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Therapy by means of creative self-expression by M. Burno

TCSEB as the Russian native method-school of Therapy by means of Spiritual Culture

Burno M. Ye Mark Burno
Prof. MD, Ph.D., Department of Psychotherapy of the Russian Medical Academy for Professional Postgraduate Training,
Russian league of professional psychotherapists (PPL), Weshniakovskaja St. 4-1-101, Moscow 111402, Russia

Abstract. The article gives an idea of a wide meaning of the word «spiritual» in Russia, than in the West and in the East. It also deeply explains the nature of Russian spiritual materialism, which makes the foundation of the Russian Clinical Therapy by means of Spiritual Culture. «Therapy by means of creative self-expression by M. Burno» (TCSEB), worked out by the author and his followers, is one of the variant of today's Russian native Psychotherapy. The article describes the essence of TCSEB — this method-school, it's difference from other approaches, methods of Therapy by means of Spiritual Culture (Art-Therapy, Existential-humanistic Psychotherapy, Religious Psychotherapy).

Keywords: Clinical Psychotherapy, Clinical Therapy by means of Spiritual Culture, Therapy by means of creative self-expression, Russian Psychotherapy.


For more than a hundred years the word «Spiritual» is understood in Russia not only as referred to God, church, belief, faith, but also as referred to Man's soul and all his intellectual and moral abilities, his will. It is explained the Dictionary of the Russian Language by Dahl (1880). And today according to the Dictionary of the Russian Language by Ozhegov (2006) the word «spiritual» in its first meaning originates from the word «spirit». And «spirit» is «consciousness, ability of thinking, psychic abilities; the beginning defining the behaviour and actions; the inner moral power» and only then, in the third meaning — as immaterial supernatural being.

For a spiritual Russian materialist (a psychotherapist as well) the spiritual, just as the emotional, is not material. However both the spiritual and the emotional cannot exist without matter, which eliminates soul life and spirit. The spiritual unlike the emotional, characterological (kind, malicious, brave, etc.) is always characterized by more or less complex personal search of sense, meaning. Who am I? Where am I going from? In what direction am I going and why? What's really important and dear for me? What is the Good, the Evil, Morality, Responsibility? What am I living for? And so on.

For the Russian psychotherapist, who is a spiritual materialist, the body (the living matter) is the basis of the emotional and the spiritual. Because of that the basic peculiarities of the emotional and the spiritual of a patient correspond to his corporeal peculiarities caused by his nature. The body here is the source, but not the receiver of the spirit. This approach is certainly well-known from ancient Greek times as the theory of temperaments. This approach as the essence of doctoring is discovered in Clinical Psychotherapy by Ernst Kretschmer (1888-1964, Germany) and Semen Isidorovitch Konstorum (1890-1950, Russia). Victor Viktorovich Makarov supposes that this approach is traditional for Russia. This approach as a really philosophical world outlook creates the basis of Clinical Therapy by means of Spiritual Culture.

So, the word «spirituality» can be used in Russia for a long time already outside religion. It can mean the fact, that a man can be full of high-flown noble conscientious suffering. Pushkin and Chekhov were not religious people, but they were undoubtedly highly spiritual writers. Many Russian patients are also spiritual anxious materialists, not religious people, but with a great inner desire to make the Good. However some religious people say that such people, do not know themselves, they are closer to the God, than many of those who consider themselves God believers.

Therapy by means of Spiritual Culture is a psychotherapeutic approach in which the leading psychotherapeutic mechanism is that of creative self-expression, creative inspiration. Yet the state of creative inspiration can be felt in different ways according to the nature of the particular soul. For example, an individual with a more idealistic nature will experience spirituality and creative inspiration quite differently than one with a more materialist bent.

In Western tradition, the state of creative inspiration is often understood as something sent from Above, as to a receiver. As such, this state is called Freedom (Fromm), Logos (Frankl), Self-Actualization (Maslow), Personal Growth (Rogers), Psychosynthesis (Assagioli), Transpersonal State (Grof), etc. This approach is more of an idealistic relationship to a transcendent spirituality.

In Russian there are more people of a materialistic nature of soul than in the West or the Far East. Such people feel the state of creative inspiration as an emission of their own bodies. Because of this, the Russian notion of spirituality is broader; it includes not only what is sent to us from Above, but is also Something emitted by ourselves. In this way we can say that Pushkin and Chekhov are spiritual writers, but without an idealistic, religious worldview; they are more in the natural-scientific stream.

This same distinction can be seen in psychotherapy.

Our Therapy by means of Spiritual Culture also shows itself in every day clinical practice not only as religious or existential, humanistic psychotherapy, but as native spiritual Clinical (natural-scientific) Therapy by means of Spiritual Culture. «Therapy by Means of Creative Self-expression M. Burno» (TCSEB), as this method is called in all the three variants of «Psychotherapeutic Encyclopaedia», edited by B.D. Karvassarskiy (SPb: Piter, 1998, 2000, 2006), is, in fact, a kind of today's Clinical Therapy by means of Spiritual Culture in Russia, worked out by the author and his followers (Burno M.Ye., 2006; Burno M.Ye., Dobrolyubova E.A. (ed.), 2003).

The theoretical basis of the Method is Gannuschkin's conception (1933) of «life compensation of psychopaths» and «mild schizophrenics» and «epileptics» (discovery or not discovery of this pathology depending on «outer influence, on the sun on their convents») and similar Kretschmer's ideas consonant to Gannuschkin's ideas (1934) with the conclusion that here lie psychotherapeutic tasks. Kretschmer's psychotherapeutical conception «The creation of a personality, person by the main constitutional laws and activities» is meant. The TCSEB is based on psychiatry and is meant for different chronic anxious and depressive patients suffering from the feeling of their own inferiority (pathological passive defence opposite to aggression). There are first of all defensive variants of schizotypical disorder and different personality disorders. However, recently the method has started being more and more used for the patients that are quite sane form the neurological and somatic point of view but have some defensive character peculiarities as well as to help defensive children (at school or nursery school), etc.

The Essence of the Method

Patients or sane people with defensive character peculiarities supervised by a psychotherapist learn elements of clinical psychiatry with pathography; characterology (including characters of artists and scientists), elements of psychotherapy, natural sciences in different forms of creative self-expression in order to learn to express themselves creatively in harmony with their natural characterological peculiarities. In order to gain their own healing inspiration as unique persons who at the same time belong to certain types, that is, autistic, psychastenic, syntonic, polyphonic-schizotypic, etc. and it all lifts them from the «mixture» of their sufferings.

Natural characters and symptoms of diseases are not considered here as pinned labels but as important natural reference points (like male or female natural orientation) which help the people to find their own paths to their own creative autistic, psychastenic, etc. uniqueness, their own Love and their own Sense. It is similar to the way a conservatoire student while playing one of his favourite music pieces does it like a musician whose soul is consonant to his own meanwhile going from imitation to what Ravel called «unconscious inaccuracy».

The Practice of the Method

Eye-to-eye meetings, creative home-tasks, groups for creative self-expression in the chamber atmosphere of a psychotherapeutic sitting-room, realistic psychotherapeutic theatre are all the practical ways of applying this method. Particular methods of creative therapy intertwined with each other are as follows: 1) therapy by making creative works; 2) therapy by creative contact with the nature; 3) therapy by creative communication with literature, art and science; 4) therapy by creative collecting of some articles; 5) therapy by inspirational and creative immersion into the past; 6) therapy by writing diaries and notebooks; 7) therapy by correspondence with a psychotherapist; 8) therapy by creative travelling; 9) therapy by searching spirituality in everyday life. «Creative» here means the search and cognition of one's own autistic, psychastenic, etc. nature in communication with art, nature, etc. in order to find one's own unique inspirational and creative path in life.

In order to live naturally, that is, in accordance with one's own nature, one must study one's own natural features; these then become real orienting points for following one's own spiritual nature: one's own nature, emitting spirit.

This method helps not people of a materialistic outlook, but also those with a more idealistic nature, to find their own psychotherapy. Here is an excerpt from a group session on creative self-expression that helps individuals to feel their own outlook and understand whether they are more idealistic and religious or natural-scientific in their own nature. This session is called «Polenov and Rublev». It begins by viewing a painting by the Russian artist Vasiliy Polenov entitled «Christ and Sinner» (1887).

In Polenov's picture, Jesus is a young but wise man: wholly human, realistically depicted. This is realistic pictorial art on a religious theme.

Then we view an icon by Andrei Rublev, the famous Russian artist and monk of the 15th century.

Here we see the face of Jesus, but we do not know whether the neck is male or female. The nose looks rather like a duck's bill, and the hair is just an inarticulate mass. For the idealist it must be this way: the face of Christ should not be full-blooded and alive, for it is the origin of Spirit. If the face were life-like, we would not see the stream of spirit flowing from his eyes. This image of Christ is the glace of the transcendental world, of God. It reminds us of how the girl in Gogol's story speaks of the stars in the sky. She says, «The angels open the windows of their houses».

So, we have one image of spirit for idealists, and another for materialists. Spirit is no less important to the materialist, but it is secondary: body (matter) emits spirit. For such a person, his or her own body is the source of spirit. So, therapy by means of spiritual culture may be creative inspiration that takes a more religious, idealistic form, or it may take the natural-scientific form of creative self expression. The approach is different for differing patients.

Long-term TCSEB lasts 2-5 years. Shorter versions — from one week to four months.

The estimation of the effectiveness of TCSEB

3 degrees of the therapeutic effectiveness of TCSEB (Burno M., 1989).

  1. The insignificant effectiveness is unstable improvement with confidence that thanks to the studies by TCSEB, the hard state can diminish and the growth of wish to create and this helps to feel your own inspiration.
  2. The medium effectiveness is a more or less stable improvement in which the patient or the client is able to lessen his own hard state with the help of methods received in the therapy. In this he will feel his own social growth (his professional achievements, his social work, the improvement of relation with his relatives and friends) with a feeling of his own social use and he will be sure, that all this appeared first of all thanks to the therapeutic process used (taken).
  3. The high effectiveness is a stable improvement with his optimistic mood and inspiration in spite of decompensation (in case of personality disorders) and worsening (in case of endogen disorders), all this in very well overcome in creative self-expression, a high growth of social life (patients, clients really turn to life, social work) their desire to help other people with their own experience becomes real.

The medium and high degrees of the effectiveness of TCSEB mean the patient's deep improvement which is the result of his ability to oppose to different difficulties of life. This ability is therapeutically created. If this pathology takes place (psychopathy, schizophrenia) it is not cured, but dissolves in created self-expression, in the new highly moral attitude to life.

High and well expressed (moderate) therapeutic effectiveness of TCSEB (> 80%) is discovered by the author and stated in this thesis (Burno M. Ye., 1998). This effectiveness is supported in the theses of the author's disciples (doctors and psychologists).

Read the theses of Zuikov N. Z., 1998; Gogolovitch T. Ye., 1998; Nekrasova S. V., 1999; Makhnovskaja Z. V., 2003; Grushko N. V., 2003; Unanov T. A., 2003; Terletskiy A. R., 2003; Bogdanovich M. A. (2007) All in all more than 800 dissertation cases.

The ideal efficiency is considered reached when the creative life style is formed. That is, when a person has developed ways to drive himself to creative inspiration and to live in the state of creative inspiration for long periods.

The method-school TCSEB is recognized by the State and the Society (Russian league of professional psychotherapists — PPL) in Russia. The teaching of this subject is included into the excepted program of the doctors for improving their qualification on psychotherapy (Moscow. The ministry of Health and Social development of Russian Federation, 2005), into Unified program of the additional training in speciality «Clinical Psychology (Moscow. The ministry Education of Russian Federation, 2002), into Education program of the League (PPL)».

In the «Practical Handbook on the Therapy by means of creative self-expression» (ed. M. Burno, E. Dobrolyubova, 2003) a detailed Programme of the course of preparation of psychotherapists to the work by the method of TCSEB in the frames of Educational program for receiving European certificate of psychotherapist made by is published (312 hour teaching).

TCSEB as an independent whole psychotherapeutic method should be differentiated from art-therapeutic, existential-humanistic and religious methods.

Unlike art-therapeutic, existential humanistic and religious approaches the TCSEB sees the natural bodily basis in the most complex movements of the soul and is governed in its spiritual and poetic psychotherapeutic influences not by the Spirit but by Nature.

As a clinical specialist a psychotherapist sees the defensive and adjusting work of the nature in the clinical picture and in the personal peculiarities of a person. He investigates them in order to help the spontaneous nature as much as possible to fully protect itself from harmful internal and external influences.

Just as Hyppocratus did it. For example, the depersonalisation suffering is considered to be a defensive and adjusting unnaturalness of feeling and emotional experience («I feel it not in my own way, for example, my soul is getting numb») which softens the limitless anguish. This spontaneous imperfection of natural defense is corrected as much as possible by psychotherapeutic creative work which helps the patient to feel himself as himself and also to feel enlightened in his creative inspiration.

It is in case of TCSEB a more or less, clear understanding yourself according to your own nature, to your understanding of the real life and light in your soul. It is so both in the hight of your life and before dying. TCSEB goes along natural-scientific ways and is directed by peculiarities of the clinical picture natural characters, but not psychoanalytical, existential and religious conceptions.

Unlike Art-Therapy our patients and healthy anxious people can find their healing creative inspiration not only in fine arts, but, for example, in creative immersion into Nature, into their own Past, into studying sciences, into their own scientific creative work.

We are trying to perfect individual natural spontaneous treatment as Hippocrates taught us.

It is done with the purpose of helping people with anxious uncertainty, and self-reproaches in their soul to find their own healing creativity and the life road proper for them, to understand the Power of their Weakness, their own Sense of life and discover the kind of inspiration which is natural for them.

Therapy by means of creative self-expression helps our patients and healthy anxious people to learn to understand and anticipate people with different characters and to approve of them. The Method also helps them to see the human value, where they did not expect to find it. Besides the Method helps to forgive somebody's weakness and not to reconcile only with insolence and immorality.

After working by this method for many years we have come to the conclusion that this method is very helpful in weakening the suffering of our patients concerning the «brand», «stigma» of their psychiatric inferiority. From one study to another the patient analyses in what way the peculiarities of character and mental disease of famous writers, artists and scientists tell on the origin and specific features of their creative work.

After all the patients come to the conclusion that really genial creativity is always serious natural treatment of their psychic disorder, of their suffering. It is a kind of treatment without which it would be difficult for a sick person to survive. In TCSEB we follow the method of famous creators to treat themselves by their own creativity. It is becoming clearer and clearer, where and how one should try himself in creative work from the point of view of their psychic peculiarities and difficulties.

The best works on pathography, which we study together with the patients, are inseparable from TCSEB.

Last but not least, this method helps healthy people to respect mental patients because the great creators very often come from the mass of mental patients. There are no quite healthy geniuses (E. Kretschmer, «Genius people», 1958). Thus even quite untalented, demented schizophrenic or epileptic has something to do with genial creativity being a grain of sand of its genetic soil.

TCSEB has been developing endlessly along with the clinical psychotherapy, practical psychology, characterology, art and all areas of spiritual life. From all of them this system selects the required material which is later converted in the clinical psychotherapeutic way just like surgery converts all new discoveries in science and engineering for its purposes.

Russia by its soul as it is seen in the best Russian people, especially representatives of intelligentsia is neither the West nor the East. The Soul of Russia combines the psychological (intellectual) complexity of the West and the emotional complexity of the East.

All this is refracted by the earthly realistic warmth with the feeling of your own blame before those who are in trouble, who feel worse than yourself.

We have many such defensive people, patients — psychasthenics and like psychasthenics.

Their consonance with the souls of Dostoevsky, Tolstoy, Chekhov is vivid. They need earthly Therapy by means of creative self-expression with studying their own nature and character in comparison with the natures and characters of other people. It happens in the process of the creative studying of this comparison first of all with their own characters, their own sick souls.

Not only special Russian fiction, but also special Russian Psychotherapy is good for them therapeutically. This special Russian Psychotherapy originates not from the Spirit, but from the nature, emanating Spirit. In the process of this Psychotherapy the patients to some extent must become a kind of psychiatrists and psychotherapists for themselves with creative light in their souls. Medicines help such patients very little to feel and accept themselves in order to rise as high as possible in their life.


Bogdanovich M. A. (2007) Borderline psychic disorders of patients with primary glaucoma, who can see. Tomsk: Diss (in Russian). [Pogranichniye nervno-psichicheskiye rasstroistva u zryachih bolnih pervichnoey glaucomoey].

Bonstedt-Wilke Y., Rüger U. (1997). Yn: Heigl-Evers A., Heigl F., Ott J., Rüger U. Lehrbuch der Psychotherapie. Miteinem Geleitwort von Werner Stucke. 3., Überarbeitete Ausgabe. Lübeck. Stuttgart. Jena. Ulm: Gustav Fisher.

Burno M. Ye. (1994) La Therapie clinique par auto-expression. Psychotherapies, 1, pp. 49-55, Burno M. Ye. (2002) Therapy by Means of Creative Self-Expression. Archives of Psychiatry and Psychotherapy, 4, 2, pp. 49-53.

Burno M. Ye. (2005) Native Psychotherapy in Russia. Archives of Psychiatry and Psychotherapy, 7, 1, pp. 71-76.

Burno M. Ye. (2006) Therapy by Means of Creative Self-Expression. 3 ed. Moscow: Akademichesky Proekt (in Russian). [Terapia tvorcheskim samovirazheniem].

Burno M. Ye. (2006) Clinical Psychotherapy. Moscow: Akademichesky Proekt, OPPL (in Russian). [Klinicheskaja psichoterapia].

Burno M. Ye., Dobrolyubova E. A. (editor). (2000) Practical Manual for Therapy by Means of Creative Self-Expression. Moscow: Akademichesky Proekt, OPPL (in Russian). [Prakticheskoe rukovodstvo po Terapii tvorcheskim samovirazheniem].

Gogolevitch T. Ye. (1998) Short term Therapy by means of creative self-expression patients with schizoid and psychastenic psychopaths in stage of decompensation. Moscow: Diss. (in Russian). [Kratkosrochnaya terapia tvorcheskim samovirazheniem pacientov s schizoidnoey I psichastenicheskoey psichopatiyami v stadii decompensacii].

Ganuschkin P. B. (1964). Selected works. Moscow: Meditzina (in Russian). [Izbrannie trudi].

Grushko N. V. (2003) Social-psychological investigation of creative self-expression in additional education. Yaroslavl: Diss. (in Russian). [Sozialno-psichologicheskoe issledovanie tvorcheskogo samovirazheniya v uslovijah dopolnitelnogo obrazovaniya].

Kretschmer E. (1958) Geniale menschen. Fünfte auflage 21-26. Tausend. Berlin. Gӧttingen. Heidelberg: Springer.

Makhnovskaja L. V. (2003) Therapy by means of creative self-expression with patients with schizotypical disorders with depersonalisation. Moscow: Diss. (in Russian). [Terapia tvorcheskim samovirazheniem pazientov s schizotipicheskim rasstroystvom depersonalizatcieye].

Nekrasova S. V. (1999) Short term Therapy by means of creative self-expression patients with schizotypical disorders and defensive traits. Moscow: Diss. (in Russian). [Kratkosrochnaya terapia tvorcheskim samovirazheniem bolnih s schizotipicheskim rasstrojstvom i defenzivnimi projavleniami].

Terletskiy A. (2003) Short term Therapy by means of creative self-expression as basis of treatment somatophorm disorders in Gastroenterology. Odessa: Diss. (in Russian). [Kratkosrochniy variant Terapii tvorcheskim samovirazheniem kak osnova lecheniya somatophormnih naruscheniye organov pischevarenia].

Unanov T. A. Short term Therapy by means of creative self-expression in complex treatment of scoliosis children. Odessa: Diss. (in Russian). [Kratkosrochniy variant Terapii tvorcheskim samovirazheniem v kompleksnom lechenii scolioza u deteye].

Zuikova N. Z. (1998) Short term Therapy by means of creative self-expression of schizoid persons with family conflicts. (in Russian). [Kratkosrochnaya terapia tvorcheskim samovirazheniem schizoidnich lichnosteiy s semejnymi konfliktami].


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