual and, accordingly, the ratio of mental and spiritual illnesses. The Confessor Georgy (Lavrov), who was famous in the years of Melekhov's youth, labored in the Danilovsky Monastery, clearly distinguished two groups of these diseases. To one he said: "You, baby, go to the doctor," and to others: "You have nothing to do with the doctors." There were cases when an elder, helping a person to adjust his spiritual life, recommended that he go to a psychiatrist. Or, on the contrary, he took people from a psychiatrist to him for spiritual treatment.

In the book Psychiatry and Questions of Spiritual Life, Melekhov proceeded from the patristic trichotomous understanding of the human personality with its division into three spheres: bodily, mental and spiritual. In accordance with this, a disease of the spiritual sphere is treated by a priest, a mental illness is treated by a psychiatrist, and a disease of the body by a somatologist (therapist, neurologist, etc.). At the same time, as Metropolitan Anthony (Blum) noted, "one cannot say that the spiritual ends somewhere and the spiritual begins: there is some area where mutual penetration takes place in the most normal way" 4 .

All three spheres of the human personality are closely interconnected with each other. Physical illness often affects mental and spiritual life. St. John Chrysostom wrote about this back in the 4th century: “And God created the body in accordance with the nobility of the soul and capable of fulfilling its dictates; were not so, the actions of the soul would have met with strong obstacles. This is evident during illnesses: when the state of the body deviates even a little from its proper structure, for example, if the brain becomes hotter or colder, then many of the mental actions stop "5.

This raises some fundamental questions: can a person suffering from a severe physical illness be mentally and spiritually healthy? The answer here is unequivocal. We know such examples not only from the lives of the saints and from the exploits of the New Martyrs, but also among our contemporaries. The second question is: can a spiritually ill person formally be mentally and physically healthy? Yes maybe.

Third question: Can a person suffering from serious mental illness, including severe forms of depression and schizophrenia, have a normal spiritual life and achieve sainthood? Yes maybe. Rector of PSTGU Prot. Vladimir Vorobyov writes that "a priest must explain to a person that mental illness is not a disgrace, it is not at all some kind of condition crossed out of life. It is a cross. Neither the Kingdom of God nor the grace-filled life is closed to him" 6 . St. Ignatius (Bryanchaninov) cited specific examples, “St. Nifont Bishop suffered from insanity for four years, Sts. Isaac and Nikita suffered from insanity for a long time. which the Lord allowed His humble-wise servant" 7 .

The attitude of the Church to the problem of the correlation of spiritual and mental illnesses is clearly formulated in the Fundamentals of the Social Concept (XI.5.): “Singling out the spiritual, mental and bodily levels of its organization in the personal structure, the holy fathers distinguished between diseases that developed “from nature” and ailments, In accordance with this distinction, it seems equally unjustified both to reduce all mental illnesses to manifestations of possession, which entails the unreasonable performance of the rite of exorcism of evil spirits, and to attempt to treat any spiritual disorders exclusively by clinical methods. In the field of psychotherapy, the most fruitful combination of pastoral and medical care for the mentally ill, with a proper delimitation of the areas of competence of the doctor and the priest.

On the correlation of spiritual and mental states

Unfortunately, attention is drawn to the high prevalence of the rite of "casting out evil spirits" in modern church practice. Some priests, without making a distinction between spiritual ailments and mental illnesses, send patients with severe genetically determined mental illnesses to commit "reprimands". Back in 1997, Patriarch Alexy II, at a diocesan meeting of the clergy of Moscow, condemned the practice of "reprimands".

There are a number of states that outwardly have similar manifestations, but relate to spiritual or mental life and, accordingly, have a fundamentally different nature. Let us dwell on the ratios of some of them: sadness, despondency and depression; obsession and delirium of "demos-possession"; "charm", manic and depressive-delusional states.

Among spiritual states, sadness and despondency are singled out. With sadness, there is a decline in spirit, impotence, mental heaviness and pain, exhaustion, grief, constraint, despair. As its main reason, the holy fathers note the deprivation of what is desired (in the broad sense of the word), as well as anger, the influence of demons 8 . It should be noted that St. John Cassian the Roman, along with this, emphasizes "unreasonable sorrow" - "unreasonable grief of the heart" 9 .

Depression (from the Latin depressio - suppression, oppression) is no longer a spiritual, but a mental disorder. In accordance with modern classifications, it is a condition, the main manifestations of which are a stable (at least two weeks) sad, sad, depressed mood. With melancholy, despondency, loss of interests, decreased performance, increased fatigue, reduced self-esteem, pessimistic perception of the future. And also with the loss of the need for communication and sleep disturbance, a decrease in appetite up to its complete absence, difficulties in concentrating and comprehending. In addition, depression often causes unreasonable self-condemnation or excessive guilt, repetitive thoughts about death.

Believers in a state of depression will experience a feeling of God-forsakenness, loss of faith, the appearance of "petrified insensitivity", "coldness at heart", talk about their exceptional sinfulness, spiritual death, complain that they cannot pray, read spiritual literature. With severe depression, suicidal thoughts are often noted. Believers usually say that they cannot commit suicide, because hell awaits them for this. But, as practice shows - and this should be paid attention to - they also commit suicide, although a little less often, since mental suffering is the most severe and not everyone is able to endure it.

Among depressions, there are reactive ones that occur after traumatic situations (for example, after the death of a loved one), and endogenous ("unreasonable sadness"), which are genetically determined. Depression is especially common in the elderly, among whom they are noted in more than half of the cases. Quite often, depression acquires a protracted and chronic course (more than two years). According to WHO, by 2020, depression will come out on top in the structure of morbidity and will be observed in 60% of the population, and mortality from severe depression, often leading to suicide, will come in second place among other causes. The reason for this is the loss of traditional religious and family values.

Among the spiritual states demon-possession stands out. Here are two examples illustrating this state. The first of them is associated with Bishop Stefan (Nikitin; †1963), who, even before being ordained to the priesthood in the camp, as a doctor, bore the Holy Gifts. Once, as a doctor, he was asked to consult the daughter of the head of the camp. When he came to her, she suddenly began to rush around the room and shout to remove the shrine, the doctor was asked to leave. Another example from the life of Archbishop Meliton (Soloviev; †1986). It belongs to the late 1920s. One day, late in the evening, almost at night, he transferred from one apartment to another a portrait of St. John of Kronstadt. A man was walking towards him, who suddenly began to shout and call the name of John of Kronstadt. That is, the leading criterion for determining demonic possession, as noted by many pastors, is a reaction to a shrine.

At the same time, mental illnesses include schizophrenic psychoses, when, along with a variety of delusional topics, the patient often considers himself the ruler of the world or the Universe, a messiah called to save Russia or all of humanity from world evil, economic crisis, etc. There are also delusional disorders, when the patient is convinced that demons, shaitans have moved into him (depending on which culture he belongs to). In these cases, the ideas of demonic possession, as well as the ideas of messianic content, are only the subject of the patient's delusional experiences in severe mental illness.

For example, one of the patients in the first psychotic attack considered himself Cheburashka and heard the voice of the crocodile Gena in his head (auditory hallucinations), and in the next attack he said that dark forces had entered into him (delusions of demonic possession) and they also belong voices. That is, in one case, the subject of delusional experiences was associated with a children's cartoon, in the other it had a religious connotation. Both attacks were treated with equal success with antipsychotic drugs.

We had to deal with situations when priests qualified auditory hallucinations as the impact of demonic forces and did not recommend patients to go to doctors. Although these patients received communion regularly, there were no changes in their mental status, which should have been noted in cases of demonic possession.

Spiritual states also include the state of "charm", the most important manifestation of which is a person's overestimation of his personality and an intensive search for various "spiritual gifts". However, this symptom, along with the patient's feeling of a surge of strength, energy, a special spiritual state, psychomotor agitation, disorder of desires, reduction in the duration of night sleep, is one of the manifestations of manic states. There are other states when a person begins to actively "engage in his spiritual growth" and stops listening to his confessors.

Some time ago, I was approached by the parents of a girl who had come to faith about a year earlier, but in the last two months her spiritual life had become very intense. She lost so much weight that there was a real threat to her life due to dystrophy of internal organs. She prayed for about two hours in the morning, about three in the evening, and for about two hours in the afternoon she read kathismata and certain passages from the Gospel and the Epistle of the Apostles. She took communion every Sunday, and before that, every Saturday, she stood in line for many hours for confession in one of the monasteries. She came to confession with numerous sheets. In the temple, she repeatedly became ill and had to call an ambulance. The confessor's words that she was not a nun-schema, that she was not supposed to follow such prayer rules, she did not hear. She also did not hear the requests of her elderly parents. They asked at least sometimes to go to the temple near the house, since it is physically difficult for them to spend all weekends with her in the monastery, and they cannot let her go alone. She stopped coping with work and communicating with her colleagues. She did not consider herself sick, and at the same time she spoke negatively about the priests who tried to limit her prayerful "exploits". Under pressure from her parents, she passively agreed to take medication, which gradually restored her appetite and ability to work. The prayer rule (on which the confessor insisted) was reduced to reading morning and evening prayers and one chapter from the Gospel.

It is clear that not a single abbess or elder in any of the monasteries will bless a young novice for such “feats”. No one has canceled the old monastic rule: when you see a brother rising sharply upstairs, pull him down. When a person perceives himself as a "great specialist" in the spiritual life and does not hear his confessor, it is customary to speak of a state of delusion. But in this case, it was not charm, but a mental illness that acquired a religious connotation.

Obsessive states and their forms

When discussing the topic of the correlation of spiritual and mental illnesses, it is necessary to dwell on the problem of obsessive states (obsessions). They are characterized by the emergence in the mind of the patient of involuntary, usually unpleasant and painful thoughts, ideas, memories, fears, drives, in relation to which a critical attitude and a desire to resist them remain. There are motor obsessions when a person repeats some movements. For example, he returns several times to a locked door, checks whether it is locked or not. With mental illness, it happens that the patient makes bows and knocks his forehead on the floor (this happened with both Orthodox and Muslims). In addition, the so-called contrast obsessions are distinguished, when a person has an inevitable desire to throw someone under a train in the subway, a woman has a desire to stab her child with a knife.

Such a thought is completely alien to the patient, he understands perfectly well that this cannot be done, but this thought persists. Contrasting obsessions also include the so-called blasphemous thoughts, when a person has a kind of blasphemy against the Holy Spirit, the Mother of God, and saints. A similar condition was experienced by one of my patients at the stage of depression after a schizophrenic attack. For him, an Orthodox person, blasphemous thoughts were especially painful. He went to the priest for confession, but he refused to confess, saying that everything would be forgiven a person, except for blasphemy against the Holy Spirit (cf. Matt. 12:31). What was left for him to do? He attempted suicide. After the psychopharmacotherapy, these psychopathological disorders stopped and did not recur in the future.

conclusions

The above-mentioned depressive states, states with delusions of demonic possession, with obsessions, with manic and depressive-delusional states generally respond successfully to psychopharmacotherapy, which indicates the biological basis of these states. This was also noted by Metropolitan Anthony (Surozhsky), who wrote that “mental states largely depend on what happens physiologically in terms of physics, chemistry in our brain and in our nervous system. Therefore, every time a person becomes mentally ill, this cannot be attributed to evil, sin or a demon. Very often this is caused more by some kind of damage in the nervous system than by demonic obsession or the result of such a sin that a person has been cut off from any connection with God. And here medicine comes into its own and can very a lot to do" 10 .

Many classics of psychiatry and modern researchers noted that the Christian perception of life makes a person resistant to various stressful situations. Viktor Frankl, the founder of the theory of logotherapy and existential analysis, formulated this idea very clearly: "Religion gives a person a spiritual anchor of salvation with a sense of certainty that he cannot find anywhere else" 11 .

The difficulty of distinguishing between mental and spiritual illnesses sharply raises the question of the need for mandatory inclusion in the training programs for future priests in all higher educational institutions of the Russian Orthodox Church of the course of pastoral psychiatry, as well as special courses in psychiatry in the training of social workers. Professor Archimandrite Cyprian (Kern) wrote about the need for this knowledge for every pastor in his manual "Orthodox Pastoral Ministry", devoting a special chapter to the issues of pastoral psychiatry. He urged every priest to read one or two books on psychopathology, "so as not to indiscriminately condemn in a person as a sin that which in itself is only a tragic distortion of spiritual life, a riddle, and not a sin, a mysterious depth of the soul, and not moral depravity" 12 .

The task of a priest in identifying signs of a mental illness in a person is to help him critically comprehend the condition, encourage him to consult a doctor, and, if necessary, to systematically take drug therapy. There are already many cases when patients, only thanks to the authority of the priest, with his blessing, take maintenance therapy and are in a stable condition for a long time. As practice shows, further improvement of psychiatric care is possible only with close cooperation between psychiatrists and priests and with a clear delineation of areas of competence.

NOTES:

1. Data from the Scientific Center for Mental Health of the Russian Academy of Medical Sciences.
2. Filimonov S., prot., Vaganov A.A. 0 counseling of the mentally ill in the parish // Church and medicine. 2009. No. 3. P. 47–51.
3. Melekhov D.E. Psychiatry and problems of spiritual life // Psychiatry and actual problems of spiritual life. M., 1997. S. 8–61.
4. Anthony (Blum), Met. Body and matter in spiritual life / Per. from English. by ed.: Body and matter in spiritual life. Sacrament and image: Essays in the Christian understanding of man. Ed. A.M. Allchin. London: Fellowship of S.Alban and S.Sergius, 1967. http://www.practica.ru/Ma/16.htm.
5. John Chrysostom, St. Discourses on Statues Spoken to the People of Antioch. Eleventh conversation // http://www.ccel.org/contrib/ru/Zlat21/Statues11.htm.
6. Vorobyov V., prot. Repentance, confession, spiritual guidance. S. 52.
7. Ignatius (Bryanchaninov), St. Selected letters to monastics. Letter No. 168 //
http://azbyka.ru/tserkov/duhovnaya_zhizn/osnovy/lozinskiy_pisma_ignatiya_bryanchaninova_170-all.shtml.
8. Larcher J.-C. Healing mental illness (Experience of the Christian East of the first centuries).
M .: Publishing House of the Sretensky Monastery, 2007. P. 223.
9. John Cassian the Roman, St. Interviews of Egyptian ascetics. 5.11.
10. Anthony of Surozh, Metropolitan Steps. On mental and physical illness // http://lib.eparhia-saratov.ru/books/01a/antony/steps/9.html.
11. Frankl V. Psychotherapy and religion. M.: Progress, 1990. S. 334.
12. Cyprian (Kern), Archim. Orthodox pastoral ministry. Paris, 1957. P.255

blasphemous thoughts

A kind of contrasting obsessive states; their indecent-cynical content, inconsistency of the situation is characteristic.

. V. M. Bleikher, I. V. Kruk. 1995 .

See what "blasphemous thoughts" are in other dictionaries:

blasphemous thoughts- Contrasting obsessions. See Obsessions...

Thoughts that contradict the moral and ethical properties of the individual, the patient's ideas about ideals, worldview, attitude towards loved ones, etc. Because of this, they are extremely painfully experienced, they deprive the patient ... Explanatory Dictionary of Psychiatric Terms

blasphemous thoughts- obsessive thoughts, representing in their content a desecration of the ideals of the patient (his worldview, attitude towards loved ones, religious ideas, etc.) and painfully experienced by him ... Big Medical Dictionary

Thoughts are contrasting- the phenomenon of obsessive thinking in the form of the appearance of blasphemous, offensive or obscene thoughts when perceiving or remembering objects that are of particular personal value to the individual. Synonym: blasphemous thoughts ... Encyclopedic Dictionary of Psychology and Pedagogy

Obsessive states- (synonym: obsessions, anancasms, obsessions) involuntary emergence of irresistible thoughts alien to the patient (usually unpleasant), ideas, memories, doubts, fears, aspirations, drives, actions while maintaining critical to them ... ... Medical Encyclopedia

Obsession- Felix Plater, scientist who first described obsessions ... Wikipedia

Sin- This term has other meanings, see Sin (meanings) ... Wikipedia

Obsessions- - irresistibly arising thoughts and figurative, most often visual representations of inadequate, "insane", often contrasting, contrary to reality and common sense content. For example, the patient is vivid and in horrifying detail ... ... Encyclopedic Dictionary of Psychology and Pedagogy

SECOND COMING- [Greek. παρουσία arrival, arrival, advent, presence], the return of Jesus Christ to earth at the end of time, when the world in its present state will cease to exist. In the New Testament texts, it is called "appearance" or "coming" ... ... Orthodox Encyclopedia

Gennady Gonzov- (Gonozov) Saint, Archbishop of Novgorod and Pskov. About his life until 1472, almost no news has been preserved; apparently he came from a boyar family (the Book of Power calls him "dignitary") and owned estates (according to ... ... Big biographical encyclopedia