Resume Gnezdilov A.V.
Gnezdilov Andrey Vladimirovich (Saint Petersburg)
Andrey Vladimirovich Gnezdilov- St. Petersburg psychiatrist, Doctor of Medical Sciences, professor of the Department of Psychiatry of the St. Petersburg Medical Academy of Postgraduate Education, scientific director of the gerontological department, honorary doctor of the University of Essex (UK), chairman of the Association of Oncopsychologists of Russia.
Andrey Vladimirovich was born in 1940 in Leningrad. In 1963 he graduated from the Leningrad Pediatric Institute. After residency, he retrained as a psychiatrist. He worked at the Bekhterev Psychoneurological Institute as a chief researcher, and from 1973 to 1983 at the Oncological Institute. In 1976 he defended his candidate's dissertation and in 1996 his doctorate. In 1990, he created and headed a hospice in the Primorsky district of Lakhta of St. Petersburg.
Andrey Vladimirovich is a very religious person, an ascetic and public figure, a tireless researcher and “generator” of new methods in psychotherapy: fairy tale therapy, image therapy, bell therapy.
Author of many articles and publications, as well as several dozen scientific and popular books.
Main scientific interests - psychosomatic disorders, mental disorders of dying patients, psychiatric care in hospice settings, creativity.
The books of Andrei Vladimirovich Gnezdilov are a real literary treasure:
The book by the famous St. Petersburg doctor and storyteller contains his fairy tales that help people cope with difficult situations for them - family problems, loss of loved ones, discover new strengths in themselves and find inner harmony.
A psychotherapeutic fairy tale is a bridge between realities: social, objective and subtle, mental. Andrei Gnezdilov’s psychotherapeutic tales not only create these bridges, they also nourish our mental world. They form a wiser and more tolerant attitude even towards those things that we cannot change; they allow us to more subtly, spiritually comprehend the meaning of the most difficult life situations.
“I don’t know about you, dear reader, but I’ve always been interested in finding out what dreams other people have. But the inquiries were most often in vain. Someone said that they don’t see dreams at all; others admitted that by morning they forget their dreams; those who remembered could rarely convey what they saw in a dream to even the most attentive listener: when retelling the dream, they lost all their charm, turning into dead butterflies with broken wings.
And here are these stories. They are like living butterflies. The wings flutter and shimmer, and the flight path is difficult to predict. These stories do not obey the laws of literature. Whether they are parables, fairy tales or short stories, it is difficult to determine to which genre they can be classified.” Gnezdilov A.V.
In the book of the famous St. Petersburg psychiatrist, psychotherapist and humanist A.V. Gnezdilov, issues of psychotherapeutic assistance to dying patients are discussed. Based on many years of experience and the results of scientific research, the author analyzes the key points of palliative medicine: understanding the problems and needs of a terminally ill person; developing the ability to endure inevitable suffering; medical control over the symptoms of a terminal condition, primarily chronic pain syndrome, principles of integrated work with loved ones and the family of the dying person; use of various therapeutic methods and techniques. The book also discusses the problem of recruiting personnel to work in hospices and the issue of professional “burnout” of personnel.
Essays on the work of a psychotherapist in an oncology clinic and hospice.
The book “The Path to Calvary” is a documentary essay on the work of a psychotherapist in an oncology clinic and hospice.
This book fills a serious and socially dangerous gap in the education of doctors. The ascent to the martyr's end of life while dying of cancer is her theme.
The purpose of the book is to teach a doctor to free a person from physical and mental suffering associated with illness, providing the opportunity to perform the last earthly act of the soul, understanding, farewell, forgiveness and reassurance, preserving the work of the mind until the last moments of life.
Keys to forgotten doors
Psychiatrist, Doctor of Medical Sciences, Honorary Doctor of the University of Essex in England and famous storyteller finds the keys to the forgotten doors of the soul, revealing that hidden reality in which our dreams and daydreams, fears and grievances, the desire to make a choice and the desire to stay on the other side of any changes live. Tales by A.V. Gnezdilov, the famous doctor Balu - this is a way to open up the elusive world of fantasy and direct its forces to heal the most intimate in a person. The beauty and harmony contained in his stories will give the reader not only the pleasure of the writer’s elegant style, but will also give strength, heal anxiety, and help find an answer in difficult situations.
Interesting facts
This year marks 20 years from the day when Andrei Vladimirovich Gnezdilov created the first hospice service in our country (Hospice No. 1, located in St. Petersburg). Hospice provides comprehensive care to terminally ill patients and their loved ones. Every year, about 300 patients pass through the hospice hospital, the mobile service takes care of 400 patients, 5 thousand home visits are carried out, and the number of relatives annually covered by the hospice is about 1,500 people.
Hospice is a little familiar word in Russia. In the past, hospices were the name given to hospices that monks built for pilgrims traveling to the Holy Land. Modern hospices are houses in which they spend their last days incurable patients. For the first time such houses appeared in England. The first among them was the establishment founded in 1967 by Lady Cicily Saunders on own funds. She named him after Saint Christopher. Five years ago, hospices appeared in our country. The very first one was organized near St. Petersburg in the village of Lakhta.
Its founder was Andrei Vladimirovich Gnezdilov, a doctor who recently received the priesthood. Sister nuns also work on the shores of the Gulf of Finland. There are only a few hospices in Russia, and the experience of their work is worthy of widespread dissemination.
Not far from the Gulf of Finland there is a small temple in honor of Saints Peter and Paul. Next to it is an elongated one-story hospice building. In ancient times, this territory was the site of the estate of the legendary Princess Olga. The structure of the hospice is simple: a hospital with 30 beds, which has mobile teams to provide assistance to cancer patients (as well as psychological support for their relatives) at home. All help is free.
The meaning of hospice, according to the ideologists of the movement, is the fight for the souls of people not only dying, but also those remaining to live, the fight to relieve pain, physical and mental, through repentance and forgiveness. May God help them in this. And so do we. They put it here, essentially, only in three situations. Firstly, those suffering from indomitable pain syndrome, when no medications help at home. Then they conduct round-the-clock surveillance, select effective scheme pain relief. Secondly, they take into account that exhausted relatives need at least a short rest. Thirdly, special attention allocated to single people and those living in communal apartments. For most of them, this cozy house with a quiet courtyard is a paradise. After being in bed for a week or two, many no longer want to be discharged, perceiving this as a cruel act.
In communication with patients, one can trace that affectionate familiarity that is possible only in relation to the closest people.
Andrey Vladimirovich Gnezdilov (Dr. Balu) is a St. Petersburg psychiatrist, Doctor of Medical Sciences, honorary Doctor of the University of Essex in England.
Andrey Vladimirovich was born in 1940 in Leningrad. In 1963 he graduated from the Leningrad Pediatric Institute. After residency, he retrained as a psychiatrist. He worked at the Bekhterev Psychoneurological Institute, and from 1973 to 1983 at the Oncological Institute. In 1976 he defended his candidate's dissertation and in 1996 his doctorate. In 1990, he created and headed a hospice in the Primorsky district of Lakhta of St. Petersburg.
Andrey Vladimirovich is a real St. Petersburg Storyteller who has preserved traditions Good Wizards. Andrey Gnezdilov is a devotee and public figure, a tireless researcher and “generator” of new methods in psychotherapy: fairy tale therapy, image therapy, bell ringing therapy.
The psychotherapeutic tale of Andrei Gnezdilov is a gentle touch to the Soul of a person, support for him on the Path, a soft form of initiation into spiritual knowledge. The view of the Storyteller is the view of a person who is able to understand and accept the secret sides internal processes, support in good and spiritual searches, share pain and give joy.
Books (9)
Meetings on the road. Therapeutic tales
A psychotherapeutic fairy tale is a bridge between realities: social, objective and subtle, mental. Andrei Gnezdilov’s psychotherapeutic tales not only create these bridges, they also nourish our mental world. They form a wiser and more tolerant attitude even towards those things that we cannot change; they allow us to more subtly, spiritually comprehend the meaning of the most difficult life situations.
Labyrinths of the soul. Therapeutic tales
The book “Labyrinths of the Soul” presents tales of the St. Petersburg psychotherapist, Andrei Vladimirovich Gnezdilov, known to many as Doctor Balu.
Everything described in these stories is reality. But not external, but internal, psychological.
This collection contains many fairy tales that seem to be inspired by the sea. Each breath of the wave brings a new story; they roll over each other, intertwining in a bizarre pattern.
Music of dawn. Therapeutic tales
Andrei Gnezdilov’s psychotherapeutic tale is a gentle touch to a person’s soul, support on his path, a gentle form of introduction to spiritual knowledge.
The view of a storyteller is the view of a person who is able to understand and accept the secret aspects of internal processes, support in good and spiritual quests, and share pain and joy.
Petersburg dreams
“I don’t know about you, dear reader, but I’ve always been interested in finding out what dreams other people have. But the inquiries were most often in vain. Someone said that they don’t see dreams at all; others admitted that by morning they forget their dreams; those who remembered could rarely convey what they saw in a dream to even the most attentive listener: when retelling the dream, they lost all their charm, turning into dead butterflies with broken wings.
And here are these stories. They are like living butterflies. The wings flutter and shimmer, and the flight path is difficult to predict. These stories do not obey the laws of literature. Whether they are parables, fairy tales or short stories, it is difficult to determine to which genre they can be classified.” Gnezdilov A.V.
Psychology and psychotherapy of losses
In the book of the famous St. Petersburg psychiatrist, psychotherapist and humanist A.V. Gnezdilov, issues of psychotherapeutic assistance to dying patients are discussed. Based on many years of experience and the results of scientific research, the author analyzes the key points of palliative medicine: understanding the problems and needs of a terminally ill person; developing the ability to endure inevitable suffering; medical control over the symptoms of a terminal condition, primarily chronic pain syndrome, principles of integrated work with loved ones and family of the dying person; use of various therapeutic methods and techniques. The book also discusses the problem of recruiting personnel to work in hospices and the issue of professional “burnout” of personnel.
Pilgrim's Paths. Therapeutic tales
The collection “The Pilgrim's Progress” presents more than 20 tales of the famous St. Petersburg psychotherapist and storyteller.
Dr. Baloo's tales are therapeutic tales. They not only transport the reader into the enigmatic and mysterious, whimsical and wondrous world of fairy tales, but also help people find a way out of current difficult situations, understand themselves and find inner harmony.
You may not go to a resort or on an excursion, or go to college or work. But we will not pass by the ending of our own lives. And past what will happen next, too.
You may not go to a resort or on an excursion, or go to college or work. But we will not pass by the ending of our own life. And past what will happen later, too.
Psychiatrist Andrei Vladimirovich Gnezdilov works with the most severe cancer patients. A quarter of a century ago, he founded the country's first hospice - a hospital that alleviates the lives and suffering of people whose hope is microscopically small or non-existent. Today it is called the First Hospice, in Lakhta near St. Petersburg. From there the Russian hospice movement began.
We talk with Andrei Vladimirovich, who is also called Doctor Baloo, in his apartment full of mysterious things, dolls and fairy tale characters. Doctor Gnezdilov writes works on psychotherapy, and Doctor Balu writes fairy tales that also help patients.
The main conclusion from our conversation is that life, not death, triumphs, and we move up along it, along its ringing strings, in order to end up high. And to whom it is given - very highly.
Often patients, returning from the hospital or institute, burn their old wardrobe,” says Dr. Gnezdilov. - Imagine: separating from the disease, changing the stereotype. And I took advantage of this moment, I have a whole theatrical wardrobe that we use for a person to transform himself.
Do sick people come to your home?
Yes, sure! Many people hold on because they start living again, for the sake of interests in some other area or to overcome the situations that drove them into illness. Often a disease, and especially an oncological one, is, I would say, metaphysical.
Testament of Paracelsus
We hear a scream - we rush to help. Patients do not always want this help. I walk through the hospice, I see patients who are huddled, a grimace of suffering on their faces. I say: “What’s wrong with you? Are you hurt? - “Don’t pay attention, doctor.” - “How can you not pay attention? We started a whole movement and opened a hospice so that you don’t experience pain.” - “Doctor, you know, it seems to me that along with the pain, everything bad comes out of me.”
Bang bang! The moral principle appears. When we get sick, we think: we sinned somewhere, did something wrong. But here it turns out that illness and pain act not as punishment, but as atonement.
And then Dostoevsky comes to mind, Tolstoy and our entire galaxy famous writers and teachers of life. Of course, under these conditions the hospice service movement itself takes on an ethical character. After all, you can not only heal, but at least alleviate a person’s suffering with a smile and a special attitude. And this also applies to gerontology, helping the elderly. We found so many unironed old people that it was time for us to cry ourselves, because when you touch a person with a gesture or affection, he begins to cry. Why is he crying? But, he says, no one pets me.
The medieval physician Paracelsus said that the time would come when every doctor should become a medicine for the patient. It is impossible to cure, and it is also impossible to turn away. If you can't help, share it with him, because he can't be left alone against the tanks that fate brings with it. The problem is narrowed to the point that palliative medicine should only relieve pain, but the concept of pain itself is quite complex.
Because pain sometimes has the character of a psychosomatic relationship, when a psychological impasse in life turns into a somatic disease, that is, a real one. A real doctor is the one who comes to the patient and, without even writing a line of prescription, but simply talking, calms him down with his appearance.
Even in the old days, it was noted that there are special midwives who take birth well, there are nurses, a whole community of nurses who were placed with the child and the child recovered. These nurses were even tested: they were given pearls and turquoise from the dying, on which they faded, and the stones were again filled with colors and freshness. This is a fact that is widely known.
For God's sake, don't take me for a fan of extrasensory perception - I'm against it, but a fact is a fact.
That is, it is not just the hospice that is important, but first of all the doctor’s personality?
This is the idea with which we entered the hospice movement. This is romance, this is a dream. In order for a doctor to say that he will not be afraid, not painful, not lonely, he must himself experience a tragedy: either the loss loved one, or your own illness.
There are some life scenarios that serve as motivation to study to become a doctor, to become an assistant to humanity. In myths Ancient Greece it talks about the centaur Chiron, who was on the side of the titans, fought with the gods, then they made peace, everything is fine. He was artistic, was fond of music and was such a sensitive man-horse. Heroes came to him and talked about their problems and exploits.
And Hercules also got into the habit. Once he came to tell how he dealt with creepy birds, how he shot them with a bow. The centaur asked to see the bow and began to twirl the arrows: is it really possible to kill birds with this? "Be careful, the arrows are poisonous Lernaean Hydra. If you get scratched, it will be bad,” Hercules warned. He laughed: “Hercules, you forgot that I am immortal, nothing threatens me.”
And suddenly he accidentally scratches his hand, a terrible poison pours into his body and begins to devour him. He seeks salvation from pain in minerals and plants. Some things make it easier, some make his condition worse. He eventually becomes proficient in medicine and trains the god Asclepius. Wounded healer - that's what it's called.
Either the person experienced pain, or in his memory is the pain that his parents experienced, or some kind of pain awaits him ahead, and he anticipates it. This pain is an incentive for self-sacrifice.
Summon Granin
Previously, there were knights, templars, and hospitallers; they established monasteries for pilgrims who went to worship shrines, which, if necessary, protected them and gave them shelter during the journey. That's what they were called - hospices, hospices. Hospitality - hospitality.
But it's all much deeper. The life of any person can be imagined as a pilgrimage. We go, we make a fortune and so on. But this is not the meaning of life. And the meaning of life is the example of the Savior.
If you remember, before going to Calvary, he prayed in the Garden of Gethsemane. And he prayed like this: “Lord, let this cup pass from me.” But before that, he told his disciples: “Stay with me, don’t sleep.” Three times he called to them, and three times they said: “Yes, teacher.” And three times they fell asleep.
In fact, somewhere in the depths of the hospice movement, many - although I don’t know for sure, I speak for myself - perceived it as a call to be with the patient. The greatest psychotherapeutic effect on the patient is not even the medicine, but the psychotherapy of presence. Very often, an adult, having found himself in a situation of illness, returns to the path of his childhood. And, as in childhood, the child runs to his mother: “Mom, I hurt my knee.” She will kiss this place, stroke it - everything goes away, he runs on. From these foundations the hospice movement grew.
How did the hospice movement begin in our country?
We must first of all remember Daniil Granin, who in the 1980s addressed people from a high rostrum and said: “Citizens, comrades, friends, do not hope that the authorities will ever be concerned about your situation. If you want to do something good, hurry to do it now with your own strength.”
And then, I remember, people had a great upsurge. We met, were ready to give an apartment, a house, each blowing his own tune. I was blowing the hospice trumpet without even knowing that hospices existed.
He spent ten years at the Oncological Institute, where he came from the Bekhterev Institute of his own free will, when there were no psychiatrists at all in oncology. I understood that I couldn’t drag all this mass - and there were three hundred patients there. There was also a dose from Babayan, the chief narcologist who reigned at that time: 50 mg of the drug per day and not a drop more, otherwise the patient would become a drug addict. As if it mattered whether a person became a drug addict or not when he died.
Into nothing and nothing
We organized the first hospice in 1990. The English journalist Victor Zorza came, he was actively involved in hospices in England, and when it became possible, he came to us.
We went to England with Victor Zorza and at his expense, where I studied how all this should be arranged. Thanks, I believe, to Granin, a group of not even nurses, but simply people without medical education who came to the hospice, followed me.
Who could they be? Nurses, paramedics - no education required here. Penny salaries. And many retrained to become sisters. But the most interesting thing is that the team was such that I remember every single one of them. Poor conditions, a rural hospital in Lakhta, which was built by Princess Olga. But warm. Something happened there that I have never seen in the world - equality of all medical workers.
In terms of?
When you walk into a regular hospital, who’s in charge? Chief physician. And then the chief of medicine. And then the doctors. And then the sisters. And then the nurses. And then the sick. When the patient must come first! And there must be a reference group to which he trusts his health and so on.
There is no offense here that the patient is frank and asks that they send not a doctor to him, but, say, a nurse. Which is simply easier.
I don’t know if you’ve ever been to a hospital where everything immediately comes down to the issue of stool. You are lying in a room, and there are three other people with you. Doesn't matter. You should go big. Just lying in bed, wearing all sorts of diapers. But you're embarrassed to fart or something. And suddenly Zinochka, our nurse, who was once Romanov’s thrush, appears. She looked after the cow that gave milk to Grigory Romanov.
First Secretary of the Leningrad Regional Committee of the CPSU?
Well, yes. And here she is - this creature is so, well, a little ridiculous. Large, rough. But somehow calm. She comes, the patients are waiting for her when she comes on duty. With her, pooping is not scary and it all happens naturally. Why? Everything is fine. Calm down. They wiped and washed everything. It was very important that patients could choose someone with whom they felt easier. Partnerships.
Was it a religious institution?
Not religious, but spiritual. What is spirit? Everyone understands as they please. But first of all they think that spiritual means religious. Call Father and so on. But this is only part - religious care of the sick. And each according to the confession to which he belongs.
Spirituality is much deeper. This is the introduction into the patient’s consciousness of some ideas about death. Because they ask: what should they expect, what will happen next. And our important task is not to give easy recipe death to the patient, but for him to comprehend it.
Meaningful death is associated with the meaning of life. And dying is much easier when you understand what you are dying for. Or dedicating your death: for example, “let me die, but my children will be healthy.”
But a person dies not as part of an act of self-sacrifice, but from an illness that happened to him involuntarily.
One of my clients underwent surgery and found out that she had rectal cancer. They didn’t touch him, they only took him for a biopsy. And they discharged me, saying that everything was fine. She understood that this was not order, it was just said that way, for the word. She says: “I must live. I have a daughter, my husband is an alcoholic. And I got sick because my husband chased me drunk with an ax and kicked me in the crotch. After a month and a half, my tumor began to grow. I must live."
And she lives. She lives for a year, although she was not given a month. One and a half lives. Finally, things somehow work out: the husband disappeared somewhere, unable to bear the aroma, some relative appeared, the daughter got a job in college. She says: “Now I can die in peace. Everything is built in." And he dies.
They perform an autopsy on her and find no cancer. There is no doubt that it was, she just actually beat cancer. She was so connected with her daughter, and there was such an internal attitude.
So the talk about the disease being a self-sacrifice did not arise out of nowhere.
By the way, it is curious that when young doctors come to an oncology clinic or hospice, their first question is: “Are there cases of healing?” There are.
And a wonderful example of this is the story of Seraphim of Sarov. Father Motovilov was very friendly with him and became seriously ill. They started talking about how “you are not ready for death.” “Yes, father, I’m not ready, I don’t know what to do.” - “Okay, let’s pray, think.” He comes the next time and says: “You will live, my spiritual daughter, yours, agreed to die instead of you.” cousin. She is already ready for anything, she will die instead of you.” And indeed, my sister dies, but this one remains.
Now, let’s say, in St. Petersburg, a person with stage 4 cancer can always count on hospice care?
Yes. We always remember Victor Zorza well. He said that it would be better for us not to open a hospice at all than to make it paid. And then this principle of free palliative medicine was adopted from us by dozens of institutions across the country. In general, I won’t even say how difficult it was to rouse and stir up the masses in order to instill in them something new.
Why is Russia such a stumbling block? With us, any undertakings dissolve into nothingness and end in nothing. Perhaps we survive because both bad and good things don’t come out of us, they drown. Therefore, all this had a hard time taking root in Russia.
Unfortunately, giving a person a guarantee that dying will not be painful, not lonely, not scary is too much responsibility, it is simply a matter of sacrificing oneself.
Inner child
Look, she's not pretty, but she's so cute! I call her Peggy Maggie Molly. In the morning she is Peggy, in the afternoon Maggie, in the evening Molly, she also knows lullabies.
Why dolls?
These are special beings with whom psychotherapy is associated. This is the child's first friend, because he is small, and the doll is even smaller. And on dolls he plays out the relationships that his parents impose on him.
And here a lot of interesting things happen. There was never a time without tears, because meeting with childhood stirs up a lot in patients. This is the reserve we have in life.
After all, how is a child different from an adult? A child has imagination, he can own the world without appropriating it, but freely letting it go. And this possibility of irrational thinking, inherent in a child, consoles an adult. Because the inner child lives in everyone and saves us from the most difficult situations- right up to when we say that cancer is in the last stage, it’s time to die.
The inner child says: “But there is no death. If she threatens me, then she’s gone!” And his thinking is affective, it is saturated with emotions, his faith. She helps him overcome many problems. That's why we practice psychotherapeutic return to childhood.
Surprised medical workers share: our professor is lying in the clinic, which he himself created, turns to the nurse, says: “Could you read to me?” - "Please. What would you like to read? - “A fairy tale.” - “Why a fairy tale?” - “Because there is an element of miracle in a fairy tale.”
People can be divided into:
- those who believe in miracles,
- admitting that our whole world is a miracle,
- on people who don't believe in miracles.
And I began to write fairy tales about our patients. If a fairy tale suddenly begins to sound, it means you have an abyss of time, no less than Scheherazade, and a fairy tale in this sense makes it possible to create, as it were, models of a new life.
Where are these dolls from?
Let's do it. I looked for storytellers, but I couldn’t find them, and it was very sad. And suddenly I came across the puppeteers. And puppeteers, it turns out, are also storytellers, they make fairy-tale figures that replace people. They replace - that is, they know how to build the future.
Build the future?
Yes. Do you know that an action that is lost in some situation is easier to implement in reality? Sometimes a doll becomes a mascot. The most important thing is that the so-called transfer occurs here. A doctor came to the patient and said: “I am the Nutcracker, I have come to serve you.” And he gave me a doll. Due to stubbornness, perseverance, and pride, the patient cannot trust the doctor. But he puts the doll on the sore spot - and he feels better! Here is a doll that has consoled so many sick people!
Death and miracles
In his books, along with detailed description psychotherapeutic methods, as well as conditions experienced by cancer patients, you also talk about unusual phenomena associated with clinical death.
Clinical, not clinical - it is still connected with the same thing.
When does death line up? Heart stops, brain stops, nothing comes in, nothing comes out. But in fact, when a person dies, the heart has stopped, the blood has stopped, the brain does not work, the person experiences what is far away.
A simple peasant woman from the Pskov region suddenly speaks the purest English - personal experience. I was sitting next to her, she was dying, suddenly she came to her senses, smiled and said: “Doctor, do you know what I saw now?” I ask: “What did you see?” “I saw that I was in some strange place. I understand that this is England, and I, in a white bride’s dress, must go down the stairs and go to church to get married. And my name is Annie."
It's interesting that her Russian name Annie sounds exactly like English. I say: “Do you speak English?” And suddenly she answers me in English, beautiful English speech sounds. She said something else, her hand fell, her eyes dimmed, and she died.
All sorts of miracles that everyone argues about quietly happen here. The dying patient fell into a coma, and a second patient was placed in his ward. And he, seeing that this one was dying, was afraid for himself and called the priest to confess and receive communion, just in case. They came and received communion. The priest leaves, turns to say goodbye, and suddenly the dying man comes to his senses first and looks with such an expression that it is difficult to make a mistake.
The priest comes up: “Perhaps you, too, would like to take communion?” He doesn’t have a voice, he blinks his eyes: yes. He gave communion. He began to leave, and again at the threshold he turned to say goodbye: “Goodbye!” - and this one, the first patient, has already died. It’s the last minute, imagine, and receiving communion is something! And feel it, and only a tear in his eyes.
What is important to know when living and remembering death?
I really love Heraclitus. He said: “A man lights a light for himself on the night of death; and he is not dead, having extinguished his eyes, but is alive; but he comes into contact with the dead while asleep, and while awake he comes into contact with the slumbering.”
I don’t want to criticize our Christianity at all, but it seems to me that while we talk so much about sin, we shouldn’t forget about joy. I was brought up on Rabindranath Tagore, where there is such optimism, such light, colors, brightness, love. And for me, God appears not as a judge, but as love. If you maintain love for God, then this already gives you the opportunity to hope for salvation. This is how you can say it.
But here you rely not only on divine description, here Robert Burns turns up, the epitaph on the grave:
“Here I rest, Jimmy Hogg.
Perhaps God will forgive me my sins,
What I would do if I were God
And he is the late Jimmy Hogg!
This is a joke, of course, but nevertheless it seems to me that everything is much deeper. And what does it mean: someone will be saved, someone will not be saved? I think that in some deep sense the whole world is striving for unity. It is difficult to believe that God made a mistake in something when creating.
Confessors of Pain
People lose strength, get sick, and decline from quite simple things and stress. Where does the doctor and hospice staff in general get their strength? How do they manage to hold on?
You know, oddly enough, they knock out a wedge with a wedge. And, so to speak, we are induced in our professional burnouts by the sick. On the one hand, they are precisely the factor that burns us out, and on the other hand, it is the sick who become the motivation for support and help.
You understand, we are cooking in the same pot with them. Therefore, do not rush to throw stones at doctors and medical staff: what they have to endure and come to terms with is actually dooming themselves to a constant stay in the negative field.
We get used to the sick when we eat a ton of salt with them in pain. And in fact, all the suffering that the patient endures, we also endure on ourselves - in a reduced amount, but more often. But in general this is... What word should I find? Confessors of pain, or something. Yes, maybe.That's who hospice doctors are.
But, of course, we hold on not only to the patients who support us, we also hold on to our loved ones. By the way, you can even check mentally and speculatively who your friend is. Not the one who shares joy and fun with you, but the one whom you would take, dying, to your bed as a mourner.
Is there a hospice community?
It exists, but it... That is, in the West it exists more. We have so many problems all the time that it is difficult to exist. And then everything is based on some kind of competition: whose hospice is better. This is some kind of nonsense. Who will die better, who will die faster? What criteria should you choose? Therefore, it is very difficult here.
But you're talking about a cohort iron knights. Does this cohort still exist?
It exists in people. Even, perhaps, not in doctors, but in those who are able to understand and feel this problem.
The last lullaby
One simple woman, talking to me, says: “Andrei Vladimirovich, speak to me frankly, I am not afraid of death!” I answer: “Well, what are you talking about, we are all afraid, there is nothing wrong here.” “I have such a case,” she says, “I lived happy life, although she was not married to a rich man and so on. But I wanted to get married and have a girl - I had a girl, then I wanted a granddaughter - a granddaughter was born. In general, I lived a decent and sufficient life. And having learned everything about her that could be learned in my position, I want more.”
Can you imagine: looking for an explanation of life in death! This is a great thing. This is the beginning of some kind of optimistic philosophy, or something.
While reading your book “The Road to Calvary,” I noticed that a person’s reaction to the news that he has cancer is quite typical and predictable, and his further behavior is also classified. You catch yourself under the impression that we humans are calculated and somewhat mechanical. And the question arises: is there something in a person that is both unpredictable and completely real?
Well, you see, if we generalize everything, we need to remind ourselves of one more factor: every dying person gives himself permission to die. It could be the smile of a loved one... Permission to die from relatives, from a priest... A person gives himself permission to die.
Moreover, death is sometimes seen as balloon, from which air flows. He falls - and that’s it...
In fact, the last step is very often accompanied by tension. That is, a person must step into the unknown. Allow yourself. He stops struggling and walks. And the current catches him.
In this sense, Sokurov’s statement is interesting. He came to see us there, in Lakhta, and was delighted. He says, “What a wonderful place to die.” Why is it great? “But the bay is nearby. It’s like a platform for planes that take off”...
One woman was dying. Her husband was sitting with her. He held her hand, as if everything was according to the rules. She doesn't die. The sister comes up and says: “You are holding her. She won't die while you're here." - “What should I do?” - “Go for a walk for an hour and come back.” He went for a walk. The sister sat down in his place, took the patient’s hand and began to sing. What do you think she started singing? Lullaby. Suddenly the patient smiled. This death languor subsided from her. She put her hands under her cheeks and took this pose like a child. And she left... She left with a smile, lulled by a lullaby.
Having received a diploma as a general practitioner in 1963, he later became a psychiatrist at the V. M. Bekhterev Psychoneurological Institute, from where he came to the Leningrad Oncology Research Institute. N.N. Petrova, guided by the idea psychological assistance the most severely ill patients. His public lectures facilitated his acquaintance with the English journalist and hospice movement activist Victor Zorza.
With the support of A. Sobchak, in 1990, in the suburbs of St. Petersburg (then Leningrad) Lakhta, they opened the first hospice in our country - medical institution to provide assistance to incurable patients. published
Interviewed by Mikhail Rogozhnikov
Andrey Vladimirovich Gnezdilov (Doctor Balu) is a St. Petersburg psychiatrist, Doctor of Medical Sciences, honorary Doctor of the University of Essex in England.
Andrey Vladimirovich was born in 1940 in Leningrad.
Andrey Gnezdilov: The day of a person’s death is not accidental, just like his birthday
In 1963 he graduated from the Leningrad Pediatric Institute. After residency, he retrained as a psychiatrist. He worked at the Bekhterev Psychoneurological Institute, and from 1973 to 1983 at the Oncological Institute. In 1976 he defended his candidate's dissertation and in 1996 his doctorate. In 1990, he created and headed a hospice in the Primorsky district of Lakhta of St. Petersburg.
Andrey Vladimirovich is a real St. Petersburg Storyteller who has preserved the traditions of the Good Wizards. Andrey Gnezdilov is a devotee and public figure, a tireless researcher and “generator” of new methods in psychotherapy: fairy tale therapy, image therapy, bell ringing therapy.
The psychotherapeutic tale of Andrei Gnezdilov is a gentle touch to the Soul of a person, support for him on the Path, a soft form of initiation into spiritual knowledge. The view of the Storyteller is the view of a person who is able to understand and accept the secret aspects of internal processes, support in good and spiritual searches, share pain and give joy.
Gnezdilov A.V.. Audio booksGnezdilov A.V. on video
Books (9)
Section: Fairy tale therapy
The book by the famous St. Petersburg doctor and storyteller contains his fairy tales that help people cope with difficult situations for them - family problems, loss of loved ones, discover new strengths in themselves and find inner harmony.
Meetings on the road. Therapeutic tales
Section: Fairy tale therapy
A psychotherapeutic fairy tale is a bridge between realities: social, objective and subtle, mental. Andrei Gnezdilov’s psychotherapeutic tales not only create these bridges, they also nourish our mental world. They form a wiser and more tolerant attitude even towards those things that we cannot change; they allow us to more subtly, spiritually comprehend the meaning of the most difficult life situations.
Labyrinths of the soul. Therapeutic tales
Section: Fairy tale therapy
The book “Labyrinths of the Soul” presents tales of the St. Petersburg psychotherapist, Andrei Vladimirovich Gnezdilov, known to many as Doctor Balu.
Everything described in these stories is reality. But not external, but internal, psychological.
This collection contains many fairy tales that seem to be inspired by the sea. Each breath of the wave brings a new story; they roll over each other, intertwining in a bizarre pattern.
Music of dawn. Therapeutic tales
Section: Fairy tale therapy
Andrei Gnezdilov’s psychotherapeutic tale is a gentle touch to a person’s soul, support on his path, a gentle form of introduction to spiritual knowledge.
The view of a storyteller is the view of a person who is able to understand and accept the secret aspects of internal processes, support in good and spiritual quests, and share pain and joy.
Petersburg dreams
Section: Miscellaneous
“I don’t know about you, dear reader, but I’ve always been interested in finding out what dreams other people have. But the inquiries were most often in vain. Someone said that they don’t see dreams at all; others admitted that by morning they forget their dreams; those who remembered could rarely convey what they saw in a dream to even the most attentive listener: when retelling the dream, they lost all their charm, turning into dead butterflies with broken wings.
And here are these stories. They are like living butterflies. The wings flutter and shimmer, and the flight path is difficult to predict. These stories do not obey the laws of literature. Whether they are parables, fairy tales or short stories, it is difficult to determine to what genre they can be classified.” Gnezdilov A.V.
Psychology and psychotherapy of losses
Section: Practical psychology
In the book of the famous St. Petersburg psychiatrist, psychotherapist and humanist A.V. Gnezdilov, issues of psychotherapeutic assistance to dying patients are discussed. Based on many years of experience and the results of scientific research, the author analyzes the key points of palliative medicine: understanding the problems and needs of a terminally ill person; developing the ability to endure inevitable suffering; medical control over the symptoms of a terminal condition, primarily chronic pain syndrome, principles of comprehensive work with loved ones and the family of the dying person; use of various therapeutic methods and techniques. The book also discusses the problem of recruiting personnel to work in hospices and the issue of professional “burnout” of personnel.
Pilgrim's Paths. Therapeutic tales
Section: Fairy tale therapy
The collection “The Pilgrim's Progress” presents more than 20 tales of the famous St. Petersburg psychotherapist and storyteller.
Dr. Baloo's tales are therapeutic tales. They not only transport the reader into the enigmatic and mysterious, whimsical and wondrous world of fairy tales, but also help people find a way out of current difficult situations, understand themselves and find inner harmony.
The path to Calvary
Section: Basics of psychotherapy
Essays on the work of a psychotherapist in an oncology clinic and hospice.
The book “The Path to Calvary” is a documentary essay on the work of a psychotherapist in an oncology clinic and hospice.
This book fills a serious and socially dangerous gap in the education of doctors. The ascent to the martyr's end of life while dying of cancer is her theme.
The purpose of the book is to teach a doctor to free a person from physical and mental suffering associated with illness, providing the opportunity to perform the last earthly act of the soul, understanding, farewell, forgiveness and reassurance, preserving the work of the mind until the last moments of life.
Old Prince's Chest. Selected Tales
Section: Fairy tale therapy
Everything that is told about in a therapeutic fairy tale is real.
But not in the social, material world, but in the mental world. Our thoughts, feelings, unrealized aspirations, impressions of relationships and travel become heroes. The development of the plot and its twists and turns symbolically convey the dynamics of our experiences. And at the end of the fairy tale, the problem is resolved, answers are found. difficult questions about yourself and life.
This collection includes the best - old and new - fairy tales of the famous St. Petersburg psychotherapist Andrei Vladimirovich Gnezdilov, chosen to become assistants to our thoughts and feelings, desires and possibilities, aspirations and values.
Reader comments
GNEZDILOV Andrey Vladimirovich (born 1940)
GNEZDILOV Alexander Vladimirovich
Doctor of Medical Sciences, Professor
Born on October 8, 1957 in Moscow. Father - Gnezdilov Vladimir Ivanovich (born 1923). Mother - Gnezdilova Galina Petrovna (1930–1988). Wife – Gnezdilova Elena Fedorovna (born 1957). Daughters: Victoria (born 1978), Alexandra (born 1981), Ekaterina (born 1984), Anna (born 1986), Marina (born 1987). Son – Andrey (born 1983). Has ten grandchildren.
In the medical environment, the image of a doctor is often linked to the presence of an academic degree, and official recognition to the title of academician or corresponding member of the Russian Academy of Medical Sciences. This is the established rule. With an academic degree, Alexander Gnezdilov, as they say, cannot be higher. He is a doctor of medical sciences, professor. The attitude of his medical colleagues towards him is clearly respectful, he is recognized as a doctor of the highest rank. The main indicator of class is the crowd of sufferers in the clinic, where he sees dozens of people from all over Russia and neighboring countries from seven in the morning every day. People come to him who have been tormented for years by pain in the spine, joints, musculoskeletal system, headaches... In the treatment of these diseases, Dr. Gnezdilov is a real ace.
Alexander Gnezdilov’s parents had nothing to do with medicine; they worked as engineers in the development of control systems aircraft. Each of the parents has a rather difficult fate. Alexander Vladimirovich’s father, Vladimir Ivanovich Gnezdilov, is a native of the village of Milenino, Kursk province. He volunteered for the army in 1941, was surrounded near Moscow, and was wounded near Vyazma.
Due to heart disease he was discharged. Alexander Vladimirovich’s mother, Galina Petrovna, lost her parents very early. During the years of the Leningrad blockade, she was brought up in orphanage. She didn't let her younger brother die. They were taken from besieged Leningrad according to “The Road of Life”, when my mother was 11 years old and my brother was 3 years old. Later, Galina was adopted by her own aunt, who lived in Moscow.
Alexander Vladimirovich’s parents met while studying at the institute, then worked together.
Andrey Gnezdilov: We will not pass by the finale of our own lives
It was a rather late marriage. They were tough people and very demanding. The war and the mother’s childhood during the siege left their mark on the foundations of the family. The family lived in austerity mode. In addition to Sasha, there was a sister eight years younger in the family. Alexander Vladimirovich was born in the famous maternity hospital named after G.L. Grauerman on Arbat, the best doctors in the country worked there, then Soviet Union. For the first three years, the family lived in a private house on Mozhaisky Val. There were terrible drafts in the house, the house was being prepared for demolition, and no one was doing any repairs. Little Sasha suffered from pneumonia several times and developed bronchial asthma, which haunted him throughout his childhood. Receiving hormonal intensive therapy, which was fashionable at that time, he was tied to medications. Back in school years he realized that this had to end. I started playing sports intensively. I chose running. When he started running, his face turned blue, he ran for the first 500 meters with signs of suffocation, then it became easier to run, and by the 10th kilometer he returned home, pink and happy. So he fought a serious illness. Until the age of 35, Alexander Vladimirovich ran a marathon distance, jogging up to 10 kilometers daily.
Having suffered a serious illness, in the 8th grade he firmly decided to enter medical school. His technical parents drilled him harshly and demanded that he study well. He had difficulties only with exact disciplines. But by the time he graduated from school, he was well prepared in chemistry and biology - he was interested in these subjects at school. He wrote quite competently, studied physics for several months with a tutor and achieved the amount of knowledge required to enter a university. In 1974, he successfully passed the exams at the 2nd Moscow State Medical Institute named after N.I. Pirogov (MGMI). Starting from the 3rd year, I studied with pleasure and easily, when I left the disciplines that were not in demand in medicine. Specialization began, disciplines such as propaedeutics appeared, a component of the foundation that preceded deeper and detailed study other disciplines. Since 1977, after nursing practice, Gnezdilov began working as a nurse in the intensive care unit of the Research Institute of Proctology. There he met his future wife Elena Fedorovna Gurycheva, who worked as a nurse in the operating room. We became friends and had an early student marriage.
Even then, he decided to become an anesthesiologist-resuscitator, and his work at the Research Institute of Proctology helped him acquire his first practical skills in working with patients, especially the most severe ones. It was a rather eventful and difficult period in his life. The need to take care of his family forced him to combine work in several places at once. Elena Feodorovna took upon herself all the care of the children. She gave Alexander Vladimirovich the opportunity to develop creatively, do interesting work, and become a unique doctor. While studying at the 2nd Moscow State Medical Institute, he took special interest in his favorite subjects: normal physiology, therapy, pharmacology, neurology, anesthesiology and resuscitation. After graduating from college, he had skills in a number of medical procedures and in intensive care.
In 1980, Gnezdilov was enrolled in clinical residency in anesthesiology and resuscitation at the All-Union science center Surgery (VNTsH) of the USSR Academy of Medical Sciences (at that time the All-Union Research Institute of Clinical and Experimental Surgery of the USSR Ministry of Health). In 1978, a department of planned microsurgery was organized, a team of young enthusiastic surgeons was organized: researchers, graduate students. Microsurgery work was just beginning there. Gnezdilov’s first teacher was Vsevolod Anatolyevich Svetlov, Candidate of Medical Sciences, senior researcher, who taught him the basics of anesthesiology and resuscitation. Most of Gnezdilov’s time in residency was spent working in the microsurgery department.
It was very interesting, productive work. The first children appeared whose lower limbs were replanted after train injuries, after industrial injuries, frostbite, burns in adults. Transplantation of flaps, restoration of nerves, blood vessels, muscles, free muscle transplantation with microsurgical techniques, transplantation of organs and tissues - all this was a field of activity in microsurgery. Hours of operations were carried out. The longest operation in which A.V. participated. Gnezdilov, lasted 21 hours. Surgery within 10 hours was the norm. There was a great desire to become a professional anesthesiologist-resuscitator. “In intensive care,” says Alexander Vladimirovich Gnezdilov, “I am a supporter of the fact that any graduate medical university must work in the intensive care unit for some time. This teaches manipulation skills and teaches one not to be afraid of seriously ill patients. You have an approach to them, you are not afraid of difficulties. For short term provide the patient with effective effective assistance, the result of which you see immediately.”
Since 1982, after completing his residency, Gnezdilov worked as a doctor in the anesthesiology department of the All-Russian Scientific Center for Surgery, mainly in the unit providing anesthesiological care during microsurgical operations. Over seven years of work, Alexander Vladimirovich mastered the entire arsenal of anesthesiological and resuscitation care, except for the anesthesia of patients in cardiac surgery, and primarily the methods of conduction anesthesia, which played a big role in his further work. The work of a resuscitator is lively and interesting, but only until a certain age, according to Gnezdilov. He suddenly became uninteresting and bored. I wanted to treat the patient from scratch, to guide him as an attending physician from the acute period to recovery. Simultaneously with his main work, he became interested in the treatment of acute and chronic pain. However, anesthesiological skills were not enough - pain treatment requires a multidisciplinary approach and knowledge of traumatology: orthopedics, neurology, therapy, radiology. In addition, knowledge of non-traditional methods of treatment was also required: manual therapy, reflexology... By this time, Gnezdilov had independently learned some techniques of manual therapy. His classmate Gennady Ivanovich Demidov, who works as a rehabilitation doctor in Kursk, helped him in this. An amazing, passionate person with a completely out-of-the-box thinking, who, in order to study Chinese medicine in order to read treatises in the original, independently learned Chinese.
Huge help and support for Gnezdilov in mastering unconventional methods treatment was facilitated by acquaintance and cooperation with Professor V.N. Tsibulyak. In 1976, Professor V.N. Tsibulak was the first in the country to create a department for the treatment of pain syndromes, where, under his leadership, serious scientific research, new methods of pain management were developed. Gnezdilov was assigned part-time to the physiotherapy department of the pain syndrome therapy department. There were joint meetings with V.N. Tsibulak's work and ideas, interesting publications were published.
In 1988, the first medical cooperatives appeared in the country. I had to earn extra money on weekends, working as a chiropractor. The number of patients per appointment sometimes reached 150 people. It was necessary to provide financially for the family. The Gnezdilov family already had six children growing up.
In 1989, Alexander Gnezdilov defended his thesis on the tactics of infusion therapy during long-term microsurgical interventions (lasting from 8 to 21 hours), and in 1991 he received an invitation to the Central Research Institute of Prosthetics and Prosthetic Engineering to the position of senior research fellow Department of Anesthesiology and Resuscitation. This is the institute of prosthetics where a bioelectric hand prosthesis was first developed and introduced, and mechanical hand prostheses were created. Gnezdilov was given the task of organizing the resuscitation service at the institute in such a way that there would be no fear for the death of the patient when performing any amount of surgical interventions. And then the opportunity was given to engage in therapeutic pain. Within six months, he brought the intensive care service to the proper level, completely changing the staff, recruiting young doctors and nurses. When the work in the operating resuscitation room was put on stream and there was no doubt about future fate the patient in the postoperative period, he realized his dream - he occupied himself with therapeutic pain.
In 1992, Gnezdilov created a department of anesthesiology and functional rehabilitation at the institute, combining the departments of anesthesiology-reanimation, physiotherapy and a reflexology and physical therapy room. The scientific team under his leadership was engaged in the development of methods for treating pain syndromes in orthopedic patients, providing operations and rehabilitation of patients in the postoperative period. At the same time, the main emphasis was placed not only on the treatment itself, but also on the prevention of pain with the development of a set of special methods. For these purposes, the department worked closely with orthopedic departments, in particular, carried out joint treatment of patients with phantom pain syndromes and vertebrogenic headaches.
Under the leadership of Gnezdilov, special diagnostic neurophysiological methods for objectification and pain intensity were developed. As a result, it was possible to create a system of work based on close cooperation between traumatologists, anesthesiologists, reflexologists, physiotherapists, physical therapy specialists, and functional diagnostics specialists, which made it possible to successfully diagnose treatment, monitor it and rehabilitate the patient at all stages of his stay in the clinic.
In 1999, Alexander Vladimirovich defended his doctoral dissertation on the diagnosis and therapy of phantom and vertebrogenic pain syndromes. In this work, Gnezdilov implemented integrated approach to the treatment of pain based on traditional and non-traditional therapeutic methods, developed electrophysiological methods for diagnosing and monitoring the effectiveness of pain therapy.
In 2001, Gnezdilov moved to the Russian Scientific Center for Surgery of the Russian Academy of Medical Sciences to the position of head of the department of pain syndrome therapy, where he continues to work in the field of studying pain syndromes and integrative medicine. In 2004 he received the academic title of professor. Under his leadership, a team of like-minded people formed. All employees understand what pain is and how to approach it; each has their own method. The task of the department is not just pain relief, but further monitoring of the patient, pain prevention and rehabilitation as the final stage of treatment. Each patient who comes to the department with his or her problem receives consultation on the treatment provided. He immediately receives the consultation of the specialist he needs, who finds out the source of the pain and influences the cause of the disease. Pain is a criterion for assessing the effectiveness of a doctor’s work. It requires a special approach and the efforts of various specialists that the department has at its disposal. Professor Gnezdilov is a doctor who can effectively work with any patient.
In addition to scientific and practical activities, since 1980 he has been actively involved in the work of the Moscow Scientific Society of Anesthesiologists and Reanimatologists, as well as the Russian interregional public association “Society for the Study of Pain,” a member of the organizing committee of which he has been since 2000. He is also a member of the organizing committee of the association and the journal Regional Anesthesia and Treatment acute pain».
Gnezdilov's main achievements are summarized in his numerous publications and scientific works, the main of which are: “Anesthetic tactics of infusion therapy for long-term reconstructive and plastic surgery with microsurgical equipment”, “Differentiated complex pharmacotherapy of phantom pain syndrome after limb amputation”, “Methods of treating pain syndrome in patients with amputated limbs and spinal pathology
Methodical recommendations", "Modern principles of multidisciplinary treatment of pain in an orthopedic clinic", "Nocicent reflex reactions of the muscles of the upper limb in humans", "Methods of treating pain in orthopedic patients. Methodological recommendations”, “Modern principles of treatment of chronic pain in complex rehabilitation of patients with pathology of the musculoskeletal system”, “Technique of electroneuromyographic diagnostics in a modern clinic”...
Over the past four years, he has published 45 articles on further pain research and integrative medicine.
In 2008, A.V. Gnezdilov was awarded the Order of Hippocrates, which was presented to him in the Hall of Fame at Poklonnaya Hill.
He has no permanent hobbies. Loves good music. Appreciates the paintings of the Impressionists and Russian artists of the early 20th century. The main book for him is the Bible.
He loves animals - he previously owned Giant Schnauzers, a Small Longhaired Dachshund, and currently a Central Asian Shepherd Dog.
Lives and works in Moscow.
Everything described in these stories is reality. But not external, but internal, psychological.
This collection contains many fairy tales that seem to be inspired by the sea. Each breath of the wave brings a new story; they roll over each other, intertwining in a bizarre pattern. Once you open this book, you will go swimming.The psychotherapeutic tale of Andrei Gnezdilov is a gentle touch to a person’s soul, support on his path, a gentle form of introduction to spiritual knowledge. The view of a storyteller is the view of a person who is able to understand and accept the secret aspects of internal processes, support in good and spiritual quests, and share pain and joy.
The book will be of interest not only to specialists, but also to wide range readers.This collection presents more than 20 new fairy tales by the famous St. Petersburg psychotherapist and storyteller. Dr. Baloo's tales are therapeutic tales. They not only transport the reader into the enigmatic and mysterious, whimsical and wondrous world of fairy tales, but also help people find a way out of current difficult situations, understand themselves and find inner harmony.Everything that is told about in a therapeutic fairy tale is real. But not in the social, material world, but in the mental world. Our thoughts, feelings, unrealized aspirations, impressions of relationships and travel become heroes. The development of the plot and its twists and turns symbolically convey the dynamics of our experiences. And at the end of the fairy tale, the problem is resolved, answers to difficult questions about oneself and life are found.