giorgi naneiSvili

nino okribelaSvili

samedicino fsiqologiis

safuZvlebi

Tbilisi
2009
 g. naneiSvili, n.okribelaSvili / samedicino fsiqolo-
giis safuZvllebi. _ Tbilisi 2009w., 150 gv.

winamdebare naSromi warmoadgens Cvens qveyanaSi

pirvel saxelmZRvanelos samedicino fsiqologiisa da
dermatologiis sakiTxebSi. saxelmZRvaneloSi gaSuqebu-
lia fsiqologiis safuZvlebi, pirovnebis roli daava-
debaTa ganviTarebis procesSi, eqimisa da pacientis ur-
TierTobis ZiriTadi sakiTxebi, eqimis winaSe mdgari eTi-
kuri sakiTxebi.
wigni gankuTvnilia universitetis samedicino da
fsiqologiis fakultetis studentebisaTvis; fsiqo-
logebis, fsiqoTerapevtebisa da fsiqiatrebisaTvis.

redaqtori: prof. s. sxuluxia

recenzenti: prof. z. beria

prof. T. silagaZe

2
 s a r C e v i

Sesavali .......................................................................................................... 5

Tavi I. samedicino fsiqologiis sagani da

amocanebi. kavSiri sxva mecnierul
disciplinebTan........................................................................................ 7

Tavi II. fsiqika. fsiqikuri procesebi da

funqciebi........................................................................................................ 19

Tavi III. pirovneba. pirovnebis Tanamedrove

fsiqologiuri Teoriebi................................................................ 42

Tavi IV. pirovnebis ganviTarebis asakobrivi

aspeqtebi. ...................................................................................................... 71

Tavi V. eqimis da pacientis urTierTobis

fsiqologiuri Taviseburebani. ............................................. 93

Tavi VI. samedicino eTikis da deontologiis

sakiTxebi......................................................................................................... 132

Tavi VII. pacientis uflebebi saerTaSoriso da

saqarTvelos kanonmdeblobaSi. .............................................. 138

eqimis fici ................................................................................................. 147

3
4
wigni eZRvneba Cveni maswavleblis, gamoCenili qarTveli

fsiqiatris, faizula kontriZis xsovnas

S e s a v a l i

Tanamedrove medicinis meTodologiur baziss

fsiqosomaturi (kortiko-visceraluri regulaciis)
Teoria warmoadgens. adamianis organizmis da misi
sistemebis funqcionireba da kontroli kortiko-
visceraluri gzebis meSveobiT mimdinareobs. Tavis
tvinis qerqi da umaRlesi nervuli sistemis
struqturebi monawileoben yvela fiziologiuri da
paTologiuri procesis organizebasa da
warmarTvaSi. adamianis organizmSi mimdinare
nebismieri procesi – saWmlis monelebidan imunur
dacvamde, Tavis tvinis struqturebiT imarTeba.
fsiqika – Tavis tvinis qerqis sistemur
Tvisebas warmoadgens, romlis meSveobiT xdeba
subieqtis mier obieqturi samyaros aqtiuri asaxva,
qcevisa da moqmedebebis TviTregulacia. amdenad,
nebimieri avadmyofobis ganviTarebaSi, mis etio-
paTogenezSi, klinikuri suraTis CamoyalibebaSi da
paTologiuri procesis mimdinareobaSi, Tanamedrove
SexedulebebiT, wamyvani roli miuZRvis avadmyofis,
rogorc pirovnebis, fsiqikur Taviseburebebs.
pirovnebis, rogorc rTuli bio-fsiqo-socialuri
arsebis ganxilva aucilebelia avadmyofobis
suraTis srulfasovani gaazrebisaTvis, rac, Tavis
mxriv, ganapirobebs efeqtur mkurnalobasa da
reabilitacias, pirovnebis socialuri funqcio-
nirebis srul aRdgenas.

5
 samedicino fsiqologia aris dargi, romelic
swavlobs saeqimo saqmianobasTan dakavSirebul
fsiqologiur problemebs. am problemebis nusxa
metad farToa. es aris fsiqikis roli sxvadasxva
avadmyofobaTa ganviTarebis meqanizmebSi, avadmyo-
fobaze pirovnebis reagirebis Taviseburebebi, eqi-
misa da pacientis urTierTobis fsiqologiuri
aspeqtebi, eqimis winaSe mdgari eTikuri da mora-
luri problemebi.
samedicino fsiqologiis amocanaa aswavlos
momaval eqims zogadi fsiqologiis safuZvlebi, rac
saSualebas miscems mas SesZlos pacientis fsi-
qikuri reagirebis TaviseburebaTa gaTvaliswineba
diagnostikisa da mkurnalobis dros; gaerkves
klinikuri suraTis subieqtur, fsiqikuri gancdebis
Sedegad saxeSecvlil niuansebSi; daamyaros
pacientTan ufro nayofieri da efeqturi kontaqti;
ixelmZRvanelos saeqimo saqmianobaSi miRebuli eTi-
kuri da deontologiuri principebiT.
winamdebare saxelmZRvanelo warmoadgens same-
dicino fsiqologiis mokle kurss. wignSi gamokve-
Tilia, Cveni azriT, samedicino saqmianobasTan
dakavSirebuli praqtikosi eqimisTvis aucilebeli
fsiqologiuri da deontologiuri sakiTxebi.
saxelmZRvanelo pirvelia saqarTveloSi, amitomac
igi ar aris srulyofili. misi srulyofa da
daxvewa dakavSirebulia am sagnis moculobisa da
Sinaarsis Semdgom gansazRvrasTan. magram, rogorc
sabaziso literaturuli wyaro, igi daexmareba
samedicino fakultetis studentebsa da eqimebs
samedicino fsiqologiis safuZvlebis SeswavlaSi.

avtorebi

6
 Tavi I.

samedicino fsiqologiis sagani da amocanebi.

kavSiri sxva mecnierul disciplinebTan

samedicino fsiqologia aris ori mecnierebis

– medicinisa da fsiqologiis mijnaze arsebuli
dargi. samedicino fsiqologia swavlobs medicinis
Teoriisa da praqtikis im sakiTxebs, romlebic
dakavSirebulia avadmyofTa diagnostikis, mkurna-
lobis, profilaqtikisa da reabilitaciis procesSi
aRmocenebul fsiqologiur problemebTan.
adamianis fsiqologiuri mdgomareoba
gadamwyvet rols TamaSobs avadmyofobis aRmocene-
baSi, mniSvnelovnad gansazRvravs mis mimdinareobas
da gamosavals, gavlenas axdens mkurnalobis
efeqturobaze. eqimis pacientTan urTierToba, misi
fsiqologiuri zemoqmedeba sagrZnoblad cvlis
avadmyofobis suraTs. avadmyofobis WeSmariti arsis,
pacientis subieqturi Civilebisa da obieqturi
paTologiuri cvlilebebis urTierTkavSiris gageba
warmoudgenelia pirovnebis individualuri da ganu-
meorebeli Taviseburebebis gaTvaliswinebis gareSe.
Sedegad, pacientTan individualuri midgoma uzrun-
velyofs diagnostikis met siRrmesa da sinatifes,
avadmyofobis prognozis ufro zust gansazRvras da
efeqturi mkurnalobis SerCevas.
gamomdinare aqedan, samedicino fsiqologiis
interesebis sfero metad farToa. es aris
avadmyofobis warmoSobis da ganviTarebis fsiqolo-
giuri meqanizmebis Seswavla, organizmSi mimdinare
ama Tu im paTologiuri procesebis zegavlenis
dadgena adamianis fsiqikaze, pacientis eqimTan da
samedicino personalTan urTierTobis fsiqo-

7
logiuri kvleva, pacientis fsiqologiuri da
socialuri adaptaciuri meqanizmebis Tavisebure-
bebis gansazRvra.
upirveles yovlisa, samedicino fsiqologia
efuZneba zogad fsiqologias. fsiqologiis safuZv-
lebis Seswavla aucilebelia adamianis fsiqikuri
funqcionirebis principebis gasagebad. eWvgareSea,
rom zogad fsiqologiaSi da mis iseT specialur
ganxrebSi gaTviTcnobiereba, rogoricaa paTofsi-
qologia, somatofsiqologia, fsiqodiagnostika,
socialuri fsiqologia, mniSvnelovnad amdidrebs
eqimis codnas. mkurnalis muSaoba ufro efeqturi
da xarisxiania, rodesac is Rrmad wvdeba pacientis
fsiqikur gancdebs, erkveva avadmyofobis gamomwvev
fsiqologiur mizezebSi, pacientTan urTierTobisas
iyenebs fsiqologiidan miRebul codnasa da Cvevebs.
samedicino fsiqologiis, rogorc
damoukidebeli disciplinis, winaSe mdgari
problemebi aucilebels xdis mis mWidro kavSirs
medicinis sxvadasxva dargebTan, gansakuTrebiT ki
fsiqiatriasTan. fsiqiatria Seiswavlis fsiqikuri
daavadebebis etiologia-paTogenezis, klinikisa da
mkurnalobis sakiTxebs. fsiqikuri aSlilobebidan
mravali mdgomareoba pirdapir kavSirSia somatur
paTologiasTan. paTologiuri fsiqikuri reaqcia
rig SemTxvevaSi gvevlineba, rogorc organizmis
uSualo, fsiqosomaturi regulaciis darRveviT
gamowveuli pasuxi sistemebsa da organoebSi
mimdinare paTologiur cvlilebebze; rig SemTxve-
vebSi es aris fsiqikuri reaqcia avadmyofobiT
gamowveuli cxovrebis Cveuli wesis darRvevaze.
ganurCevlad mizezisa, fsiqikuri adaptaciis
darRveva yovelTvis gamovlindeba sxvadasxva
simZimis da formis fsiqopaTologiur simptomebsa
da sindromebSi. amitom, eqimisTvis aucilebeli
xdeba miiRos zogadi informacia fsiqikuri sferos
yvelaze gavrcelebuli paTologiuri mdgomareo-

8
bebis Sesaxeb, rogoricaa depresia, SfoTva, asTenia
da sxva.
samedicino fsiqologia mWidro kavSirSia
neiromecnierebebTan, vinaidan fsiqikuri da soma-
turi procesebis kavSiris gageba, mkurnalobis (gan-
sakuTrebiT, medikamenturi) efeqturobis gansazRvra
warmoudgenelia adamianis organizmSi mimdinare
neirofiziologiuri da neiroqimiuri procesebis
codnis gareSe.
ukanasknel wlebSi Tanamedrove medicina sul
ufro ixreba avadmyofobis, rogorc socialuri
fenomenis aRiarebisken. sarwmuno mecnieruli
kvlevebi naTlad miuTiTebs socialuri faqtorebis
umniSvnelovanes rolze mravali daavadebis
aRmocenebaSi. amasTan, arsebobs bevri, metad saSiSi
da gavrcelebuli daavadeba, romelTa mizezi Ziri-
Tadad negatiur socialur garemosTan (cxovrebis
cudi pirobebi, siRaribe, zogadi politikur-
ekonomikuri faqtorebi, mZime mikrosocialuri
garemocva) asocirdeba. amitomac samedicino
fsiqologia gakveulad emijneba sociologiasac.
samedicino fsiqologiis, rogorc mecnieruli
disciplinis, metad vrceli sazRvrebi iwvevs am
sagnis winaSe mdgari amocanebisadmi gansxvavebul
meTodologiur midgomas. amis gamo, samedicino
fsiqologiis adgili da moculoba dRemde ar aris
mkafiod garkveuli da Camoyalibebuli.
mecnierTa nawili Tvlis, rom samedicino
fsiqologiis ZiriTadi amocanaa tradiciuli,
“klasikuri” fsiqologiis safuZvlebis gacnoba
studentebisa da eqimebisaTvis. maTi azriT, es codna
“amdidrebs” profesionali eqimis codnas zogadi
samedicino kuTxiT da momavalSi mxolod gamoye-
nebiTi xasiaTi aqvs mis praqtikul saqmianobaSi.
e.kreCmeris mimdevrebs miaCniaT, rom
samedicino fsiqologia miznad unda isaxavdes
avadmyofobis bunebis, misi klinikuri gamovli-

9
nebebis, pacientis pirovnebis fsiqologiur analizs.
am SemTxvevaSi gansakuTrebuli aqcenti keTdeba
fsiqopaTologiis (fsiqikuri aSlilobebis
simptomebisa da sindromebis) codnaze. es mimdina-
reoba uaxlovdeba klinikur fsiqiatrias. am pozi-
ciis ukiduresi gamoxatulebaa samedicino fsiqo-
logiis dayvana zogad fsiqopaTologiamde –
fsiqiatriis zogad nawilamde.
Cveni azriT, samedicino fsiqologiis inte-
resebis sfero moicavs avadmyofi pirovnebis
fsiqikis mravalwaxnagovani Taviseburebebis Seswav-
las avadmyofobis Camoyalibebis, ganviTarebis da
mimdinareobis yvela etapze; mkurnalobisa da
reabilitaciis procesSi optimaluri fsiqologiuri
samkurnalo sistemebis SerCevas da rac mTavaria,
eqimsa da pacients Soris interpersonaluri
(pirovnebaTaSorisi) urTierTobebis efeqturi
formebis Ziebas.
am mosazrebebze dayrdnobiT, SesaZlebelia
CamovayaliboT samedicino fsiqologiis winaSe
mdgari ZiriTadi sakiTxebi:
 avadmyofobis etio-paTogenezSi, klinikur
suraTSi, mimdinareobaSi fsiqologiuri
faqtorebis rolis gansazRvra.
 avadmyofi adamianis fsiqologiis ZiriTadi
kanonzomierebebi, eqimis fsiqologiis Tavi-
seburebani, eqimisa da pacientis urTierTobis
fsiqologia.
 swavleba pirovnebis Sesaxeb: fsiqikis
sferoebi da funqcia, swavleba temperamentis,
xasiaTis, fsiqikis ontogenezuri ganviTarebis
Sesaxeb.
 samedicino deontologiisa da eTikis sakiT-
xebi, samedicino saqmianobis sakanonmdeblo
safuZvlebi.

10
 miuxedavad imisa, rom samedicino
fsiqologiis, rogorc samecniero disciplinis
sazRvrebi, misi amocanebi da praqtikuli gamoyenebis
konkretuli gzebi dResac diskusiis sagans
warmoadgens, pacientis pirovnuli, fsiqologiuri
maxasiaTeblebisa da mkurnalobis procesSi
Camoyalibebuli eqim-pacientis pirovnebaTaSorisi
urTierTobis ignorireba warmoudgenelia. Tanamed-
rove mecnierebaTa, gansakuTrebiT, kortiko-
visceraluri da fsiqosomaturi medicinis ganviTa-
reba iZleva uamrav sarwmuno da utyuar masalas
pirovnebis Taviseburebebis, mikro- da makrosocia-
luri garemoebebis, emociuri gancdebis, stresebisa
da fsiqologiuri frustraciis (imedgacruebis
gancda) rolze mravali somaturi avadmyofobis
ganviTarebaSi.
sainteresoa, rom istoriuli TvalTaxedviT
adreuli civilizaciebis droidan antikur epoqamde
mkurnaloba iyo procesi mimarTuli avadmyofis
daavadebidan ganTavisuflebisken anu es iyo eqimis
brZola pacientis gankurnebisaTvis da ara - masSi
arsebuli konkretuli avadmyofobis dasamarc-
xeblad. am princips anTropocentruli ewodeba.
aseT viTarebaSi eqimsa da pacients Soris
myardeboda aqtiuri TanamSromlobis atmosfero. es
urTierToba kargad aris asaxuli arabi mecnieris
sarajas gamonaTqvamSi: “Cven samni varT: me, Sen da
avadmyofoba. Tu Sen Cems mxares iqnebi, oriveni
avadmyofobas advilad davamarcxebT”. istoriuli
wyaroebidan Cans, rom im periodis cnobili
mkurnalebi swored Zlieri fsiqologiuri
zemoqmedebis unariT iyvnen dajildovebulni.
hipokrates medicinis principebis gavrcelebasTan
erTad, TandaTan Camoyalibda eqimebis sami tipi,
romelTac sparseTSi ase eZaxdnen:
 “sulierebiT mkurnali” yvelaze maRali
kvalifikaciis mkurnalad ivleboda – es iyo

11
 im droisaTvis eqimobis umaRlesi done, sadac
samkurnalwamlo da sxva manipulaciebi
daxvewili da siRmiseuli fsiqologiuri
zemoqmedebis fonze mimdinareobda.
 “kanoniT mkurnali” - zustad xelmZRva-
nelobda imdroindeli saeqimo “kanonebiT” anu
samedicino TxzulebebiT.
 “janmrTelobis xelosnebi” – qirurgiuli
teqnikis mcodneni, romlebic zogierT
kulturaSi saerTod ar Sediodnen eqimTa
klanSi.

elinurma medicinam da, kerZod, hipokratem

udidesi Rvawli Seitana Tanamedrove medicinis
ganviTarebaSi, biZgi misca mis sabunebismetyvelo
mecnierebebTan integracias da safuZveli Cauyara
e.w. nozologiuri medicinis Camoyalibebas. adamianis
organizmis kvlevam, anatomiis, fiziologiis,
mogvianebiT - citologiis ganviTarebam, saSualeba
misca medikosebs aexsnaT bevri avadmyofobis
ganviTarebis obieqturi mizezebi. es mizezi ada-
mianis organizmis sxvadasxva sistemis an organos
dazianeba an funqciis moSla aris. yoveli
aRwerili avadmyofoba an paTologiuri mdgo-
mareoba moeqca “nozologiuri erTeulis” – erTiani
etiologiis, paTogenezis, klinikis da
mimdinareobis mqone mkafiod gansazRvrul sistemaSi.
aman gaaadvila daavadebis diagnostika, mkurnalobis
taqtikis SerCeva da prognozi, Tumca eqims daukarga
pacientTan ufro Rrma, pirovnuli urTierTobis
aucilebloba. amjerad, eqimi mkurnalobda ara
avadmyofs, aramed avadmyofobas. am mimarulebas
nozocentruli ewoda.
fsiqosomaturi medicinis ganviTarebam, XX
saukunis 40-iani wlebidan, kvlav Semoatriala
veqtori avadmyofobidan pacientisken. mravali
daavadebis warmoSobasa da ganviTarebaSi, kortiko-

12
visceraluri regulaciis Teoriis mixedviT,
dadasturda polimorfuli fsiqikuri faqtorebis
(pirovnuli Taviseburebani, fsiqikuri konstitucia,
stresuli zemoqmedeba, socialuri garemo da sxva)
mniSvnelovani funqcia da roli. aman gamoiwvia
eqimis “Semobruneba” pacientisaken, interesi misi
pirovnebis, subieqturi avadmyofuri gancdebis,
yofiTi da socialuri problemebis mimarT.
Tvisobrivad axleburad Camoyalibda
anTropocentruli midgoma.
dReisaTvis naTeli gaxda, rom mraval
avadmyofobas socialuri mizezi aqvs. Sidsi,
narkomania, diabeti, depresia, hipertonia pirdapiraa
dakavSirebuli ara mxolod pirovnebis doneze
ganviTarebul stresul reaqciebTan, aramed maT
Rrma socialuri fesvebi aqvT. iseTi globaluri
faqtorebi, rogoricaa politikur-ekonomikuri
sistema, kulturuli da eTnikuri fesvebi, samo-
qalaqo dapirispirebebi, sazogadoebaSi miRebuli
cxovrebis wesi da sxva, aSkarad aisaxeba mosax-
leobis janmrTelobaze. sazogadoebis ganviTarebis
ekonomikuri da socialuri done moqmedebs
nebismieri daavadebis mkurnalobis xarisxze,
efeqturobaze da, rac mTavaria, gamosavalze (zrdis
an amcirebs invalidobis dones). amitom Tanamedrove
janmrTelobis dacvis sistemebi orientirebulia
ara mxolod mkurnalobaze, aramed pacientTa
socialur reabilitaciaze, maT reintegraciaze
sazogadoebaSi, socialuri dacvis meqanizmebis
ganviTarebasa da srulyofaze. eqimi valdebuli
xdeba pacients miudges ara marto samedicino,
aramed socialuri kuTxiT, maqsimalurad dainaxos
masSi pirovneba, misi rTuli mikro- da
makrosocialuri problemebiT. medicinaSi Tanda-
TanobiT mkvidrdeba sociocentruli modeli.

13
 janmrTelobis fsiqologia gamoyenebiTi
fsiqologiis SedarebiT axali sferoa. misi oTxi
ZiriTadi saxea: klinikuri fsiqologia, sazoga-
doebrivi jandacvis fsiqologia, Temis fsiqologia
da kritikuli janmrTelobis fsiqologia (marksi,
miurei 2005). mraval mkvlevars swams, rom
fsiqologias SeuZlia adamianis fizikur
janmrTelobaze gavlenis moxdena pirdapiri Tu
arapirdapiri meTodiT. arsebobs garkveuli
sarwmuno monacemebi, romlis Tanaxmad, zogierTi
fsiqikuri mdgomareoba (rogoricaa depresia da
SfoTva) stresis hormonebis - kateqolaminebis da
glukokortikoidebis, Warbi gamotyorcnis gamo,
uSualod axdens gavlenas organizmis imunitetze.
aseve arsebobs monacemebi, rom swored am pirdapiri,
biologiuri meqanizmebiT negatiur fsiqologiur
mdgomareobebs SeuZliaT zogierTi daavadebis
swrafi progresirebis provocireba (mag.: Sidsi,
gulis iSemiuri daavadeba). negatiurma emociurma
mdgomareobam aseve iribad SeiZleba gavlena iqonios
daavadebis dros gamovlenil qcevaze. magaliTad,
roca jandacvis strategiebze vsaubrobT, depresia
maRali riskis faqtoria, radgan mas ukavSirdeba
gadaWarbebuli Wama, sigaretis moweva, fizikuri
aqtivobis daqveiTeba da daumorCilebloba
samkurnalo reJimisadmi.
klinikuri janmrTelobis fsiqologiis gan-
sazRvraSi aisaxa is faqti, rom es sfero
Tavdapirvelad klinikuri fsiqologiis nawili iyo:
janmrTelobis fsiqologia aris fsiqologiuri
principebis gamoyeneba, mimarTuli janmrTelobis
ganmtkicebisa da daavadebis prevenciisaken.
(teilori, 1990). es midgoma gulisxmobs biologiur,
kognitiur, qceviT, emociur, socialur,
fsiqosomatur da garemo faqtorebs, romelic ukav-
Sirdeba janmrTelobas, daavadebas da jandacvas

14
pirovnebis doneze. igi efuZneba bio-fsiqo-socialur
models.
sazogadoebrivi jandacvis fsiqologia
cdilobs daadginos mizezSedegobrivi kavSirebi
fsiqologiur faqtorebsa da mosaxleobis
janmrTelobas Soris, warudginos es informacia
ganmanaTleblebs, politikis Semqmnelebs da
jandacvis muSakebs, raTa maT gaaumjobeson
sazogadoebis janmrTeloba. is upiratesobas aniWebs
Carevebs populaciis doneze. misi momijnave discip-
linebia epidemiologia, nutriciologia, genetika da
statistika. intervencia anu Careva ganpirobebulia
da “targetirebulia” (mizanmimarTulia) mosaxle-
obis jandacvis statistikis monacemebis (janmrTe-
lobis saWiroebebi populaciis garkveul jgufebSi
da maTi Sefaseba jandacvis politikis
ganmsazRvrelebis mier) safuZvelze. es Carevebi
mimarTulia zemodan qveviT da sxvadasxvagvarad
efeqturia populaciis gansxvavebul jgufebSi.
Temis janmrTelobis fsiqologia cdilobs
gaerkves, Tu ra xdeba lokalur doneze. Temis
doneze Careva warmoebs adgilobriv TviTmarTve-
lobasTan TanamSromlobiT da mimarTulia imisken,
rom misces Tems saSualeba gaaumjobesos
adgilobrivi mosaxleobis fizikuri da/an fsiqikuri
janmrTeloba jandacvis sistemaSi adamianis nebis-
mieri formaluri CarTvis gareSe.
kritikuli janmrTelobis fsiqologia dain-
teresebulia simZlavreebis, Zalebis gadanawilebiT,
swavlobs gansxvavebuli Zalebis gavlenas adamianis
gamocdilebaze da qcevaze, janmrTelobis dacvis
sistemebze da janmrTelobis politikaze. misi prio-
ritetia socialuri samarTlianoba, adamianis
universaluri ufleba - janmrTelobis ufleba,
rasis, sqesis, asakis da socialur-ekonomikuri
mdgomareobis miuxedavad. gansakuTrebuli zrunvis

15
sagania janmrTelobis sferoSi gamovlenili araTa-
nasworuflebianoba.
janmrTelobis fsiqologia aris rogorc
Teoriuli, ise gamoyenebiTi dargi. igi iyenebs
mraval meTods – kiTxvarebs, intervius,
kontrolirebad kvlevebs, aseve aqtivobebs, romlis
mizania cvlilebebis ganxorcieleba. janmrTelobis
fsiqologebi atareben intervius klientebTan, risi
mizanicaa - aigos yoveli adamianis janmrTelobis
mdgomareobis holisturi (mTliani) suraTi. es
suraTi aerTianebs genetikas, religiur rwmenas,
socialur daxmarebas, sacxovrebel pirobebs,
emociur mdgomareobas, warmodgenebs janmrTelobaze
da sxva. am informaciis miwodeba xdeba rogorc
eqimisaTvis, ise fsiqoTerapevtisaTvis, raTa sworad
SeirCes individualur saWiroebebs morgebuli
mkurnalobis sqema. meore mxriv, am informacias
SeuZlia daexmaros Temis wevrebs cxovrebis
xarisxis SenarCunebaSi da gaZlierebaSi.
janmrTelobis fsiqologiis miznebia:
1. qceviTi faqtorebis gageba. janmrTelobis
fsiqologi cdilobs aRmoaCinos is qcevebi da
gamocdilebebi, romlebic janmrTelobas aZliereben,
xels uwyoben daavadebis aRmocenebas, moqmedeben
jandacvis efeqturobaze da jandacvis politikis
gaumjobesebisaken arian mimarTulni. amis mravali
magaliTia. sigaretis moweva, dieta da mudmivi
varjiSi – yvela maTgani daavadebis formirebis
xelSemwyobia. ufro sustia kavSiri daavadebasa da
pirovnebis individualur maxasiaTeblebs Soris.
magaliTad, agznebis maZiebeli pirovnuli Tvisebebis
mqone adamiani manqanas swrafad atarebs, riTic
zrdis avtokatastrofebis risks. aseve, ndobis
armqone pirebi ar itareben yovelwliur profi-
laqtikur gamokvlevebs. interess iwvevs faqtorebi,
romelic ayalibebs daavadebis gamomwvev qcevas,
radgan isini exmarebian specialistebs winaswar

16
gansazRvron, Tu vin aris daavadebis riskis qveS da
ratom.
Cvens qcevas mravali damatebiTi faqtori
gansazRvravs da amgvari urTierTkavSiri rom
gavigoT, gamoviyenoT pirovnebis bio-fsiqo-
socialuri modeli. biologiurad, TambaqosaTvis
Tavis danebebis procesSi mniSvnelovan rols
TamaSobs fizikuri damokidebuleba, aseve
mniSvnelovania Tambaqoze fsiqologiuri damokide-
bulebis ganviTareba, rac farTod gamoiyeneba
mimzidvel reklamaSi. fsiqologiurad, maRal
stresul samuSaoze dasaqmebulebs uviTardebaT
kardio-vaskularuli daavadeba. socialurad,
dabali Semosavlis mqone adamianebisaTvis naklebad
misawvdomia jandacvis samsaxurebi da skriningis
procedurebi. maT ufro meti Sexeba aqvT garemoSi
moxvedril toqsinebTan, aqvT ganaTlebis dabali
done, cudi sacxovrebeli pirobebi, cudi kveba
naklebad jansaRi produqtebiT, maRalia Tambaqos
moxmareba da sxv. janmrTelobis fsiqologebis
mizania destruqciuli qcevebis Secvla, rasac ori
mizani aqvs – mosaxleoba darCes janmrTeli da
daexmaros pacients, moergos mkurnalobis reJims. am
mizniT xSirad gamoiyeneba kognitiuri qceviTi
Terapia da qcevis modifikaciis teqnikebi.
2. daavadebis prevencia. fsiqologebi
daavadebebis prevencia sxvadasxva gziT axdenen.
praqtikosebs miaCniaT, rom ganaTleba daavadebaTa
prevenciis umniSvnelovanesi nawilia. mravali
adamiani an ver amoicnobs mis cxovrebaSi arsebul
daavadebis gamomwvev risk-faqtorebs, an ver iyenebs
codnas yoveldRiuri cxovrebiseuli wnexis
pirobebSi. amis TvalnaTeli magaliTia, Tambaqos
moxmarebis winaaRmdeg mimarTuli kampaniebi. isini,
visTvisac Tambaqos produqcia naklebad misawvdomia,
yvelaze mets moixmaren. emociuri mdgomareobebis da
yoveldRiuri stresuli gamocdilebis kontrolis

17
es meTodi aris damaxasiaTebeli deprivirebuli da
mowyvladi mosaxleobisTvis. fsiqologebi eqimebsa
da eqTnebs informacias awvdian, Tu rogor
daamyaron kontaqti pacientTan, raTa gadalaxon is
fsiqosocialuri barierebi, rac xels uSlis riskis
daqveiTebisaken da qcevis modifikaciisaken
mimarTuli efeqturi strategiebis gagebas,
damaxsovrebas da danergvas.
3. daavadebis Sedegebis gamovlena. daavadeba
adamianis fsiqikur keTildReobaze seriozul
gavlenas axdens. roca daavadeba an ubeduri
SemTxveva “Tavs daatydeba” pirovnebas, mTeli misi
cxovreba icvleba – icvleba urTierTobebi, TviT-
Semecneba, reaqciis xarisxi, emociebi, rwmenaTa
sistemac ki... roca letaluri gamosavali gardau-
valia, janmrTelobis fsiqologi cdilobs pacients
maqsimalurad SeunarCunos cxovrebis xarisxi.

18
 Tavi II.

fsiqika. fsiqikuri procesebi da funqciebi

fsiqika - es aris tvinis, rogorc

maRalorganizebuli materiis, unari asaxos samyaro,
obieqturi realoba da moaxdinos srulyofili
Segueba, adaptacia garemoSi. garemos asaxvis
procesebi fsiqikuri funqciebis saxiT gamovlindeba
(aRqma, azrovneba, mexsiereba, emociuri gancda da
sxva) da mTlianobaSi adamianis subieqtur (Sinagan)
samyaros qmnis. asaxvis obieqturobisa da realobis
kriteriums praqtika, cxovrebiseuli gamocdileba
warmoadgens. fsiqikuri moqmedebis Tandayolili
Tvisebebi bio-fsiqo-socialuri adaptaciis procesSi
srulyofas, daxvewasa da ganviTarebas ganicdis.
aRzrdis, swavlebisa da sxva adamianebTan
urTierTobis dros yalibdeba adamianis rTuli da
mravalwaxnagovani fsiqikuri moqmedeba, iqmneba
pirovneba.
fsiqikaSi warmodgenilia da garkveulwilad
mowesrigebuli, sistematizirebulia warsulSi
momxdari faqtebi da gancdebi, mimdinare movlenebi
da momavlis gegmebi. ukve momxdari faqtebi da
SeZenili gamocdileba mexsierebaSi inaxeba da
saWiroebisamebr aqtualizdeba. mimdinare movlenebi
uSualo warmodgenebis, gancdebis da gonebrivi
aqtebis saxiT arian mocemulni fsiqikaSi, momavali
ki - survilebis, ltolvebis, miznebis, ocnebebis
saxiT gvxvdeba. Tavis tvinisa da grZnobaTa
organoebis mier xdeba obieqturi realobis aqtiuri
da moqmedebis winmswrebi asaxva fsiqikaSi, rac
saSualebs aZlevs adamians imoqmedos arsebuli
realobis adekvaturad da amiT uzrunvelyos
srulyofili adaptacia garemoSi. aqedan gamodinare,

19
fsiqikis ZiriTadi Tvisebebia: asaxva, romelic
iZleva sagnobrivi garemos xats; am garemoSi
orientaciis unari da moTxovnilebebis dakmayo-
fileba gare samyaros obieqtebTan kontaqtiT. es
kontaqtebi, Tavis mxriv, ukukavSiris principiT
akontrolebs asaxvis siswores. adamianisTvis
sakontrolo instancias socialuri garemo warmo-
adgens. amdenad, fsiqika erTian rTul, ciklur da
ganviTarebad sistemas warmoadgens, romelic
xelmZRvanelobs adamianis, rogorc bio-fsiqo-
socialuri arsebis, rTul da dinamikur Seguebas
sasicocxlo pirobebTan.
adamianis fsiqikuri moqmedeba erTiani da
mTliani fenomenia. amave dros fsiqikaSi SesaZle-
belia gamovyoT calkeuli sferoebi an procesebis
erTob-lioba, romlebic garkveulad gansxvavebul,
di-ferencirebul funqciebs asruleben. es dayofa
meTodologiuria, raTa ukeT iqnas aRwerili da
gagebuli fsiqikuri procesebis Tvisebebi da
maxasiaTeblebi. magram, realurad, fsiqikuri
procesebi erTiani da ganuyofelia. arsebobs
sxvadasxva midgoma fsiqikis diferenciaciis mimarT.
Cven migvaCnia, rom fsiqikis urTulesi bunebis
SeswavlisaTvis meTodologiurad gamarTlebuli
iqneba fsiqikis formaluri dayofa calkeul
sferoebad an funqciebad. esaa: aRqma, mexsiereba,
azrovneba, inteleqti, emocia, neba da cnobiereba.
aRqma rTuli inteleqtualuri aqtia, romlis
saSualebiT xdeba gare samyarodan miRebuli
informaciis sagnebisa da movlenebis saxiT asaxva.
igi realuri, obieqturi fsiqikuri procesia da
misi realizaciisaTvis aucilebelia gamRizia-
nebeli sagnis an movlenis arseboba. aRqma SegrZne-
baTa safuZvelze yalibdeba, magram igi gacilebiT
ufro maRalorganizebuli procesia da ar
warmoadgens calkeuli grZnobaTa organoebidan
miRebuli sensoruli informaciis meqanikur jams.

20
 aRqmis ZiriTad Tvisebas misi sagnobrioba
warmoadgens. amiT gansxvavdeba aRqma SegrZnebe-
bisagan da iZleva saSualebas subieqtma asaxos gare
samyaroSi arsebuli mTeli sagani an misi nawilebi,
rogorc pirovnebidan damoukidebeli obieqti.
magaliTad, iseTi calkeuli sensoruli signalebi,
rogoricaa siTbo, kvamlis suni, cecxlis naTeba da
tkacunis xma – erTianad aRiqmeba, rogorc koconi.
aRqmis sagansa da mis sensorul Sinaarss
Soris arsebobs Taviseburi damokidebuleba: sagani
yalibdeba sensoruli impulsebis safuZvelze.
magram, garkveul farglebSi, Tavad aRqmuli sagani
gavlenas axdens SegrZnebebis Sinaarsze. aRqmis am
Tvisebas emyareba fizikuri iluziis fenomeni:
realurad arsebuli erTi sagnis sxva sagnad aRqma.
aRqmis metad mniSvnelovani Tvisebaa agreTve
konstantoba – SedarebiTi mdgradoba da
damoukidebloba SegrZnebebis sensoruli paramet-
rebis cvlilebebis dros (mag.: ganaTebis
intensivoba, mxedvelobis kuTxe, manZilis cvlileba
da sxva).
aRqmis mTlianoba am fsiqikuri funqciis erT-
erTi yvelaze mTavari fenomenia. aRqma geStalturia
(Gestalt – germ. forma, xati) – pirveladi, imanenturi
Tvisebaa da ara - nawarmoebi, meoradi. adamians
gancdaSi eZleva sagnis aRqma mis mTlianobaSi,
xolo SegrZnebebi miiReba misi Semdgomi
gaanalizebis an ganyenebis gziT.
aRqmis bazisuri formebia droisa da sivrcis
aRqma. sivrcis aRqmis CamoyalibebaSi mravali
sensoruli SegrZneba monawileobs (smena, Sexeba,
mxedveloba, akomodacia). miuxedavad imisa, rom
axlo-sivrcis aRqmis sensoruli parametrebi
gansxvavdebian Sori-sivrcis aRqmis parametrebisagan,
adamiani sivrces erTian, mTlian obieqtad aRiqvams
da aseT erTian sivrceSi moqmedebs. drois aRqma
gamoixateba awmyos, warsulis da momavlis da

21
agreTve drois dinebis, mimdinareobis gancdaSi.
miuxedavad imisa, rom warsuli – mogonebebiTaa
Sedgenili, awmyo – ganicdeba uSualod, xolo
momavali mxolod igegmeba; dro ganicdeba, rogorc
uwyveti procesi, romelSic momavali uwyvetad
gadadis awmyoSi, xolo awmyo - warsulSi.
arsebobs aRqmis procesis darRvevis
sxvadasxva formebi, romelTa umetesoba gvxvdeba
sxvadasxva somaturi Tu fsiqikuri daavadebis dros.
senestopaTiebi miekuTvneba upiratesad SegrZnebebis
darRvevaTa jgufs da gamoixateba mgrZnobelobis
zRurblis SecvliT an usiamovno, polimorfuli
SegrZnebebis arsebobiT sxeulis sxvadasxva
nawilebSi: hiperesTezia - gamRizianeblebze
momatebuli mgrZnobelobiT gamoixateba. hiposTezia
- mgrZnobelobis Sesustebaa. anesTezia -
mgrZnobelobis ararseboba. uSualod senestopaTiebi
- mravalferovani vegetatiuri simptomatikis msgavsi
arasasiamovno SegrZnebebia (wvis, daWimvis, qavilis,
dabuJebis grZnoba da a.S.) sxeulis sxvadasxva
nawilSi. iluzia realurad arsebuli sagnis
mcdari, damaxinjebuli aRqmaa. igi SeiZleba iyos
fizikuri, fiziologiuri, afeqturi da
pareidoliuri. fizikuri iluzia gamowveulia
optikuri fenomenebiT, sinaTlis sxivis gardatexis,
bgeris deformaciis da sxva fizikuri kanonebiT da
ar aris dakavSirebuli adamianis fsiqikur
mdgomareobasTan. fiziologiuri iluziis mizezia
grZnobaTa organoebis funqciuri TaviseburebiT
gamowveuli darRvevebi. afeqturi iluzia ganpiro-
bebulia pirovnebis emociuri winaswarganwyobiT:
SiSis, SfoTvis, molodinis gancdiT. pareidolia -
sustad struqturirebuli obieqtis iluzoruli
aRqmaa. magaliTad: laqebi kedlebze an xaliCaze,
Rrublebi, Suq-Crdilebi tyeSi aRiqmeba fantastikur
peizaJebad, cxovelebad, mcenareebad an arabunebriv,
zRaprul sagnebad. halucinacia uobieqto aRqmaa. am

22
fenomenis dros aRqma viTardeba obieqturi sagnis
ararsebobis fonze, rodesac warmodgenebi ikaveben
dominirebul pozicias fsiqikaSi da intensivobiT
utoldebian realur SegrZnebebs. rogorc wesi,
halucinacias Tan axlavs gancda, rom obieqti,
movlena realurad arsebobs drois aRniSnul
momentSi da srulyofilad aRiqmeba. halucinaciebi
SeiZleba iyos mxedvelobiTi, smeniTi, ynosviTi,
gemovnebiTi, taqtiluri da visceraluri. fsiqosen-
soruli aSliloba viTardeba aRqmis procesSi
informaciis gadamuSavebis, integraciis da sinTezis
(am process fsiqosensoruli sinTezi hqvia)
defeqtis SemTxvevaSi da gamovlindeba ramdenime
saxiT: depersonalizacia sakuTari sxeulisa da
pirovnebis srulyofili aRqmis darRvevaa;
derealizaciis dros darRveulia gare samyarodan
momavali informaciis sinTezi, rac gamoixateba
sivrcis, drois da gare wris dinamikurobis aRqmis
SecvlaSi. agnoziis dros sensoruli aparati
normalurad funqcionirebs, sagani SeigrZnoba,
magram ar xdeba misi Secnoba anu sagnobrivi aRqma.

mexsiereba fsiqikis erT-erTi umniSvnelova-

nesi funqciaa. mexsierebis saSualebiT xdeba gare
samyarodan da sakuTari sxeulidan momavali
informaciis miReba (fiqsacia), Senaxva (retencia) da
saWiroebis SemTxvevaSi misi gamoyeneba
(reproduqcia). fiqsacia – es axali informaciis da
impulsebis miRebis unaria. es SeiZleba iyos ara
marto gare samyarodan aRqmis saxiT miRebuli
masala, aramed sakuTari azrebi da gamocdileba.
bavSvebSi retencia ufro Zlieria, vidre mexsierebis
sxva funqciebi. asakTan erTad mexsierebis es
Tviseba sustdeba. retencia codnisa da
gamocdilebis Senaxvis unaria. rodesac Cven
vlaparakobT cud an karg mexsierebaze – vgulisx-
mobT swored am unars. individis fsiqikis mier

23
cxovrebis ganmavlobaSi miRebuli codnis,
gamocdilebis, gancdebis Senaxvis unari da misi
moculoba sxvadasxvaa. mexsierebis moculoba
mniSvnelovnad ganapirobebs sxva fsiqikuri
procesebis, gansakuTrebiT, azrovnebis xarisxsa da
Tavisebebs. reproduqcia mexsierebaSi arsebuli
masalis gadmocemis, operatiulad misi gamoyenebis
unaria. arCeven mexsierebis sxvadasxva tips: zogierT
adamianSi Warbobs grZnobiT-xatovani mexsiereba,
zogSi - asociaciur-logikuri. grZnobaTa
organoebis mixedviT arCeven mxedvelobiT, smeniT,
iSviaTad - ynosviT, gemovnebiT (magaliTad,
degustatorebSi), motorul da sxva saxis
mexsierebas. funqciis mixedviT igi iyofa operatiul
anu moklevadian da grZelvadian mexsierebad.
moklevadiani mexsiereba uzrunvelyofs rogorc
sensoruli organoebidan, aseve grZelvadiani
mexsierebidan mosuli informaciis operatiul
“dakavebas” cnobierebaSi, am masalis azrovnebis
procesebSi Semdgomi gamoyenebis mizniT.
grZelvadiani mexsiereba uzrunvelyofs codnis,
gamocdilebis, grZnobiTi xatebis SenarCunebas
dReebis, wlebis da zogjer aTwleulebis manZilze.
mexsierebis am formis moculoba mniSvnelovnad
aRemateba moklevadians.
mexsierebis funqciis srulyofilad reali-
zaciisaTvis aucilebelia fsiqikuri procesebis
orientacia, maTi aqtiuri mimarTva sagnebsa da
movlenebze. am funqcias yuradReba ewodeba. pasiuri
yuradReba saSualebas aZlevs adamians gaerkvios mis
garSemo mimdinare movlenebSi da adekvaturi
reagireba moaxdinos situaciis cvlilebaze.
aqtiuri yuradRebis saSualebiT xdeba inteleqtua-
luri procesebis nebiTi, mizanmimarTuli koncent-
racia pirovnebisTvis mniSvnelovan obieqtze.
mexsierebasTan erTad informaciis miRebis da

24
gadamuSavebis procesebSi umniSvnelovanes rols
TamaSobs yuradRebac.
mexsierebis raodenobriv cvlilebebs miekuTv-
neba: hipomnezia anu dismnezia - mexsierebis daqvei-
Teba, Sesusteba (SeiZleba iyos Tandayolili,
inteleqtis saerTo ganuviTareblobasTan erTad, da
asTeniis fonze, ZiriTadad, qronikulad mimdinare
somaturi daavadebebis dros) da hipermnezia -
mexsierebis gamaxvileba, gaZliereba, misi
moculobis gazrda (Tandayolili, zogjer gansa-
kuTrebuli fenomenis saxiT gamovlenili an fsiqo-
motoruli agznebis dros da febrilitetiT
mimdinare somaturi daavadebebis SemTxvevebSi).
amnezia mexsierebis ararsebobaa. SeiZleba iyos:
retrograduli - rodesac amnezirebulia movlenebi,
romlebic droSi win uswrebdnen avadmyofuri
mdgomareobis ganviTarebas; anterograduli -
daviwyebulia avadmyofuri mdgomareobis Semdgomi
movlenebi; antero-retrograduli - ori zemoT
aRniSnuli variantis kombinacia; fiqsaciuri -
damaxsovrebis unaris dakargva, rodesac pirovneba
ver afiqsirebs mimdinare movlenebs; progresuli
amnezia - rodesac TandaTanobiT xdeba mexsierebaSi
arsebuli informaciis waSla. am dros pirvel
rigSi qreba ukanaskneli, axlo warsulSi miRebuli
informacia, xolo Zveli movlenebi da dagrovili
gamocdileba gacilebiT didi xani inaxeba.
mexsierebaSi arsebuli codnisa da gamocdilebis
maragis axlidan - Zvelisken, SeTvisebis
ukuproporciulad dakargvis kanonzomierebas ribos
kanoni ewodeba.

azrovneba rTuli inteleqtualuri procesia,

obieqturi realobis asaxvis umaRlesi forma,
romlis saSualebiT xdeba saganTa da movlenaTa
Soris Sinagani kanonzomierebebis damyareba, maT

25
arsSi wvdoma, ganzogadebuli Semecneba, cnebebis
Camoyalibeba da daskvnebis gamotana.
azrovneba sazogadoebrivi ganviTarebis
produqtia, Tumca misi Camoyalibeba bevradaa damo-
kidebuli individualur da subieqtur faqtorebze,
umaRlesi nervuli sistemis potencialze da
cxovrebis pirobebze. adamianis azrovnebis speci-
fikuroba metyvelebaSia. metyvelebas aqvs komunika-
ciuri (adamianTa Soris urTierTobis), eqspresiuli
(subieqtis gancdis gamomxatveli), signifikaciuri
(sagnebisa da movlenebis aRmniSvneli) da azrdebiTi
(sityvisaTvis konkretuli Sinaarsis micema) funqcia.
azrovnebis procesebs, cnebaTa warmoqmnisa da
Semecnebis procesebs, safuZvlad udevT ganviTa-
rebis garkveuli stereotipebi, “moqmedebis sqemebi”.
magram, aqamde mizezSedegobrivi kavSiris damyarebis
procesSi saazrovno operaciebi gaivlian garkveul
fazebs. pirveli fazaa problemuri situacia. jer
kidev antikuri filosofosi platoni am mdgoma-
reobas ganixilavda, rogorc Semecnebis dasawyiss.
Tu Seqmnili situacia iTxovs pirovnebisagan axali
gzebis Ziebas adaptaciisaTvis, individs aqvs
“...mcdeloba gascdes situaciis uSualo Sefasebas
da gamoiyenos mexsierebaSi arsebuli codnisa da
gamocdilebis maragi – maSin Cven vlaparakobT
azrovnebaze” (vudsvorti). problemur situacias
mivyavarT miznis gansazRvramde. mizani xdeba
saazrovno procesebis warmmarTveli da ganmsa-
zRvreli. amave dros igi organizacias ukeTebs Cvens
qcevas, manam, sanam ar aris miRebuli gadawyve-
tileba. gadawyvetileba aris azrovnebis procesis
gvirgvini. es aris aqtualur situaciaSi, sagnebsa da
movlenebs Soris kavSirebSi wvdoma. logikuri,
obieqturi kavSirebis Seqmna yovelTvis ar aris
saazrovno procesebis Sedegi, magram arsebobs
gzebi, romlebic aadvileben swori gadawyvetilebis
miRebas. analizi esaa sagnis an movlenis mTlia-

26
nobidan calkeuli Semadgeneli nawilebis, niSnebis,
Tvisebebis gamoyofis procesi. sinTezi - calkeuli
nawilebis erT kanonzomier mTlianobaSi gaerTia-
nebaa. es ori urTierTsawinaaRmdego saazrovno
procesi mWidro kavSirSi imyofeba. Sedareba -
obieqtTa msgavsebis an gansxvavebis dadgenis
procesia. ganzogadeba anu abstraqcia - sagnebisa da
movlenebis gaerTianebaa maT Soris saerTo
Tvisebebis safuZvelze. konkretizacia - zogadi
kanonzomierebis danaxva da Cvenebaa konkretuli,
realuri sagnis an movlenis magaliTze. azrovnebis
procesis ZiriTadi aqti msjeloba da sabolood -
daskvnaa. daskvna msjelobis formaa, azrovnebis
Sedegi - mizezSedegobrivi kavSiris dadgena garkve-
ul movlenebs an sagnebs Soris. daskvnamde misvla
SeiZleba induqciuri (kerZo msjelobaTa
ganzogadebiT) an deduqciuri (zogadi debulebidan
kerZo daskvnis gamotana) gziT. calkeuli azrebi,
msjelobebi, warmodgenebi, mogonebebi SekavSire-
bulia asociaciebSi. asociaciaTa Camoyalibebis
procesi ZiriTadi da wamyvania inteleqtualur
funqciaTa Soris. azrovnebis procesi asociaciaTa
Tanmimdevrul, logikur anu mizezSedegobrivi
urTierTkavSiriT Sekrul jaWvs warmoadgens.
saazrovno procesebis paTologia SeiZleba
gamovlindes asociaciaTa tempis, wyobis an mizan-
mimarTulebis moSliT da msjelobaTa gaukuR-
marTebiT. asociaciur procesTa aCqarebis dros
azrebi swrafad cvlian erTmaneTs. amasTan, maTi
Sinaarsi Tvisobrivad ar icvleba. asociaciaTa
Seneleba gamoixateba azrTa dinebis damuxruWebiT.
gaZnelebulia logikur kavSirTa da warmodgenaTa
Seqmna, asociaciebi erTferovani, Sinaarsobrivad
Raribia. wyvetili azrovneba - logikuri,
Sinaarsobrivad dakavSirebuli asociaciebis war-
moqmnis unaris dakargvaa. qaosuri azrovneba
SeiZleba sityvaTa daukavSirebel nakadad iqces. am

27
fenomens inkoherencia anu sityvieri salaTi ewo-
deba. uazro, wyvetili frazebiT metyvelebas
verbigeracia ewodeba. gaWianurebuli azrovneba -
axal asociaciaTa warmoqmnis SenelebaSi, movlenaTa
meorexarisxovan, araarsebiT detalebze yuradRebis
gamaxvilebaSi, zedmet detalizaciaSi gamoixateba.
perseveracia - erTi asociaciis an erTi azris
xangrZlivi dominirebaa, ris gamoc saubrisas
warmoTqmuli pirveli fraza meordeba Semdgomi
SekiTxvebis pasuxad. azrovnebis Tvisobriv
darRvevas miekuTvneba zeRirebulovani ideebi,
akviatebuli azrebi da bodviTi ideebi.
zeRirebulovani ideebi realuri, obieqturi movle-
nebis safuZvelze aRmocenebuli emociurad
Seferadebuli Seusabamo, mcdari azrebia, romelTac
pirovneba gansakuTrebul mniSvnelobas aniWebs.
akviatebuli azrebi anu obsesiebi ewodeba
iseT azrebs, romelTac aqvT naZaladeobis, Tavs
moxvevis da, amasTan erTad, pirovnebisaTvis
ucxoobis gancda. bodva aris avadmyofur,
paTologiur niadagze aRmocenebuli mcdari
msjeloba, romelic ar Seesabameba sinamdviles, ar
eqvemdebareba koreqcias da mis mimarT kritika ar
aris. azri iTvleba bodviTad maSin, rodesac igi
winaaRmdegobaSia realur situaciasTan, gamom-
dinareobs mcdari msjelobidan, rezistentulia
logikuri argumentebis mimarT da mis warmoSobas
aqvs garkveuli paTologiuri safuZveli -
damokidebulebis radikaluri Secvla gare
samyarosTan, sakuTar TavTan, rac mTlianad cvlis
adamianis urTierTobis adrindel, Cveul stereo-
tipebs. amiT bodviTi azrebi gansxvavdeba mcdari
msjelobisagan, romlis Camoyalibeba mWidrodaa
dakavSirebuli obieqtur viTarebasTan da ar iwvevs
ZiriTadi pirovnuli Taviseburebebis Secvlas.

28
 cudi Tu kargi mexsiereba, gamWriaxi Tu
tlanqi azrovneba, yovelTvis asocirdeba zogadad
inteleqtTan. cneba “inteleqti” gansazRvravs
individis unars miiRos swrafi da adekvaturi
gadawyetileba adaptaciis procesSi, gansazRvravs
analizisa da sinTezis individualur unars,
azrovnebis xarisxs. sakuTriv inteleqti warmoad-
gens cxovrebis procesSi miRebuli codnisa da
gamocdilebis marags da am maragis Semdgomi
gamdidrebis unars.
inteleqtis funqciebis - aRqmis, azrovnebis,
mexsierebis saSualebiT xdeba adamianis mier
STabeWdilebebisa da gancdebis miReba, Senaxva,
analizi, gansja, kritikuli Sefaseba da
gadawyvetilebis miReba. erT-erTi ZiriTadi
inteleqtualuri procesia cnebaTa Camoyalibeba.
cneba - sagnebisa da movlenebis zogadi da
Tvisobrivi niSnebiT gamoyofisa da gaerTianebis
unaria. cneba sityviT aRiniSneba da sityvis gareSe
ar arsebobs. arCeven cnebis sam tips:
 umartivesi anu ZiriTadi cneba - sagnebisa da
movlenebis ganzogadebis unaria ZiriTadi
Tvisebebis mixedviT da, Sesabamisad,
warmodgenaa didsa da pataraze, sinaTlesa da
sibneleze, weliwadis droze, saganTa
raodenobaze (bevri-cota) da a.S.
 sagnobrivi anu konkretuli cneba gulisxmobs
sagnebisa da movlenebis gaerTianebas
garkveuli saerTo niSnis, funqciis an
daniSnulebis mixedviT. magaliTad, “Sinauri
cxovelebi”, “aveji”, “transporti” da sxva
cnebebi.
 ganyenebuli anu abstraqtuli cneba – konk-
retuli sagnisa da movlenis saxiT ararse-
buli, ganyenebuli, magram socialur garemoSi
adaptaciisaTvis saWiro warmodgenis SemuSa-
vebis Sedegia. magaliTad, warmodgena sikeTis,

29
 borotebis, patriotizmis, zneobis arsze da
a.S.

inteleqtis daqveiTebas Wkuasustoba ewodeba.

Wkuasustoba - fsiqikuri moqmedebis myari,
praqtikulad Seuqcevadi daqveiTebaa. igi SeiZleba
iyos Tandayolili (gonebrivi CamorCeniloba) da
SeZenili (demencia). gonebriv CamorCenilobas sami
xarisxi aqvs: idiotia - yvelaze Rrma xarisxi,
romlis dros cnebebis ganviTareba ar xerxdeba,
mexsiereba, azrovneba da metyveleba ar aris
ganviTarebuli; imbeciloba - elementaruli
cnebebisa da Cvevebis ganviTarebis done da debi-
loba - Wkuasustobis ioli xarisxi, romlis dros
ganviTarebulia ZiriTadi da konkretuli cnebebi.
demencia sxvadasxva avTvisebiani da progresirebadi
fsiqikuri da nevrologiuri daavadebebis dros
viTardeba. misi simZime da klinikuri forma
dakavSirebulia avadmyofuri procesis etio-
paTogenezze, progredientulobaze da sxva paramet-
rebze.

emocia - obieqtur samyarosTan damokide-

bulebis erT-erTi gamoxatulebaa da gulisxmobs
miRebuli informaciis individualuri, subieqturi
Sefasebis unars. adamianis fsiqikur procesebs -
aRqmas, azrovnebas yovelTvis Tan axlavs esa Tu is
gancda, grZnoba. arsebobs bazisur emociur
reagirebaTa sistematikis mravali cda, romel-
Taganac gansakuTrebiT sayuradReboa vudvortsisa
da izardis klasifikaciebi.
vudvortsi saxis gamometyvelebis analizis
mixedviT gamohyofs eqvs bazisur emocias: 1.
siyvaruli, sixaruli, bedniereba; 2. gancvifreba; 3.
SiSi, tanjva; 4. mrisxaneba; 5. zizRi; 6. siZulvili.
izardma Semoitana e.w. “fundamenturi
emociebis” cneba da maT miakuTvna: 1. interesi-aRel-

30
veba, 2. sixaruli, 3. gakvirveba, 4. dardi-tanjva, 5.
mrisxaneba, 6. zizRi, 7. siZulvili, 8. SiSi, 9.
sircxvili da 10. codvianobis-danaSaulis grZnoba.
emociur gancdaTa intensivoba araerTgva-
rovania. igi yalibdeba, rogorc garemodan miRebuli
informaciis zemoqmedebiT, ise organizmis fizikuri
mdgomareobis zegavleniT - saerTo tonusis,
Sinagani organoebidan momavali SegrZnebebis (mag.:
simZimis gancda gulis areSi, saxsrebis texvis
grZnoba, gulis revis SegrZneba da sxva) xarjze. es
fenomenebi monawileobs TviTgrZnobis emociuri
gancdis CamoyalibebaSi. TviTgrZnoba ki, garemodan
miRebuli STabeWdilebebis SefasebasTan erTad,
warmoadgens guneb-ganwyobis safuZvels.
guneb-ganwyoba - mcire intensivobis da didi
xangrZlivobis emociuri gancdaa, romelic dRis
ganmavlobaSi miRebuli STabeWdilebebisa da fizi-
kuri TviTgrZnobis safuZvelze yalibdeba. guneb-
ganwyoba emyareba fiziologiuri da fsiqologiuri
komfortis an diskomfortis Sinagan gancdas. igi
SesaZloa warmodgenili iyos rogorc zogadi,
difuzuri maxasiaTebeli (“kargi guneb-ganwyoba”,
“xalisiani ganwyoba”, “cudi guneb-ganwyoba”) an
organizmis sxvadasxva sistemaSi an adgilSi
lokalizebuli gancda, zogierTi motoruli an
kognitiuri funqciis Sesrulebis gaZneleba. guneb-
ganwyobis cvlilebebi SesaZloa gamovlindes
individSi iseTi zogadi mdgomareobebis saxiT,
rogoricaa daRliloba, daZabuloba, simxneve da
sxva.
afeqti - xanmokle da Zlieri emociuri
gancdaa, romelsac, rogorc wesi, Tan axlavs
gamoxatuli motoruli da vegetatiuri kompo-
nentebi. guneb-ganwyobis tonis mixedviT afeqti
SeiZleba iyos sTeniuri (dadebiTi tonis Zlieri
gancda, magaliTad: eqstazi, aRtaceba), asTeniuri
(SiSi, boRma, sevda) da Sereuli, romelSiac

31
Serwymulia rogorc sTeniuri, aseve asTeniuri
gancdis elementebi (molodini, mrisxaneba). afeqtis
aRmoceneba yovelTvis ukavSirdeba individisTvis
mniSvnelovani cxovrebiseuli garemoebebis mkveTr
da uecar cvlilebebs. am dros fsiqikur
mdgomareobasTan erTad mniSvnelovad icvleba
Sinagani organoebis funqciac (taqikardia,
oflianoba, kankali, gulis revis SegrZneba da sxva).
afeqti viTardeba kritikul viTarebaSi, situaciidan
adekvaturi gamosavlis ararsebobis dros da mas
axasiaTebs dominantis Tvisebebi – igi aferxebs
ZiriTad fsiqikur procesebs. es garemoeba,
cnobierebis SeviwrovebasTan erTad, xdeba araade-
kvaturi qcevis mizezi (agresia, gaSeSeba, gaqceva).
emociuri reaqciebi SeiZleba gamoixatos
agreTve vnebebis saxiT. vneba - Zlieri intensivobis,
yovlismomcveli, sakmaod xangrZlivi gancdaa,
romelic mTlianad ipyrobs adamianis pirovnebas da
warmarTavs mis mizandasaxul moqmedebas Sesatyvisi
mimarTulebiT. vneba axdens pirovnebis Zalebisa da
miswrafebebis koncentracias erT saganze an
movlenaze. es SeiZleba iyos gacnobierebuli ideuri
an religiuri mrwamsi, fizikuri ltolva, emociuri
damokidebleba. vnebis ZiriTadi Tviseba misi
qmediToba, emociuri da nebiTi komponentebis
erTobaa. moralur-eTikuri, saazrovno da emociur-
nebiTi faqtorebis gaerTianeba xSirad mniSvne-
lovani wamowyebebis, gmirobis an didi aRmoCenis
sawindari xdeba.
emociuri sferos paTologia ZiriTadad
gvxvdeba guneb-ganwyobis awevis (hiperTimia), guneb-
ganwyobis dawevis (hipoTimia), emociuri Sefasebis
gaukuRmarTebis (paraTimia) da ararsebobis (apaTia)
saxiT.
hiperTimias miekuTvneba: eiforia - aweuli,
mxiaruli guneb-ganwyoba. am mdgomareobaSi adamiani
yvelafers “vardisfer ferebSi” xedavs,

32
araadekvaturad udardelia, ganicdis Zalebis
mozRvavebas da savsea usafuZvlo optimizmiT. moria
- xasiaTdeba aweuli guneb-ganwyobis fonze
araadekvaturi, jambazuri da suleluri qcevebiT,
gamomwvevi mxiarulebiT, azrovnebis gazerelebiTa
da sruli ukritikobiT. maniakaluri mdgomareoba
xasiaTdeba simptomTa triadiT: aweuli guneb-
ganwyoba, asociaciuri procesebis aCqareba da
motoruli agzneba. hiperTimiuli emociuri mdgoma-
reobis Tavisebur gamovlinebas warmoadgens eqstazi,
romelic xasiaTdeba ukiduresad zeaweuli guneb-
ganwyobiT, aRfrTovanebis da gasxivosnebis gancdiT,
rasac xSirad Tan erTvis cnobierebis Secvla.
guneb-ganwyobis daqveiTeba anu depresia
melanqoliuri, daweuli, sevdiani ganwyobilebaa,
dardi momavali safrTxis difuzuri gancdiT,
fizikuri daZabunebis SegrZnebiT. depresiis dros
arafers ar moaqvs sixaruli, xalisi. awmyo da
momavali Sav ferebSi Cans, warsuli aRiqmeba,
rogorc Secdomebisa da codvebis jaWvi. qveiTdeba
mada da irRveva Zili. garda am ZiriTadi niSnebisa,
depresiul reaqcias axasiaTebs mdgomareobaTa
farTo speqtri, saidanac gansakuTrebiT
sayuradReboa: klasikuri depresia, romelic niSnebis
“triadiT” xasiaTdeba: guneb-ganwyobis daweva,
asociaciaTa Seneleba da motoruli Sekaveba. SfoT-
viani, aJitaciur depresia anu melanqolia -
CamoTvlil niSnebs emateba ipoqondriuli, nihilis-
turi xasiaTis bodviTi azrebi, Seferili
polimorfuli senestopaTiuri SegrZnebebiTa da
ipoqondriuli gancdebiT. farul, maskirebul anu
lavrirebul depresiebs miekuTvneba hipoTimiis
iseTi saxeebi, romelTa dros wina planze gamodis
polimorfuli somato-vegetatiuri aSlilobani,
tkivili da arasasiamovno SegrZnebebi sxeulis
sxvadasxva niwilebSi. isini faraven, “Slian”

33
emociuri tonis daqveiTebas da dominirebul
adgils ikaveben klinikur suraTSi.

neba anu nebeloba Segnebuli, mizandasaxuli

fsiqikuri aqtivobis individualuri SesaZleblobis
unaria. nebiTi aqtis Camoyalibeba sxvadasxva
sasicocxlo instinqtebis (sqesobrivi, kvebis,
Tavdacvis), moTxovnilebebis da interesebis bazaze
xdeba. misi pirveli etapi survilia, romelic
cnobierebaSi garkveuli miznis dakmayofilebis
gzebisa da xerxebis gaformebas, Camoyalibebas
warmoadgens. SemdgomSi xdeba miznis miRwevis
saSualebaTa gaazreba anu Secnoba da yalibdeba
motivacia. garemosTan individis Seguebis procesSi
yalibdeba mravali situacia, romelic saWiroebs
operatiul regulacias (winaaRmdegobebis gada-
laxva, motivTa konfliqti, konfliqti biologiur
moTxovnilebebsa da socialur normebs Soris). igi
SesaZloa daviyvanoT sam ZiriTad momentamde,
esenia: moqmedebisadmi survilis deficitis Sevseba
arasakmarisi motivaciis pirobebSi; motivebis,
miznebis da qcevis modelebis arCeva maT Soris
konfliqtis SemTxvevaSi; qcevis tipisa da
fsiqikuri procesebis regulacia. motivebis
brZolas mivyavarT gadawyvetilebis miRebis
etapamde, romelic mTavrdeba gadawyvetilebis
realizaciiT. am fsiqikuri procesebis Sedegad
adamiani axorcielebs mizandasaxul motorul,
moZraobiT aqts. nebiTi aqtebi sirTulis mixedviT
SesaZloa davyoT moZraobebad, moqmedebebad da
qceviT anu motivaciur aqtebad.
adamianis cnobierebaSi xSirad srulad ar
aris warmodgenili moZraobebisa da moqmedebebis
stimulebi. aseT aramotivirebul moZraobebs
Cveuli moZraobebi warmoadgenen. es moZraobebi
“Cvevebia”, romelTa Soris aris adaptaciisTvis
saWiro avtomatizebuli, praqtikulad gaucnobiere-

34
beli aqtebi – xelis bana, kovzisa da Canglis
xmareba, tansacmlis Cacma d sxva.
moqmedeba warmoadgens garkveuli miznis
misaRwevad warmoebul motorul aqtivobas. Cveuli
moZraobebidan gansxvavebiT, moqmedeba uSualodaa
ganpirobebuli arsebuli situaciiT. moqmedebaSi
SesaZloa gamovyoT misi saorientacio, aRsrule-
biTi da sakontrolo nawilebi. Tu erTi moqmedebiT
ar xerxdeba dasmuli amocanis gadawyveta, igi
SesaZloa gadavides operaciaSi - mizanmimarTul
qcevaTa kompleqsSi.
adamianis qcevas gansazRvravs or ZiriTadi
faqtori: subieqtis moTxovnileba da misi
SesaZleblobebi da garemo, romelmac es moTxov-
nebi unda daakmayofilos. d.uznaZem mogvawoda
mizanmimarTul moqmedebaTa anu qcevaTa formebis
originaluri klasifikacia, romelic ufuZneba
subieqtis moTxovnilebebis cnebas. avtori gamo-
hyofs adamianis qcevis formebis or did jgufs:
eqsterogenul da introgenul qcevebs.
eqsterogenuli qcevisaTvis aucilebelia
obieqturad arsebul sagani, romelic gansazRvravs
da ganapirobebs moqmedebas. am tipis qcevebs
miekuTvneba:
1. moxmarebiTi qceva (kveba, Tavis movla, TviT-
da axlobelTa momsaxureba).
2. Sroma – saqmianoba, romelic mimarTulia
sazogadoebrivad saWiro produqtis
Sesaqmnelad, rodesac Tavad procesi winaswar
dagegmil mizans emsaxureba.

introgenul qcevas gansazRvravs ara obieqti,

aramed pirovnebaSi arsebuli motivebis realizaciis
moTxovnileba. am tipis qcevaa:
1. sporti – moqmedebis azrs TviTfunqcioba,
garkveuli moZraobebis kompleqsis Sesru-
lebis moTxovnileba Seadgens.

35
 2. TamaSi – moqmedebebi, romlebic mimarTulia
ara materialuri Sedegisken, aramed TviT
procesiT miRebuli emociuri
dakmayofilebisken, rac, Tavis mxriv, ZalTa
da unarTa ganviTarebaSi gamoixateba.
3. Semoqmedeba – am dros ZiriTadi
ganmsazRvrelia xelovnebiTi Semoqmedebis
Sinagani moTxovnileba. am moTxovnilebaTa
safuZveli, garkveulwilad, garedan mosuli
impulsebicaa da es procesi SromasTanacaa
dakavSirebuli, magram SemoqmedebiTi
aqtivobis ZiriTadi ganmsazRvreli mainc
Sinagani motivaciaa.

qcevis calke formad d.uznaZe swavlas

gamohyofs. qcevis es saxeoba uaxlovdeba eqstero-
genuls, vinaidan swavlis process, iseve rogorc
Sromas, aqvs Tavisi mizani – codnis miReba. amasTan,
swavla garemodan miRebuli informaciisa da
gamocdilebis aTvisebis procesia. meore mxriv,
swavla TamaSs waagavs, rogorc Sinagani fizikuri
da inteleqtualuri potencialis amaRlebisaken
mimarTuli qmedeba.
moZraobaTa paTologia gamoxatulia agznebis
an Sekavebis saxiT. agznebac da Sekavebac Tavisi
bunebiT SeiZleba iyos fsiqogenuri, fsiqo-
motoruli da motoruli.
fsiqogenuri agzneba viTardeba Zlieri
emociuri Sokis Sedegad (sicocxlisaTvis saSiS
situaciaSi) da gamoirCeva Zlieri, qaosuri
motoruli aforiaqebiT cnobierebis Seviwrovebis
fonze, romelsac Tan erTvis Zlieri vegetatiuri
reaqciebi. fsiqo-motoruli anu maniakaluri agzneba
Tan erTvis guneb-ganwyobis awevasa da asociaciebis
aCqarebas (maniakaluri sindromis struqturaSi) da
xasiaTdeba motoruli da metyvelebiTi agznebiT,
gadametebuli, magram mizanmimarTuli, naklebad

36
produqciuli aqtivobiT. motoruli anu
katatoniuri agzneba - mxolod Sizofreniis dros
gvxvdeba da gamoirCeva uazro, umizno, qaosuri
moZraobebiT da e.w. “eqo-simptomebiT”, rogoricaa
eqolalia (mosaubris sityvebis uazro gameoreba),
eqopraqsia (sxvisi moqmedebebis umizno gameoreba),
eqomimia (sxvisi mimikis zusti gameoreba).
mizandasaxul moqmedebaTa darRveva sxvadasxva
saxiT vlindeba. manerulobas axasiaTebs ucnauri,
gamomwvevi qcevebi, pranWiaoba, demonstraciuloba.
Tu am mdgomareobas Tan erTvis mizanmiumarTavi
bavSvuri sicelqe, moZraobaTa stereotipuloba da
jambazuri mimbaZveloba, maSin adgili aqvs
hebefreniul qcevas. impulsur moqmedebebs da
mizidulobebs axasiaTebT raime moqmedebis Cadenis
mwvaved, periodulad gaCenili dauZleveli aramoti-
virebuli moTxovnileba. es moTxovnileba imdenad
Zlieria, rom axSobs yovelgvar kritikas da
sawinaaRmdego tendenciebs. mogonebebi impulsurad
Cadenil qcevebze arasrulia da araTanmimdevruli.
impulsur moqmedebebs Soris gamoirCeva: dromomania
(xetialis dauZleveli moTxovnileba), dipsomania
(alkoholis miRebisadmi dauokebeli ltolva),
kleptomania (uazro qurdobis dauZleveli
moTxovnileba) da piromania (cecxlis wakidebis
avadmyofuri survili).
mizidulobaTa darRvevas miekuTvneba ZiriTadi
sasicocxlo midrekilebebis - kvebisa da seqsua-
luri instinqtebis gaukuRmarTeba. kvebis normaluri
instinqti SeiZleba Seicvalos da warmoCindes
Semdegi saxiT:
anoreqsia - SimSilis grZnobis Sesusteba an
sruli gaqroba. bulimia - madis paTologiuri moma-
tebaa. polidifsia - dauZleveli wyurvilis grZnoba.
madis paTologiuri gaukuRmarTeba - arasakvebi
sagnebis (miwis, lursmnebis, folaqebis, maT Soris -
eqskrementebis Wama) - koprofagia.

37
 seqsualuri midrekilebis gaukuRmarTeba
gamovlindeba maSin, rodesac sqesobrivi instinqtis
realizacia ar mimdinareobs fiziologiuri gziT
da seqsualuri agznebisa da orgazmis misaRwevad
pirovneba mimarTavs aranormalur sqesobriv kavSi-
rebs an damatebiT gamRizianeblebs. seqsualur
perverziebs miekuTvneba: sadizmi - sqesobrivi dakma-
yofilebis miReba partniorisaTvis fizikuri tki-
vilis miyenebiT; mazoxizmi - orgazmisaTvis saWiroa
partnioris mier tkivilis miyeneba, damcireba,
Seuracxyofa; homoseqsualizmi - igive sqesisadmi
seqsualuri ltolva (perverziebSi aRar ganixi-
leba); pedofilia - bavSvebisadmi seqsualuri
ltolva; gerontofilia - moxucebisadmi seqsua-
luri ltolva; zoofilia - cxovelebTan sqesobrivi
kavSiriT dakmayofilebis miReba; fetiSizmi - raime
sagnis, tansacmlis, fexsacmlis an adamianis sxeul-
Tan SexebaSi myofi nivTis gamoyeneba, sqesobrivi
dakmayofilebis misaRebad; transvestizmi – mopir-
dapire sqesis tansacmlis tareba, rogorc am
sqesisadmi kuTvnilebis gancdiT siamovnebis miRebis
saSualeba; onanizmi - sqesobrivi dakmayofilebis
miReba masturbaciiT; eqshibicionizmi – demonstra-
ciuli gaSiSvlebiT da sqesobrivi organoebis
sxvebisTvis CvenebiT seqsualuri siamovnebis miReba;
vuaierizmi - sqesobrivi aqtis faruli TvalTvaliT
sqesobrivi agznebis miRweva da transseqsualizmi -
mopirdapire sqesad gadaqcevis survili, romelic
xSirad sqesis gamocvlis operaciiT realizdeba.

cnobiereba - sinamdvilis asaxvis umaRlesi

mizanmimarTuli unaria, romlis saSualebiT
adamiani axdens orientacias sakuTar TavSi,
garemosa da droSi. igi fsiqikuri asaxvisa da
TviTregulaciis umaRles formas warmoadgens da
mxolod adamianisTvis, rogorc socialuri
arsebisTvisaa, damaxasiaTebeli. cnobiereba gvevli-

38
neba, rogorc grZnobadi da azrobrivi xatebis
mudmivad cvalebadi erToblioba, romelic qmnis
pirovnebis “Sinagan gamocdilebas” da win uswrebs
praqtikul qmedebebs. cnobiereba adamianis fsiqikur
funqciaTa integraciis, garemodan miRebuli
STabeWdilebebisa da Sinagani gancdebis Secnobis,
maTi sinTez-analizis, moqmedebis stimulad
Camoyalibebis Sedegia. cnobierebis erT-erT ZiriTad
funqcias individis, pirovnebis “me”-s Camoyalibeba,
subieqt-obieqtis gansxvaveba, socialur garemoSi
garkveva da mizandasaxul moqmedebaTa dagegmva
warmoadgens.
cnobiereba xasiaTdeba:
1. aqtivobiT – yvela cocxali organizmisTvis da
maT Soris adamianisTvis damaxasiaTebeli
dinamika, romelic xels uwyobs adaptaciur
cvlilebebs da uzrunvelyofs sasicocxlod
aucilebeli biologiuri da socialuri
kavSirebis SenarCnebas da ganviTarebas.
2. intenciiT – mimarTulebiT raime sagnisa an
movlenisaken.
3. refleqsiiT – subieqtis mier Sinagani
fsiqikuri procesebis (mexsiereba, azrovneba,
emocia) TviTSemecnebis procesi.
adamianis cnobiereba fsiqo-socialuri
fenomenia. igi adamianis istoriul ganviTarebasTan
erTad yalibdeba - instinqturi, biologiuri
donidan sazogadoebriv, socialur donemde. cnobie-
rebas, rogorc orientaciis unars, gansazRvravs ara
mxolod individualuri cnobiereba, rogorc
calkeul individTa fsiqikuri gancdebis erTob-
lioba, aramed sazogadoebrivi yofisa da urTier-
Tobebis asaxva - socialuri cnobiereba: eTikur-
moraluri, religiuri, esTetikuri, iuridiuli,
politikuri da sxva kategoriebi. cnobiereba yovel-
Tvis mWidrodaa dakavSirebuli enasTan, metyve-
lebasTan. cnobiereba yvela SemTxvevaSi codnaa,

39
codna aqtiuri da SemoqmedebiTi. cnobiereba
garemos mimarT damokidebulebasac gulisxmobs.
cnobierebis maintegrirebel TvisebaTa Soris
ZiriTadia orientacia, romelic Tavis mxriv, aris
intrafsiqikuri orientacia - adamianis mier
sakuTari fsiqikuri funqciebis individualurobis,
ganumeoreblobis, sakuTari “me”-s gancda;
somatofsiqikuri orientacia - mTlianad sakuTari
sxeulis da misi nawilebis zomis, formis,
mdebareobis, organizmidan momavali somato-
vegetatiur SegrZnebaTa gancda da alofsiqikuri
orientacia - gare samyaroSi, mimdinare movlenebSi,
adgilsa da droSi garkvevis unari.
cnobierebis aSla - pirveladi procesia da
mas axasiaTebs oTxi ZiriTadi niSani: 1. realuri
garemodan gariyva da misi fragmentuli asaxva,
aRqmulis fiqsaciis Sesusteba an sruli gaqroba; 2.
sxvadasxva intensivobis dezorientacia adgilSi,
drosa da sakuTar TavSi; 3. azrovnebis procesebis
inkoherencia da 4. mimdinare movlenebisa da
avadmyofuri gancdebis arasrulyofili damaxsov-
reba (K. Jaspers).
cnobierebis aSlis saxeebia: gabrueba,
romelic gamoixateba yvela saxis gamRizianeblis
mimarT zRurblis mkveTr awevaSi, asociaciuri
procesebis gaZnelebasa da SenelebaSi. gabruebis
xarisxebia: obnubilacia - gabruebis ioli, garda-
mavali forma, romelic orientaciis msubuqi
darRveviT xasiaTdeba. somnolencia - gabruebis
susti saxe, arasruli orientaciiT adgilsa da
droSi, kontaqtis gaZnelebiTa da nawilobrivi
amneziiT; sopori, romelic xasiaTdeba sruli
dezorientaciiT, refleqsebis SenarCunebis fonze.
gareSe gamRizianeblebidan reaqcia mxolod Zlier
tkivilze xdeba, kontaqti SeuZlebelia da
movlenebi srulad amnezirebuli. koma - cnobierebis

40
sruli gamoTiSva, areaqciuloba, arefleqsia da
sruli amnezia.
deliriumi xasiaTdeba dezorientaciiT an
Semcdari orientaciiT drosa da garemoSi,
TviTcnobierebis Senaxvis fonze. oneiroidi - cno-
bierebis sizmrismagvari, fantastikur-bodviTi
Secvlaa, sruli dezorientaciiT da fantastikuri
halucinaciuri gancdebiT. cnobierebis bindis-
magvari SecvlisTvis damaxasiaTebelia cnobierebis
uecari, spontanuri Seviwroveba, bodviTi da
halucinaciuri produqciebi da agresia. cnobierebis
Seviwrovebis gansakuTrebul fenomens warmoadgens
somnambulizmi anu lunatizmi. cnobierebis
somnambuluri Secvla viTardeba Rrma, fizio-
logiuri Zilis dros da rig SemTxvevebSi SesaZloa
cnobierebis bindismagvari Secvlis variants
warmoadgendes. avadmyofi gadaadgildeba oTaxSi,
iRebs nivTebs, icvams tansacmels da asrulebs sxva
elementur moZraobebs. misi am mdgomareobidan
gamoyvana metad Znelia. cnobierebis isteriuli, som-
nambuluri Secvla viTardeba fsiqomatravmirebel
situaciaSi da Tavisi bunebiT cnobierebis hipnozur
mdgomareobas waagavs. amencia cnobierebis aSlis
Rrma xarisxia, romelsac fsiqikuri procesebis
sruli dezorganizacia axasiaTebs.
cnobierebis abneva meoradi procesia da
gamowveulia im ZiriTadi mizezebiT, romlebic xels
uSlian intrafsiqikuri da alofsiqikuri
informaciis srulyofil gadamuSavebas. fsiqikis
sxvadasxva funqciebis darRvevis gamo adgili aqvs
sxvadasxva saxisa da intensivobis dezorientacias.
cnobierebis abnevis saxeebia: bodviTi, asociaciuri,
halucinaciuri, amneziuri, demenciuri, afeqturi da
maniakaluri.

41
 Tavi III.

pirovneba. pirovnebis Tanamedrove

fsiqologiuri Teoriebi

pirovneba (laT. persona – niRabi) - individis

qcevis SedarebiT myari sistemaa, romelic
upiratesad socialur konteqstSi CarTulobas
efuZneba. ufro farTo mniSvnelobiT, pirovneba –
sazogadoebrivi ganviTarebis fenomenia, konkretuli
cocxali adamiani, romelic cnobierebisa da
TviTSegnebis matarebelia.
pirovnebis struqtura warmoadgens
pirovnebis Sesaxeb warmodgenaTa sistemas, romelic
aerTianebs pirovnebis procesualur-ierarqiul
yvela qvestruqturas, maT Soris, xasiaTis da unar-
SesaZleblobaTa qvestruqturebs. amdenad, pirovneba
moicavs adamianis yvela fsiqologiur maxasia-
Tebels da organizmis yvela morfo-fiziologiur
Taviseburebas, nivTierebaTa cvlis CaTvliT.
sxvadasxva dros mkvlevarebi Tvlidnen, rom
pirovnebis cnebis ganmartebaSi unda asaxuliyo
konstitucia, Semgueblobis (adaptaciis) unari,
adamianis sakuTar TavTan da sazogadoebasTan
damokidebuleba. magaliTad, pirovnebis fsiqo-
logiis erT-erTi fuZemdebeli g.olporti werda –
“pirovneba aris individis im fsiqofiziologiuri
sistemis dinamikuri organizacia, romelic
gansazRvravs garemosTan Semgueblobis erTaderT
SesaZleblobas”. h.aizenkis mixedviT, pirovneba aris
xasiaTis, temperamentis, inteleqtisa da fizikuri
sxeulis SedarebiT stabiluri da myari
organizacia, romelsac gansazRvravs adamianis
unikaluri, individualuri adaptacia garemoSi.
dReisaTvis, yvelaze aqtualurad miiCneva jandacvis

42
msoflio organizaciis mier mowodebuli Semdegi
ganmarteba:
pirovneba aris azrovnebis, emociurobisa da
qcevis Camoyalibebuli stereotipebis erToblioba,
romelic axasiaTebs individis unikaluri cxov-
rebis wess da misi adaptaciis xerxebs da gani-
sazRvreba konstituciuri faqtorebiT,
ganviTarebiT da socialuri gamocdilebiT.
amrigad, pirovneba yalibdeba adamianis
cnobieri moRvaweobis da socialuri urTier-
Tobebis Sedegad da misi umTavresi maxasiaTebelia
TviTSefaseba, romlis Camoyalibebis erT-erTi
ZiriTadi faqtoria sxva adamianebis mier individis
Sefasebas da, piriqiT, Tu rogor afasebs individi
sxvebs. pirovneba yalibdeba sazogadoebasTan
urTierTobis da aRzrdis procesSi. amis gamo igi
SeiZleba iyos mxolod adamiani da isic garkveuli
asakis miRwevis Semdeg. Camoyalibebul pirovnebas
ori umTavresi kriteriumi axasiaTebs: motivebis
garkveuli ierarqiuloba da qcevis gacnobierebuli
kontrolis unari.
zogadad, pirovneba xasiaTdeba:
 aqtiurobiT, rac gulisxmobs subieqtis
miswrafebas gadalaxos pirovnuli saz-
Rvrebi, gaafarTovos moRvaweobis areali,
imoqmedos situaciuri da roluri
gansazRvrulobis CarCoebis miRma.
 mimarTebiT anu motivebis Camoyalibebuli
sistemis (interesebi, rwmena, idealebi,
gemovneba da a.S.) dominirebiT da simyariT.
 siRrmiseuli azrobrivi struqturebiT, rac
SedarebiT stabiluri warmonaqmnia da
verbalur zemoqmedebas ar emorCileba; magram
SeiZleba Seicvlos jgufuri, koleqtiuri
moRvaweobis Sedegad.

43
  realobis mimarT sakuTari damokidebule-bis
gacnobierebis xarisxiT (damokidebuleba,
ganwyoba da a.S.)

pirovnebis struqturaSi SeiZleba gamovyoT

ramdenime fsiqologiuri aspeqti: temperamenti,
romelic gansazRvravs adamianis moqmedebisa da
gancdis energetikasa da dinamikas; xasiaTi,
romelSic vlindeba adamianis sakuTar TavTan,
sxvebTan da sazogadoebriv RirebulebebTan damoki-
debulebis Taviseburebani; inteleqti, niWi, moti-
vebi, ganwyoba da sxva. individis fsiqologiuri
Tvisebebis Camoyalibebaze mniSvnelovan gavlenas
axdens rogorc garemo, ise genetikurad
ganpirobebuli faqtorebi.
yoveli pirovneba ganumeorebelia garkveuli
Tvisebebis erTobliobiT, magram fsiqologebi mainc
gamoyofen pirovnebaTa garkveuli jgufisaTvis
damaxasiaTebeli saerTo Tvisebebis
Tanavarskvlaveds da am jgufs aerTianeben cnebiT:
“tipi”. pirovnebis tipologia Zalze Zvelia. maga-
liTad, hipokratem da galenma (129 Cv.w.aR-mde) safu-
Zveli Cauyares swavlebas temperamentis Sesaxeb.
temperamenti (laT. temperamentum – nawilebis
saTanado Sexameba) – individis kompleqsuri daxa-
siaTeba misi fsiqikuri moqmedebis dinamikuri
Tvisebebis anu calkeuli fsiqikuri procesebis
tempis, siCqaris, ritmis, intensivobis mixedviT.
temperamenti yalibdeba adamianis piradi gamoc-
dilebiT misi genetikurad ganpirobebuli nervuli
sistemis tipis safuZvelze da igi mniSvnelovnad
gansazRvravs adamianis cxovrebis stils. amrigad,
temperamenti pirovnebis biologiurad
ganpirobebul qvestruqturas warmoadgens.
sxvagvarad rom vTqvaT, temperamentze
saubrisas, igulisxmeba adamianebs Soris arsebuli
mravali fsiqikuri gansxvaveba: emociuri reagirebis

44
siRrmeSi, intensivobaSi da mdgradobaSi, emociur
STambeWdaobaSi, tempSi, moqmedebaTa energiulobaSi,
fsiqikuri moqmedebis da qcevis sxva dinamikur,
individualurad myar TaviseburebebSi. mraval-
ferovan midgomaTa miuxedavad, mecnierebi aRiareben,
rom temperamenti – biologiuri fundamentia,
romelzedac formirdeba pirovneba, rogorc
socialuri arseba. temperamenti asaxavs qcevis
dinamikur, upiratesad Tandayolil aspeqtebs,
amitom pirovnebis sxva fsiqikur Tavise-burebebTan
SedarebiT igi gansakuTrebiT mtkicea da myari.
rogorc aRvniSneT, swavleba temperamentis
Sesaxeb ukavSirdeba hopokrates (460-377 Cv.w.aR-mde)
saxels. hipokratem organizmSi 4 ZiriTadi siTxis
(sisxli, naRveli, Savi naRveli da lorwo)
garkveuli SefardebiT arsebobis safuZvelze
temperamentis 4 tipi gamoyo. misi azriT, romelime
siTxis siWarbe gansazRvravs konkretul tempe-
raments: sisxlis – sangvinikurs, naRvlis –
qolerikuls, lorwosi – flegmatikurs da Savi
naRvlis – melanqolikurs. sangvinikuri tipi
xasiaTdeba emociurobiT, grZnobebis swrafi
aRmocenebiTa da mswraflve gaqrobiT, amasTan,
emociebi upiratesad dadebiTia. qoleriki – moZravi,
energiuli tipia, romelsac emociebi SesaZloa
advilad aRmoucendes, magram umetesad uaryofiTia
da swrafad ar qreba. flegmatiks grZnobebi Znelad
uCndeba, magram isini mtkice da seriozulia,
Warbobs dadebiTi grZnobebi. melanqoliks
grZnobebi aseve Znelad uCndeba, magram isini
umetesad usiamovno, uaryofiTia.
Tu samedicino profesiis warmomadgenels
garkveuli warmodgena aqvs pirovnebis temperamentis
Sesaxeb, mas SeuZlia winaswar gansazRvros
avadmyofobaze pacientis emociuri reagirebis tipi.
magaliTad, emociurad labiluri pacientebi
meryeoben sasowarkveTilebasa da optimizms Soris,

45
xolo emociurad SedarebiT civi adamianebi -
windaxedulobas da gonierebas iCenen.
xSirad, samecniero literaturaSi terminebi:
“temperamenti” da “xasiaTi”, “pirovneba” da
“xasiaTi” – sinonimebad ixmareba. magaliTad, zogi
avtori xasiaTs ganixilavs pirovnebis
qvestruqturad an, piriqiT, pirovnebas aRiqvams
xasiaTis specifikur nawilad. msgavsi koliziebidan
Tavis dasaRwevad mowodebulia Semdegi ganmarteba:
xasiaTi – viwro mniSvnelobiT, ganisazRvreba
rogorc garkveul pirobebSi adamianis Cveuli
qcevis individualuri, SedarebiT myari sistema.
sxvagvarad rom vTqvaT, xasiaTi aris konkretuli
pirovnebis urTierTobebis, Tvisebebis da emociuri
reagirebis xerxebis stabiluri struqtura, rac
unikalur pirovnul birTvs warmoadgens da
winaswarganpirobebulia memkvidruli faqtorebiT,
romlebic modificirebulia cxovrebiseuli
gamocdilebiTa da garemos zegavleniT.
xasiaTis Tvisebebi exmareba an xels uSlis
pirovnebas adekvaturi urTierToba daamyaros
adamianebTan, gamoavlinos TavSekaveba rTuli
cxovrebiseuli sakiTxebis gadaWrisas, pasuxi agos
Tavis saqcielze. pirovnebis struqturaSi swored
xasiaTi asaxavs pirovnul mTlianobas. xasiaTs da
temperaments saerTo fiziologiuri safuZveli aqvT
– nervuli sistema. xasiaTis formireba swored
temperamentis Tvisebebzea damokidebuli, magram
mTavar rols mainc socialuri urTierTqmedebis
formebi TamaSoben.
xasiaTi Semdeg socialur ganfenilobebSi
vlindeba:
 sxva adamianebis mimarT damokidebuleba
(gulRia an gulCaTxrobili, alali an
matyuara, faqizi an uxeSi);
 saqmisadmi damokidebuleba (pasuxismgebloba
an arakeTilsindisiereba);

46
  sakuTari Tavis mimarT damokidebuleba
(TviTkritikuloba an TviTdarwmuneba, siamaye
an Tavmdabloba);
 kerZo sakuTrebis mimarT damokidebuleba
(guluxvoba an sixarbe, mimWirneoba an
mflangveloba).
gansakuTrebuli yuradReba eqceva xasiaTis
klasifikacias. xasiaTi SeiZleba iyos normaluri,
aqcentuirebuli (normis ukiduresi variantebi) da
paTologiuri (fsiqopaTiebi). k.leonhardis (1904-1988)
mier Seqmnili aqcentuirebuli xasiaTis tipologia
10 ZiriTad variants moicavs (mag.: hiperTimiuli,
disTimiuri, emociuri, demonstraciuli, pedanturi
da sxv.). rac Seexeba fsiqopaTiebs, isini sxvadasxva
formis pirovnuli aSlilobis saxeliT mcire
fsiqiatriis kursSi Seiswavleba.
k.g. iungis mier mowodebuli xasiaTis klasi-
fikaciaSi aqcenti gadatanilia gare an Sinagani
samyaros mimarT pirovnebis dominirebul orien-
taciaze da, Sesabamisad, gamoyofilia ori ZiriTadi
tipi – eqstraverti da introverti. eqstraver-
tebisaTvis damaxasiaTebelia kontaqturoba, inicia-
tivis xelSi aReba, moqnili qceva, impulsuroba,
socialuri adaptaciis unari. introvertebi fiqsir-
debian sakuTar, Sinagan samyaroze, arian gul-
CaTxrobilni, socialurad pasiurebi, midrekilebas
avlenen TviTanalizisadmi, uWirT socialuri
adaptacia.
pirovnebis tipebis Sesaxeb swavlebaSi
saintereso mimarTulebaa konstituciuri tipo-
logia. am mimarTulebis fuZemdeblis, franc ioseb
galis frenologia fsiqikuri funqciebis inten-
sivobas da Taviseburebebs gansazRvravda Tavis
qalas formis Sesabamisad (galis azriT, qalas
forma “ergeba” Tavis tvinis formas, romelSic 27
ubania da TiToeuli gansazRvravs konkretul
Tvisebas, mag.: bavSvebis siyvaruls, sixarbes, iu-

47
moris grZnobas da sxv.). Cezare lombrozos
fiziognomika akavSirebda damnaSavis tips saxis
nakvTebs da formis TaviseburebebTan (win
wamoweuli ybebi da yvrimalebi, ukan wakveTili
Subli, yuris farTo niJarebi).
pirovnebis Sesaxeb mravali Teoria arsebobs.
biologiur TeoriebSi gamoTqmulia mosazreba, rom
pirovnebas gansazRvravs genetikuri faqtorebi, rac
dasturdeba sxvadasxva TaobaSi gamovlenili
msgavsi xasiaTobrivi TaviseburebebiT. magaliTad,
hans aizenki Tvlida, rom introvertebs aqvT
momatebuli kortikaluri reaqcia, rac saSualebas
aZlevT maT Tavi aaridon stimulacias. meore mxriv,
aizenks miaCnda, rom eqstravertebis susti
kortikaluri reaqcia iwvevs maT mier mastimu-
lirebeli situaciebis mudmiv Ziebas. qceviTi Teo-
riebi aviTareben mosazrebas, rom pirovneba aris
individualuris da garemos urTierTqmedebis “Se-
degi”. am mimdinareobis warmomadgenlebi (b.skineri,
a.bandura), swavlobdnen mxolod gamoxatul da
gazomvad qcevas da uaryofdnen im Teoriebs,
romlebic fokusirdebian adamianur gancdebsa da
azrebze. pirovnebis fsiqodinamikuri Teoriebis
safuZveli gaxda zigmund froidis Sromebi,
romlebSic asaxulia pirovnebis CamoyalibebaSi
aracnobieris zemoqmedebis da bavSvobisdroindeli
gamocdilebis roli. humanisturi Teoriebi
pirovnebis CamoyalibebaSi umTavres mniSvnelobas
aniWebs Tavisufal nebas da individualur
gamocdilebas. k.rojersi da a.maslou gamoTqvamdnen
mosazrebas, rom pirovnebisaTvis umTavresia
TviTrealizacia, rac warmoadgens pirovnuli
zrdis Sinagan moTxovnilebas.
saWirod migvaCnia, mokled mimovixiloT
pirovnebis Teoriebidan zogierTi.

48
 dimitri uznaZe da ganwyobis Teoria
dimitri uznaZis (1886-1950) pirovnebis
koncefcia eyrdnoba cnebas “ganwyoba”, romelsac
igi mTavar fsiqologiur warmonaqmnad miiCnevda.
ganwyoba fsiqikis mTliani, globaluri mdgoma-
reobaa, romelic principulad gansxvavdeba indi-
vidis yvela sxva diferencirebuli procesisa da
fsiqikuri Taviseburebisagan. d.uznaZis mixedviT,
ganwyoba fsiqikur TvisebaTa maintegrirebeli da
mimarTulebis momcemi sawyisia. ganwyoba ewodeba “im
specifikur mdgomareobas, romelic subieqtSi
moTxovnilebis dakmayofilebis obieqturi situa-
ciis zegavlenis Sedegad Cndeba”. moTxovnilebisa
da misi dakmayofilebis situaciis Tanxvdomis
Sedegad warmoiqmneba garkveuli qcevis Sesrulebis
ganwyoba. amgvarad, ganwyoba iTvleba adamianis
qcevis mTavar maregulirebel meqanizmad da
gansazRvravs qcevis mizanmimarTulebas da Sefar-
debiT aqtivobas.
magram pirovnebis arsi ar SeiZleba dayvanili
iqnas mxolod ganwyobaze, aramed ganisazRvreba
cnobierebiTa da obieqtivaciis unariT. adamianis
pirovneba yovelTvis atarebs mTlianobis xasiaTs,
rac d.uznaZis mixedviT, yvela biologiuri da
fsiqologiuri funqciis “mowesrigebuli mTlia-
nobaa”. moTxovnilebis aRmocenebisTanave individi
dgeba garemosagan garkveuli urTierTobis damya-
rebis aucileblobis winaSe, xolo “garemo sinam-
dvile cocxali arsebis ara romelime momentze,
aramed masze rogorc mTlianze, rogorc subieqtze
moqmedebs... da efeqtic TviTon subieqtis
modifikacias warmoadgens.”

viqtor frankli da Tavisufali nebis Teoria

v.franklis (1905-1990) Tanaxmad, adamiani
arsebobs 3 doneze. biologiuri done aris yovelive
is, rac axasiaTebs adamians, rogorc biologiur

49
arsebas Sesabamisi struqturul-funqciuri warmo-
naqmnebiT; fsiqikuri done - TviT fsiqika, rogorc
“qcevis formirebisa da marTvis aparati”,
mimarTuli rogorc organizmis biologiuri, ise
pirovnebis socialuri moTxovnilebebis dakmayofi-
lebisaken; da socialuri (noeTiuri) done, romel-
Sic ”binadroben” cnebebi, zneoba, suliereba.
adamianis normaluri funqcionirebis arsia
biologiuri donis saSualebiT fsiqikuri aparatis
gare samyarosTan Sesatyvisi funqcionirebis uzrun-
velyofa, rac Tavis mxriv, socialur (noeTiuri)
doneze adekvatur funqcionirebas ganapirobebs.
TviT noeTiuri aqtivoba gulisxmobs pirovnebis
adekvatur TanamSromlobas anu integracias
sazogadoebis globalur sulierebaSi. TiToeuli
donis funqcia SesaZloa dairRves rogorc
sakuTari, ise zemdgomi parametrebis doneze,
amasTan, zemdgom dones garkveulad kompensirebis
unari gaaCnia. magaliTad, dReisaTvis cnobilia
rogorc biologiuri kompensatoruli meqanizmebi,
aseve socialur funqciaTa ganmsazRvreli fsiqo-
logiuri parametrebis kompensatoruli
SesaZleblobani. ufro farToa umaRles - noeTiur
(socialur) doneze kompensaciis SesaZleblobebi,
kerZod, pirovnuli pereorientaciis gziT sxva
azrobriv aqtivobaze gadasvla. Tu aucilebeli
kompensacia ar xorcieldeba, saubaria funqciis
darRvevaze anu daavadebaze, magram, roca es
darRveva Seexeba socialur dones, ar SeiZleba
misi, rogorc daavadebis, ganxilva. arsebuli
avadmyofuri cvlilebebis gamo socialuri
funqcionireba SesaZlebelia dairRves qvemo struq-
turebSic, magaliTad, biologiuri donis darRve-
vebiT gamowveul fsiqikur paTologias, Tavis mxriv
SeuZlia gamoiwvios socialuri qcevis Tavisuf-
lebis SezRudva an Secvla.

50
 socialuri garemo, eyrdnoba ra adamianis
biologiur Taviseburebebs, axdens misi cnobierebis
formirebas, gansazRvravs mis socialur-fsiqo-
logiur Taviseburebebs, qmnis ganumeorebel
pirovnul maxasiaTeblebs. amdenad, TviT pirovnebas,
formirdeba ra socializaciis procesSi, garemos
zemoqmedebiT SeiZleba Seecvalos faseulobaTa
mimarT orientacia anu misi umaRlesi, noeTiuri
ganzomileba, romelic gulisxmobs pirovnebis
socialur-zneobriv kodeqss - sindiss.
frankli Tavisufali nebis Teoriis mTavar
Tezisad aRiarebs imas, rom yoveli adamiani Tavisu-
falia ipovos cxovrebis sazrisi da moaxdinos
sakuTari SesaZleblobebis realizacia, im
SemTxvevebSic ki, Tu misi Tavisufleba obieqturi
mizezebiT SesamCnevadaa SezRuduli.

abraham maslou da saWiroebaTa ierarqia

koncepcia, saWiroebaTa ierarqiis Sesaxeb,
pirvelad 1943 wels gamoqveynda. a.masloum (1908-1970)
xazi gausva TviTrealizaciis/TviTaqtualizaciis
mniSvnelobas, romelic pirovnebis zrdisa da
ganviTarebis procesia. man ierarqiaSi 5 gansxva-
vebuli done gamohyo:
1. fiziologiuri saWiroebani: is bazisuri
moTxovnilebebia, rac aucilebelia fizikuri
gadarCenisaTvis (wyali, haeri, sakvebi da
Zili).
2. adamianisaTvis mniSvnelovania daculoba da
usafrTxoeba (magaliTad, dazRveuli janmr-
Teloba, daculi samuSao, usafrTxo
samezoblo da TavSesafari garemos mavne ze-
moqmedebisagan).
3. socialuri saWiroebani aerTianebs sakuT-
rebis, siyvarulis da emociur moTxov-
nilebebs. masve miekuTvneba urTierTobebi,
rogoricaa megobroba, romantikuli mijaWvu-

51
 loba, ojaxuri Tanadgoma da sxv., rac ayali-
bebs TemSi, sxvadasxva socialur Tu reli-
giur jgufebSi CarTulobas.
4. dafasebis moTxovnileba adamianisaTvis
mniSvnelovani xdeba, roca pirveli sami done
dakmayofilebulia. igi aerTianebs iseT
sakiTxebs, romlebic asaxavs TviTSefasebas,
pirovnul Rirsebas, socialur aRiarebasa da
miRwevebs.
5. TviTrealizacia (TviTaqtualizacia) adamia-
nis saWiroebaTa yvelaze maRali donea.
TviTrealizebuli adamiani aris
Tavdajerebuli, aqvs maRali TviT Sefaseba,
fiqrobs pirovnul zrdaze, demokratiulia,
aqvs filosofiuri xasiaTis iumoris grZnoba,
naklebad awuxebs sxvebis azri da
dainteresebulia sakuTari potencialis
srul realizaciaSi.

karl rojersi – samyaros Secnoba da asaxva

k. rojersis (1902-1987) saxeli asocirdeba
pirovneba-centrul TeoriasTan da mis Sesabamis
fsiqoTerapiasTan. rojersisaTvis yoveli individi
arsebobs gamocdilebaTa mudam cvalebad samyaroSi
da am samyaros centrs Tavad pirovneba war-
moadgens. igi gansakuTrebul Rirebulebas aniWebs
TviTaqtualizacias da pirovnebas ganixilavs ar
rogorc xasiaTis Tvisebebisa da qcevis paternebis
statikur mTlianobas, aramed rogorc dinamikur
fenomens, romelic aerTianebs mudmivad cvalebad
urTierTobebs, komunikaciebsa da warmodgenebs.
rojersis mier SemuSavebuli mkurnalobis
programa klientze orientirebuli fsiqoTerapiaa.
Terapevti cdiloba Seqmnas atmosfero, romelSic
klients SeuZlia gardaiqmnas da daiwyos TviTaq-
tualizaciisaTvis brZola. amasTan, Terapevti
avlens upirobo, pozitiur mzrunvelobas, rac

52
gulisxmobs klientis sruliad ukritiko
mimReblobas (mas iRebs iseTs, rogoric aris).

kurt levini da velis Teoria

kurt levinma (1890-1947), erTi mxriv, cnobili
fizikosebis faradeisa da maqsvelis aRmoCenebis da,
meore mxriv, geStaltfsiqologiis gavleniT Seqmna
sakuTari, e.w. velis Teoria. levinis TeoriaSi
pirovneba warmodgenilia daxSuli, sazRvrebSi
moqceuli figuriT da ganisazRvreba Semdegi Tvise-
bebiT:
 gare samyarosagan gamokveTili sazRvris
arseboba (diferenciacia),
 did samyarosTan CarTuloba (kavSiri: “nawili
– mTeli”).
uSualod pirovneba arasdros amyarebs
urTierTobas fizikur samyarosTan, romelic mis
garSemo arsebobs. pirovnebasa da fizikur samyaros
Soris moTavsebulia fsiqologiuri veli, romelic,
levinis azriT, elifsis formisaa. fsiqologiuri
veli aseve Caketilia. elifsis SigniT arsebul
sivrces levini sicocxlis vels uwodebs. igi
Seicavs im SesaZlo movlenebis erTobliobas,
romelsac adamianis qcevaze gavlenis moxdena Seu-
Zlia. igi aerTianebs yvelafers, rac aucilebelia
vicodeT, raTa mocemul fsiqologiur garemosa da
drois mocemul momentSi avxsnaT adamianis konk-
retuli qceva. TviT qceva, levinis Teoriis
Tanaxmad, sicocxlis velis funqciaa. dinamikuri
fsiqologiis amocanaa mocemuli individis qceva
gamoiyvanos im fsiqologiur movlenaTa erToblio-
bidan, rac arsebobs sicocxlis velis mocemul
momentSi.
movlenebs, romelic fizikur velSi sicocx-
lis velis sazRvarTan axlos mimdinareobs,
fsiqologiuri velis Secvla SeuZliaT. es xdeba
sicocxlis velis sazRvris gansakuTrebuli Tvi-

53
sebis gamo – is SeRwevadia iseve, rogorc pirov-
nuli sazRvari, ris gamoc movlenebi, romelic
fsiqologiur velze moqmedebs, Tavad pirovnebazec
aisaxeba.
levinma velis Teoria gamoiyena jgufur
fsiqoTerapiaSi. jgufuri dinamika aris urTierT-
zemoqmedeba, warmoqmnili jgufis wevrebSi, romel-
Tagan TiToeuli sxvebze aris damokidebuli. amde-
nad, jgufs SeuZlia zemoqmedeba moaxdinos pirov-
nebaze da man qceva Seicvalos, magram roca cvli-
leba moxdeba, Tavad pirovneba zegavlenas axdens
jgufze.

zigmund froidi da fsiqodinamika

fsiqodinamika - swavleba fsiqikis Sesaxeb –
arkvevs, Tu ra monawileobas iRebs fsiqika qcevis
motivaciaSi. igi efuZneba avstrieli eqim-nevropaTo-
logisa da fsiqiatris, zigmund froidis (1856-1939)
naSromebs. froidamdeli fsiqologiis kvlevis
obieqti iyo normaluri, fsiqikurad da fizikurad
janmrTeli adamiani, xolo mizani – cnobierebis
fenomenis eqsperimentuli Seswavla. froidi, ro-
gorc fsiqopaTologi, Seiswavlida ra nevrozebs,
waawyda adamianis fsiqikis iseT sferos, rac arse-
buli fsiqologiuri mimarTulebebis mxedvelobis
vels miRma darCa. z.froidis mier mowodebuli
fsiqoanalizi iSva, rogorc nevrozebisa da,
gansakuTrebiT, isteriis mkurnalobis meTodi,
Semdgom ki Camoyalibda, rogorc damouki-debeli
disciplina, romliTac filosofiurad aixsneba
Cveni yofis yvela sfero: xelovneba, politika,
ganaTleba da sxv.
fsiqikis asaxsnelad z.froidma ori didi
modeli Seqmna: topografiuli modeli da struq-
turuli anu pirovnebis modeli sami elementis
kombinaciiT. Tanamedrove fsiqodinamikuri Teoria
orive models iyenebs.

54
 a) topografiuli modeli: cnobieri, qvec-
nobieri da aracnobieri.
aracnobieri sfero – froidis yvelaze
mniSvnelovani aRmoCenaa, xolo ZiriTadi principia
– adamianis qcevis axsna aracnobieri fsiqikuri
procesebiT. topografiuli modeli fsiqikas 3
nawilad yofs. es dayofa efuZneba Cveni Semecnebis
unars, sxvadasxva xarisxiTa da siRrmiT Caswvdes
cnobierebis TiToeul nawils. es sferoebi
xelSesaxebi rodia, ar moicavs tvinis romelime
fizikur sferos an ubans da mxolod metaforuli,
Teoriuli konstruqciebia da klinikur
gamokvlevebSi gvexmareba.
cnobieri moicavs yvela im fiqrs da
grZnobas, rasac SevimecnebT rogorc gare samya-
rodan, ise qvecnobieridan (klasikur fsiqologiaSi
cnobiereba – obieqturi realobis subieqturi
gancdaa).
qvecnobieri aerTianebs Cvens mexsierebaSi
arsebul yvela ideas, grZnobas, mogonebas, rodesac
masze yuradRebis fokusireba xdeba. amrigad,
qvecnobieri Cveni maxsovrobis matarebelia.
qvecnobieris ZiriTadi funqciaa iyos
cenzori anu marTos da wesrigSi moiyvanos indi-
vidis fsiqika, daicvas cnobieri aracnobieri
fiqrebisagan, raTa ar moxdes SfoTvis, mousven-
robis generacia. cenzorma SesaZloa imoqmedos
sruli blokirebiT da aracnobierSi Senaxulma
masalam ar miaRwios cnobieramde, anda SeniRbulad,
raTa miwodebuli informacia ver “amoicnos” cno-
bierma.
magaliTad, axalgazrda gogonas seqsualuri
ltolva mamisadmi SesaZloa gadaizardos mniSvne-
lovan SfoTvaSi, Tu Seimecnebs mas, magram gogonas
cenzori anu qvecnobieri akavebs incestur impul-
sebs. cenzors ZaluZs daaxSos es seqsualuri

55
gancdebi an SeniRbos sawinaaRmdego Sinaarsis
gancdebiT (mag.: siZulvili). im SemTxvevaSi, Tu
gogona gamoiyenebs dacvis meqanizms (reaqciis
formireba), igi SeigrZnos mamis mimarT mxolod
antipaTias, xolo seqsualuri ltolva aracno-
bierSi damarxuli darCeba. ra Tqma unda, mamisadmi
gogonas antipaTia mxolod ase ar unda avxsnaT.
mizezi SeiZleba iyos realuri fizikuri travma
(mag.: cemiT dasja) an mamis mxridan uxeSi mopyroba.
adamianis fsiqikis aracnobieri sfero
warmodgenilia im azrebiT, impulsebiT, grZnobebiTa
da fantaziebiT, rasac cnobieris wvdomis farglebs
miRma rCeba da masze yuradRebis fokusireba ar
iwvevs am sferoSi Senaxuli informaciis
gacnobierebas.
aracnobierSi Senaxuli masala aRwevs cno-
biers, roca cenzori modunebulia (mag.: Zili,
hipnozi) an roca igi gadafaravs cnobiers da
Sedegad nevrozuli simptomebi Cndeba.
aracnobieri sfero garegan zemoqmedebas ar
emorCileba, mas verc ideologia imorCilebs. igi ar
kontroldeba cnobieriT da misgan damoukideblad
arsebobs. TviT cnobieri fsiqikis Camoyalibebis
procesSi gamokristaldeba aracnobierisagan.
yuradsaRebia isic, rom erTi adamianis aracno-
bierma, gacnobierebis gareSe, SesaZloa imoqmedos
meore individis aracnobierze.
uSualod aracnobieri, froidis azriT, Cven-
Tvis miuwvdomelia da masSi mimdinareobs fsiqikur
procesTa umravlesoba. adamianebi erTmaneTisagan
gansxvavdebian ara mxolod saarsebo pirobebiT,
SeZenili gamocdilebiT, genetikiT, aRzrdiT, aramed
aracnobieri sferoTic, sadac arsebobs siyvaruli
da usazRvro egoizmi, gulkeTiloba da simkacre,
siZulvili mamisadmi da erotikuli swrafva
dedisaken.

56
 froidis topografiuli modeli aseve
moicavs fsiqikuri procesebis or tips: pirveladi
da meoradi procesebi.
cnobieri da qvecnobieri sferoebis muSaoba
froidma miakuTvna meorad procesebs, vinaidan xa-
siaTdeba realuri samyaros gancdebiT. magaliTad,
meoradi fsiqikuri procesebi gvkarnaxoben, rom
dRevandeli dRe ar aris guSindeli an xvalindeli;
rom adamiani erTdroulad or adgilas ar SeiZleba
iyos.
pirveladi procesi aris araorganizebuli
gonebrivi aqtivoba, rac CvenTvis ucxoa, vinaidan
igi moqmedebs pirveladad Cvens aracnobierSi.
pirveladi fsiqikuri procesi ar emorCileba
logikas, ar gaaCnia droiTi ganfeniloba, savsea
aSkara winaaRmdegobebiTa da cvalebadobiT. igi
iswrafvis miiRos siamovneba imis miuxedavad, Tu ra
Sedegi mohyveba am qcevas realur samyaroSi (mag:
sizmrebi).
ukve aRvniSneT, rom pirvelad fsiqikur
procesebSi logikuri kanonebi ar moqmedebs, aramed
erTveba sul sxva meqanizmebi, rac pirvelad
procesebs aniWebs saocar eqscentrulobas, esenia:
1. simbolizmi _ obieqti an idea aRniSnavs sxva
rames, rac efuZneba msgavsebas originalsa da
Semcvlels Soris (mag.: penisi – banani)
2. kondensacia _ sxvadasxva azri an obieqti
SeTavsdeba erT simboloSi (mag.: mama, Sefi,
ministri ZilSi SeiZleba iyos erTi
pirovneba)
3. gadanacvleba _ emociebma, ideebma, survi-
lebma SesaZloa ganicadon transformacia
maTi Tavdapirveli obieqtidan (mag: brazi
mamis mimarT gadaitanos maswavlebelze).

57
 b) pirovnebis struqturuli modeli
froidis topografiuli modeli srulad ver
asaxavda yovelive imas, rasac eqimi pacientebTan
muSaobisas gadaawyda. froidma “individis
fsiqikuri aparati” 3-ad dahyo: Id (idi – “igi”), Ego
(ego – “me”), Super Ego (“superego” anu “ze-me”).
“idi” (Id) ewoda individis yvelaze Zireul,
bazisur biologiur stimulebsa da primitiul
impulsebs. ids xelmZRvanelobs siamovnebis
principi _ survilis warmoqmnisTanave misi sas-
wrafo dakmayofilebis tendencia, siamovnebis
dauyovnebeli miReba da tkivilis Tavidan acileba.
idSi gaerTianebulia tkivilisa da mZvinvarebis,
SimSilisa da wyurvilis gancdebi, seqsualuri
ltolva, agreTve TviTSenaxvisa da Tavdacvis
impulsebi.
“id”—is impulsebi da instinqtebi
aracnobieria. instinqturi ganzraxvebi, rasac Cveni
cnobieri wvdeba, rogorc wesi, cenzuragavlilia,
rac niSnavs, rom informacia “irecxeba”, raTa
gamoiyurebodes ufro respeqtabelurad.
froidma “id”-Si ori ZiriTadi (Tandayolili)
instinqti gamohyo:
 erosi _ TviTgadarCenisa da STamomavlobis
gagrZelebis instinqti
 Tanatosi _ swrafva sikvdilisaken,
destruqciisaken, ganadgurebisaken.
yoveldRiur saubarSi egos miewereba
egoizmisa da pativmoyvareobis Sinaarsi, magram am
termins sul sxva datvirTva aqvs fsiqologiaSi.
ego pirovnebis TvisebaTa is nawilia, romelic
erTveba adamianis yvela im unarSi (fiqrebSi, SegrZ-
nebebSi, grZnobebsa da moqmedebebSi), rasac igi
iyenebs, raTa moxdes idis Zlieri survilebis
harmonireba, erTi mxriv, garemos moTxovnilebebTan
da, meore mxriv, super-egos swrafvebTan da Sekave-
bebTan.
58
 ”ego” cdilobs daTrgunos da ufro dasaSvebi
aqcios instinqtebi. misi funqciebi umetesad
cnobieria da viTardeba mozardis garemosTan, Ziri-
Tadad, mSoblebTan da aRmzrdelebTan urTier-
Tobisas. egos ganviTarebisas, dacvis meqanizmebTan
erTad, yalibdeba pirovnebis iseTi inteleqtu-
aluri funqciebi, rogoricaa sazrianoba, gamWria-
xoba, daskvnis gamotanis unari, metyveleba.
janmrTeli egos matarebeli mowifuli individi
aris ufro moqnili sxvadasxva cxovrebiseuli
stresebis mimarT.
amrigad, ”ego” aris cnobieri sfero, Suama-
vali id-sa da gare samyaros Soris. individi Tavisi
ltolvebiT, siamovnebis miRebis surviliT (anu
idiT) ejaxeba gare samyaros realobas. am procesSi
gamoiyofa ego, romelic akavebs aracnobier
ltolvebs da mimarTavs maT socialurad dasaSvebi
qcevis kalapotSi.
mesame elementis, ”superegos” literaturul
analogad SeiZleba CaiTvalos buxris WriWina,
romelic pinoqios mxarze ajda da xis biWunas
winamZRoli iyo moralur da eTikur standartebSi.
froidma adamianis kritikuli azrovnebis unari
gaigo, rogorc calke Camoyalibebuli fsiqikuri
“organo”, romelic Tvalyurs adevnebs azrebs,
grZnobebs da moqmedebebs, afasebs maT da Semdeg
“me”-s funqcionirebas idealur standartebs
adarebs. CvenTvis es standartebi “idealuri mes”
saxeliTaa cnobili. amdenad, superegos aqvs
kritikuli da damsjeli funqciebic, romlebic
danaSaulis grZnobasa da cnobierebis qenjnas
iwveven. Tavisi SinaarsiT superego axlosaaa idTan
da, rogorc idis “rwmunebuli”, ewinaaRmdegeba “me”-
s, rasac SesaZloa Sinagani konfliqti mohyves da
gamovlindes fsiqikur darRvevebSi.

59
 karl gustav iungi da pirovnebis
analizis Teoria
k. iungis koncepcia garkveulwilad iziarebs
z. froidis mosazrebs, magram amave dros gansxva-
vebulicaa. igi amtkicebda, rom suli (iungis Teo-
riaSi pirovnebis analogi) sami damoukidebeli,
magram urTierTdakavSirebuli struqturisagan
Sedgeba: ego, sakuTari aracnobieri da koleqtiuri
aracnobieri.
“ego” cnobieri sferos centrs warmoadgens
da aerTianebs yvela azrs, grZnobas, mogonebas da
SegrZnebas, romliTac Cven SevigrZnobT sakuTar
mTlianobas, mudmivobas da Tavs adamianad
aRviqvamT. ego Cveni TviTSegnebis safuZvelia da
misi wyalobiT vamCnevT sakuTari Segnebuli
moRvaweobis Sedegebs.
piradi aracnobieri aerTianebs konfliqtebsa
da mogonebebs, romlebsac rodesRac vacnobie-
rebdiT, magram amJamad daTrgunuli da daviwye-
bulia. masSi moqceulia yvela grZnobadi STabeW-
dileba, romelTac akliaT mkafio ferebi, raTa
cnobierebaSi kvali datovon. iungis azriT, piradi
aracnobierSi inaxeba kompleqsebi anu emociurad
damuxtuli azrebis, grZnobebis da mogonebebis
grovebi, romlebic individis mier gamotanilia
sakuTari warsuli gamocdilebidan an memkvidruli,
gvarovnuli gamocdilebidan. am kompleqsebs,
Tavmoyrils sruliad Cveulebrivi Temebis irgvliv,
SeuZliaT mniSvnelovani gavlena moaxdinon indi-
vidis qcevaze. mag: adamiani, Zalauflebis
kompleqsiT, did fsiqikur energias xarjavs Zala-
uflebis TemasTan uSualod an iribad dakav-
Sirebul moRvaweobaze. iungi Tvlida, rom sakuTari
aracnobieris masala unikaluri TiToeuli adamia-
nisaTvis da, rogorc wesi, gacnobierebisaTvis
misawvdomia.

60
 iungis mixedviT, pirovnebis struqturaSi
yvelaze Rrma Srea koleqtiuri aracnobieri. igi
warmoadgens kacobriobis (da TviT adamianismagvari
winaprebis) mexsierebis latenturi kvalis sacavs.
masSi aisaxeba yvela adamianisaTvis saerTo azrebi
da grZnobebi, rac Cveni saerTo, emociuri warsulis
Sedegad warmoiSva. iungi Tvlida, rom koleqtiuri
aracnobieri Zlieri pirveladi fsiqikuri xatebidan
- e.w. arqetipebidan, Sedgeba. arqetipebi is
Tandayolili ideebi da mogonebebia, romlebic
winawar ganawyobs adamianebs garkveuli saxiT
aRiqvas, ganicados da reagireba moaxdinos movle-
nebze. sinamdvileSi, es arc mogonebebia da arc
xatebi, ufro sworad, midrekilebaa, romlis gavle-
niTac adamianebi romelime obieqtis an movlenis
sapasuxod sakuTar saqcielSi aRqmis, azrovnebis da
qmedebis universaluri modelebis realizebas
axdenen. Tandayolilia swored konkretul situa-
ciaSi emociuri, kognitiuri da qceviTi reagirebis
tendenciebi – magaliTad, moulodneli Sexvedra
mSobelTan, sayvarel adamianTan, ucnobTan,
sikvdilTan Tu qvewarmavalTan.
koleqtiur aracnobierSi arqetipebis raode-
noba SeuzRudavia. aseT arqetipul simboloebs
miekuTvneba, magaliTad, anima – qaluri sawyisis
simbolo mamakacis aracnobierSi da animusis –
mamakacis sawyisi qalebis koleqtiur aracnobierSi.
magram yuradReba SevaCeroT personaze. persona
(pirovneba) Cveni sazogadoebrivi saxea, anu rogor
vavlenT Tavs sxva adamianebTan urTierTobaSi. igi
aRniSnavs mraval rols, romelsac vTamaSobT
socialuri moTxovnilebebis Sesabamisad. persona,
rogorc arqetipi, aucilebelia, raTa yoveldRiur
cxovrebaSi sxva adamianebs SeveTvisoT.
iungma gansakuTrebuli wvlili Seitana
tipologiaSi, dahyo ra adamianebi eqstravertebad
da introvertebad. ori ZiriTadi mimarTuloba -

61
eqstraversia da introversia - adamianSi Tana-
arsebobs, magram, Cveulebriv, erTi dominanturi
xdeba. eqstraversiul ganwyobaSi interesebis
mimarTuloba vlindeba gare samyaros – sxva
adamianebis, sagnebis – mimarT. eqstraverti advilad
amyarebs kavSirebs da mijaWvulobebs, gare faqto-
rebi misi mamoZravebeli Zalaa. introverti ki,
piriqiT, Caflulia sakuTar Sinagan samyaroSi,
midrekilia obieqtebisagan ganSorebisaken, gareg-
nulad Tamami ar aris, sazogadoebaSi daurwmu-
neblad iqceva, misi interesebi sakuTar Tavzea
gadatanili. iungis mixedviT, es ori ganwyoba
opoziciurad Tanaarsebobs adamianSi da Tu erTia
dominanturi da racionaluri, meore - damxmare da
iracionaluri xdeba.
iungiseuli fsiqoTerapiis ZiriTadi mizania
miRweuli iqnas individualizacia – procesi, ro-
melic mTeli cxovrebis manZilze mimdinareobs da
pirovnebas aniWebs unikalur identobas. ganvi-
Tarebis am procesma adamians SesaZloa axali gzebi
apovninos, rac adreuli cxovrebiseuli svlage-
zidan mniSvnelovnad gansxvavebuli iqneba.

fsiqologiuri Tavdacvis meqanizmebi

TiToeuli CvenTagani sxvadasxva xerxs,
teqnikas mimarTavs, raTa moixsnas daZabuloba an
Tavi daicvas mtkivneuli grZnobebisa da
gancdebisagan. amave dros, Cvens mier Catarebuli
TavdacviTi manevrebi upiratesad gacnobierebuli
rodia. dacvis meqanizmi ewodeba im teqnikas,
romelsac aracnobierad mivmarTavT SfoTvis
Semsubuqebis da intrafsiqikuri konfliqtis likvi-
daciis mizniT. ganirCeva umwifari (Immature) da
mwife (Mature) dacvis meqanizmebi.
adreuli, umwifari dacvis meqanizmebi,
marTalia, individs distresisagan icavs, magram
uxeSad arRvevs realobas. aqve unda ganvmartoT,

62
rom stresi aris araspecifikuri adaptaciuri
reaqcia, romelic mudmivad arsebobs da aRmocen-
deba organizmis cxovelmyofelobis procesSi.
gansxvavebiT, distresi aris saziano, uaryofiTi
stresuli zemoqmedeba.
represia (Repression _ daTrgunva, CaxSoba) -
dacvis erT-erTi ZiriTadi meqanizmi - Zlier hgavs
daviwyebis fenomens. igi akavebs moZalebul fiqrebs,
warsulis faqtebs Tu grZnobebs da aqtiurad icavs
Cvens fsiqikas maTi gacnobierebisagan. magaliTad,
represirebuli mogonebebi bavSvobaSi gadatanil
Zaladobaze pirovnebas ar aZlevs normaluri
interpersonaluri urTierTobebis Camoyalibebis
saSualebas. represia pasuxs agebs maxsovrobis
gadacdenaze (mag.: saSiSi gamocdis dRis an saaTis
daviwyeba) an TvalSisacem auxsnel gulubryvi-
lobaze. represiis Sedegia aSkara ignorireba,
rasac Tan sdevs simboluri qceva, rac imaze miuTi-
Tebs, rom daTrgunuli masala realurad daviw-
yebuli araa. magaliTad, qali ar acnobierebs Tavis
simpaTias eqimisadmi, magram konsultaciaze
wasasvlelad roca emzadeba, macdurad icvams.
represia gvicavs Cveni sakuTari fiqrebisa da
grZnobebis amocnobisagan, maSin roca meore
meqanizmi - uaryofa (Denial), icavs Cvens cnobierebas
garemo realobisagan.
uaryofa (Denial) – erT-erTi yvelaze cnobili
dacvis meqanizmia. am dros gare realoba ugulebe-
lyofilia, raTa individma tkivils da SfoTvas
Tavi aaridos. uaryofa xSirad iwvevs fiqrebis da
qcevis Zlier damaxinjebas. magaliTad, mamakaci
uaryofs colis gardacvalebis faqts da masTan,
rogorc cocxalTan, agrZelebs saubars.
literaturaSi es fenomeni m.javaxiSvils (“TeTri
kurdReli”) aqvs aRwerili. Cveulebriv, adamianebi
iyeneben uaryofas, raTa Tavidan aicilon fizikuri
daavadebis faqti. aseTi adamiani gadadebs eqimTan
63
konsultacias manam, sanam dagvianebuli ar iqneba.
kidev erTi klasikuri magaliTia, roca
alkoholizmiT an narkomaniiT daavadebuli
uaryofs problemis arsebobas.
gadanacvleba (Displacement) mimarTulebas
ucvlis sawyisi obieqtis mimarT arsebul grZnobebs
ufro metad misaReb an naklebad saSiS obieqtze
(mag.: ufrosze gabrazebuli kaci, javrs ojaxis
wevrebze an Sinaur cxovelebze iyris).
inteleqtualizacia (Intellectualization) -
SfoTvis Semsubuqeba xdeba movlenebis civi gonebiT
gansjis gziT. dacvis es meqanizmi saSualebas
gvaZlevs Tavi avaridoT situaciis stresul,
emociur aspeqtebze fiqrs da koncentracia
movaxdinoT mxolod inteleqtualur komponentze.
magaliTad, letaluri daavadebis diagnozis
Setyobis Semdeg, pacienti iwyebs daavadebis
irgvliv arsebuli informaciis Seswavlas.
racionalizacia (Rationalization) dacvis
meqanizmia, romelic miuRebel qcevas da grZnobebs
xsnis racionaluri an logikuri kavSir-
urTierTobebis damyarebis gziT. magaliTad,
studenti gamocdaze miRebul dabal SefasebaSi
adanaSaulebs pedagogs da ara - momzadebis dabal
dones. SfoTvis prevenciis garda, racionalizacia
icavs pirovnebis TviTSefasebas. magaliTad,
adamiani nebismier warmatebas sakuTar unar-
SesaZleblobebs ukavSirebs, xolo yvela marcxSi
sxva adamians adanaSaulebs.
operireba/gaTamaSeba (Acting out - dadgma) aris
termini, romliTac eqimebi aRweren avadmyofis
qcevis im Taviseburebebs, rac ar moswonT. igi
gulisxmobs aracnobier survilebze, impulsebze
qcevebiT zemoqmedebis process, riTic adamiani
iridebs Tanmxleb emociebs. magaliTad, mamakaci
misTvis aradamaxasiaTebeli uzrdelobiT iqceva da,
amave dros, ar acnobierebs, rom moswons eqimi.
64
 proeqcia (Projection) aris procesi, roca
sakuTar, magram miuRebel, Tvisebebs an grZnobebs
pirovneba sxva adamians miawers. magaliTad,
mamakaci, romelic aracnobieri homoseqsualuri
impulsebis daZlevisaTvis ibrZvis, acxadebs, rom
quCaSi yvela mamakaci misi misamarTiT
homoseqsualur winadadebebs isvris. ama Tu im
rasis sawinaaRmdego ganwyoba, aseve crurwmenebi
swored proeqciazea dafuZnebuli.
gaxleCa/dayofa (Splitting) - ama Tu im movlenis
pozitiur da negatiur aspeqtebad dayofa (“yvela-
feri kargisa” da “yvelaferi cudis” imiji). isini,
vinc gaxleCas iyeneben, rogorc dacvis meqanizms,
samyaros Sav da TeTr ferebad hyofen. es amsubuqebs
SfoTvas, rac iwyeba ambivalenturobis Secnobisas
(mag., “gagiJebamde” Seyvareba).
reaqciis formirebas (Reaction formation) adgili
aqvs maSin, roca uaryofilia miuRebeli aracno-
bieri impulsebi da mis nacvlad SeTvisebulia
cnobieris gansxvavebuli pozicia da qceva.
magaliTad, mamakaci, romlis seqsualuri ltolva
Zlier daTrgunulia, SesaZloa saTaveSi Caudges
gamomcemlobis cenzuras. qali, romelsac
aracnobierad sZuls bavSvi, mis mimarT
gadaWarbebul mzrunvelobas iCens.
regresia (Regression). zogjer, stresuli
movlenebisas, adamiani qcevis im modelze gadadis,
rac ganviTarebis adreul stadiaze hqonda. ana
froidis azriT, adamiani irCevs qcevas fsiqoseqsua-
luri ganviTarebis im stadiidan, romelzec fiqsa-
cia moxda. (fiqsacia aris fsiqikur ganviTarebaSi
adreuli fazebis tendencia, aiTvisos da
SeinarCunos fsiqikuri energiis Zlieri “muxti”.)
magaliTad, roca pirovneba yovel usiamovno ambavze
tiriliT an gabutviT reagirebs, unda vivaraudoT,
rom igi ganviTarebis adreul stadiaze aris
“miwebebuli” anu fiqsirebuli. amdenad, regresiis
65
dros gamovlenili qceva mniSvnelovnad aris
damokidebuli imaze, Tu romel stadiaSi
ganviTarda fiqsacia. iTvleba, rom oralur
stadiaze fiqsirebuli pirovneba stresul viTa-
rebaSi uzomod Wamas an sigaretis moxmarebas iwyebs
an verbalur (sityvier) agresias avlens, xolo
analur stadiaze fiqsirebuls axasiaTebs
gadaWarbebuli sisufTave an, piriqiT, sruli
uwesrigoba.
konversiisas (Conversion _ gardaqmna) yvela is
aracnobieri konfliqti, rac SfoTvas iwvevs,
gardaiqmneba da simbolur gamoxatulebas iZens
romelime fizikuri simptomis saxiT (mag: isteriuli
sibrmave, dambla, mutizmi). magaliTad, qals,
romelsac moulodnelad gauSeSda xeli, miewoda
aracnobieri impuls, meuRle daeWra.
afeqtis izolacia (Isolation of affect) _ grZno-
bebisa da azrebis daSoreba. magaliTad, mamakaci,
romelic gaSmagebulia Tavis colze, SesaZloa arc
ki grZnobdes brazs, magram emociebis gareSe
fiqrobs colisaTvis zianis miyenebaze. afeqtis
izolacia SesaZloa zogjer dadebiTic iyos.
magaliTad, eqimis yoveldRiuri zrunva pacientze,
romelic tkiviliT itanjeba, saWiroebs fiqrebis
emociisagan daSorebas, raTa eqimma muSaobis
gagrZeleba efeqturad SeZlos.
retrofleqsia (Retroflection _ sakuTari Tavis
winaaRmdeg Sebruneba) - pirovnebisaTvis sazogadod
miuRebeli impulsebi da grZnobebi (mag.: mtroba)
misaRebi xdeba gamomwvevi obieqtidan sakuTar Tavze
gadataniT. magaliTad, qali, romelic fizikurad
Seuxedavma qmarma miatova, iwyebs sakuTari Tavis
lanZRvas, TviTdamcirebas, rom is cudi coli iyo.
ipoqondria (Hypochondriasis) axlos dgas
retrofleqsiasTan. am SemTxvevaSi emociebis,
grZnobebis transformacia xdeba somaturi xasiaTis
CivilebSi, rac pirovnebas saSualebas aZlevs
66
itiros, iwuwunos sakuTar mdgomareobaze nacvlad
imisa, rom sxvis mimarT gamoTqvas ukmayofileba.

fsiqologiuri dacvis
srulyofili meqanizmebi
iTvleba, rom SedarebiT janmrTeli pirov-
nebebi SfoTvisa da intrafsiqikuri konfliqtis
Sesamsubuqeblad Semdegi dacviTi meqanizmebiT
sargebloben:
altruizmi (Altruism) - sxvisTvis konstruq-
ciuli da instinqturi siamovnebis miniWeba (mag.:
filantropia, mecenatoba). reaqciis formirebisagan
gansxvavebiT, altruizmi kmayofilebas aniWebs
individs.
iumori (Humor) - ganasaxierebs Cvens SesaZleb-
lobebs, gamovxatoT grZnobebi. igi fokusSi aqcevs
SfoTvis aRmZvrel fiqrebs yovelgvari mwuxarebis
gamowvevis gareSe. magaliTad, akrZaluli survili
SesaZloa gamoixatos komikur, ironiul elferSi
da ar imoqmedos pirovnebaze.
supresia (Suppression) - pirovneba, Tu usiamovno
obieqts yuradRebas miaqcevs, moqmedebs cnobieris
gadawyvetilebis mixedviT. represiisagan gansxva-
vebiT, supresias cnobieri akontrolebs - individi
Tavs ki ar aridebs problemis gadaWras, aramed
gadadebs garkveuli droiT. magaliTad, litera-
turuli gmiri skarleti - “I’ll think about that tomorrow! -
amaze xval vifiqreb.”
anticipaciisas (Anticipation - molodini) pirov-
neba momaval diskomforts realisturad gegmavs,
raTa daaqveiTos SfoTva. magaliTad, sayvarel
adamianTan gardauvali daSorebis winaswari
dagegmva.
sublimacia (Sublimation) _ gulisxmobs miuRe-
beli instinqturi mamoZravebeli impulsebis
(seqsualuri da agresiuli) gadatanas pirovnulad
da socialurad misaReb formebSi. magaliTad,
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sportuli TamaSobani, sadac agresia “moTvini-
erebulia” da ara – Sekavebuli. mravali xelovanis
artistuli monacemebi sublimirebuli libiduri
energia aris.

alfred adleri da
individualuri fsiqologia
a.adleris (1870-1937) individualuri
fsiqologia froidis swavlebis wiaRSi iSva, magram,
Tavisi arsiT, socialuria, radgan did yuradRebas
uTmobs fsiqikuri ganviTarebis sazogadoebriv
determinirebulobas. individualuri fsiqologia
adamianis cxovrebas ganixilavs rogorc mTlia-
nobas, xolo calkeul reaqcias, calkeul moZraobas
Tu impulss miiCnevs individualuri cxovrebiseuli
ganwyobis gamovlinebad.
am Teoriis konteqstSi yuradRebas gavamaxvi-
lebT ramdenime sakiTxze: agresiuloba, arasrul-
fasovnebis kompleqsi da kompensacia, dabadebis
rigiToba.
adleris pirveladi interesis sagani iyo
agresiulobis instinqti. agresiuloba gamovlindeba
ZalauflebisaTvis brZolaSi da igi mamakacur
Tvisebad aRiqmeba. adlerma Semoitana cneba “mama-
kacuri protesti”, riTac aRwera qaluri da pasiuri
rolidan gadasvla mamakacur da aqtiur rolSi.
adlerma agreTve Semoitana “organoTa
arasrulfasovnebis” cneba. konstituciuri sisuste,
gulis manki, kuzi, enabluoba Tu cacioba – bavSvSi
mniSvnelovan gavlenas axdens mis pirovnul
ganviTarebaze da aZlierebs ususurobisa da
arasrulfasovnebis gancdas. organoTa arasrul-
fasovnebis koncepcia adlerma ganavrco adamianis
yvela im (rogorc somatur, ise fsiqikur) funqciaze,
romelic an defeqturia, an kargad ganviTarebuli
ar aris da mas arasrulfasovnebis kompleqsi uwoda.
is gulisxmobs ususurobis da araadekvaturobis

68
gancdas, riTic yvela adamiani ibadeba, magram
ganviTarebis procesSi unda daZlios. fsiqikuri
procesebi, romelic, erTi mxriv, TviTSenaxvas
(TviTdamkvidrebis moTxovnileba), xolo, meore
mxriv, adamianis meore adamianTan kontaqts (socia-
lurobis moTxovnileba) emsaxureba, harmoniulia iq,
sadac aris wonasworoba TviTdamkvidrebis da
socialurobis moTxovnilebebs Soris.
organoTa arasrulfasovnebaze adamianis
reaqcia SeiZleba iyos araadekvaturi, rac gamoi-
xateba arasrulfasovnebis gancdiT anu pirovneba
Tavs aridebs adamianebs, kargavs sakuTari Tavis
rwmenas, aqvs gaucxovebis gancda, kargavs siTamames.
sapirispiro reaqciaa hiperkompensacia: adamiani ara
marto avsebs defeqts, aramed axdens dazianebuli
sferos funqciis hipertrofirebas (demosfenma,
dasZlia ra metyvelebis defeqti, saukeTeso ora-
tori gaxda) an cvlis mas sxva tipis intensiuri
moRvaweobiT, riTac axerxebs gamorCevas (tuluz
lotrekis xelovneba) an Zalauflebas imkvidrebs
(politikuri moRvaweobis sfero).
adleris kidev erTi saintereso mignebaa
bavSvis dabadebis rigiTobis kavSiri mis mier
arCeul cxovrebis stilTan. pirvelSobili bavSvi
yovelTvis reagirebs siblingis (da/Zma) SeZenaze da
gaRizianebulia, radgan mSobelTa yuradRebis da
“erTaderTis” brwyinvale poziciis daTmoba mouwevs.
siblingis mimarT eWvianoba SeiZleba gamovlindes
regresuli qceviT – enuresis an TiTis wovis saxiT.
meore bavSvs Tanasworoba surs da ufross xelidan
aclis Zalauflebas. nabolara, romelsac veravin
Secvlis, “marad umcrosis” momgebian poziciaSi
rCeba. kvlevebiT dadasturebulia adleris
mosazrebis marTebuloba – pirvelSobili metadaa
warmatebaze orientirebuli, gamoirCeva maRali
akademiuri moswrebiT da avtoritarulia; SuaTana
bavSvi, rogorc wesi, nakleb yuradRebas iRebs da

69
amitom SesaZlebelia Camoayalibos myari
partnioruli urTierTobebi, xolo nabolara,
zedmeti yuradRebisa da gadaWarbebuli mzrunve-
lobis gamo, SeiZleba ubralod gafuWdes.
mniSvnelovania adleris roli mcire
fsiqiatriaSi. igi nevrozsac ganixilavda, rogorc
kompensacias, romelic adamians gadawyvetilebis
miRebas uadvilebs (mag.: bavSvs, romelsac skolaSi
wasvlis eSinia, dilaobiT pirRebineba aReniSneba).
nevrozis SemTxvevaSi, saubaria dasaxuli miznis
farul ganxorcielebaze, rasac normaluri gziT
pirovneba ver miaRwevda. amitom nevrozis
mkurnalobaSi adleris Terapiuli midgoma
gulisxmobs pacientis waxalisebas, raTa man
daZlios arasrulfasovnebis gancda. umniSvnelo-
vanesi roli ekisreba mcdelobas – mivceT pacients
swori cxovrebiseuli mizani, rom gansazRvros
cxovrebis swori xazi. adlers miaCnda, rom
pacientma unda gaacnobieros sakuTari Zalebi da
SesaZleblobebi da ganaviTaros rwmena sakuTar
Rirsebasa da RirebulebaSi. zogadad, adamianma
sakuTari Tavi samsaxurSi, qorwinebasa da sxva
socialur konteqstebSi unda gamoavlinos.
amisaTvis ki aucilebelia swori cxovrebiseuli
xazi, kargi aRzrda an, saWiroebisamebr, fsiqoTe-
rapia, mimarTuli cxovrebiseuli gambedaobis
stimulirebisaken.

70
 Tavi IV

pirovnebis ganviTarebis asakobrivi aspeqtebi

cxovrebis cikli - es aris farTo

zogadmecnieruli cneba, romelic asaxvs adamianis,
rogorc biologiuri, fsiqologiuri da socialuri
arsebis ganviTarebas, mis progress dabadebidan
sikvdilamde. arsebobs ramdenime msgavsi termini,
romelTa arsi garkveulwilad gansxvavdeba “cxov-
rebis ciklis” gagebidan. “sicocxlis periodi”
warmoadgens drois intervals individis daba-
debidan sikvdilamde da ar asaxavs am periodis
Sinaarss. “cxovrebis gza” - ufro farTo
mniSvnelobis terminia da ZiriTadad pirovnebis
fsiqologiuri da socialuri progresis maCve-
nebelia. cxovrebis cikli gulisxmobs pirovnebis
ganviTarebis met-naklebad invariantul, ganmeorebad
aspeqtebs. es SeiZleba iyos biologiuri ciklebi
(dabadeba, zrda, momwifeba, dabereba, kvdoma) – e.w.
“ontogenezi”, socialuri ciklebi (gansazRvruli
SromiTi, ojaxuri da sxva socialuri rolebis
aTvisebis, realizaciis da dakargvis periodebi) da
Sereuli bio-socialuri periodebi (asakobrivi
periodebis da maTTan dakavSirebuli socialuri
funqciebis cvla). “cxovrebis cikli” gulisxmobs
mkafiod determinirebul, diferencirebul da
“Caketil” cxovrebiseul periods, romelic
gamoirCeva ganumeoreblobiT, mravalferovnebiT da
avtonomiurobiT. adamianis ganviTarebis procesSi
rogorc fsiqologebi, aseve fiziologebi aRniSnaven
kritikul anu senzitiur periodebs, rodesac
adamians axasiaTebs Sinagani da garegani faqtorebis
mimarT momatebuli mgrZnobeloba. am dros SesaZloa
ganviTardes Seuqcevadi cvilebebi, romlebmac

71
SesaZloa mniSvnelovnad Secvalon pirovnebis
ZiriTadi maxasiaTeblebi (mag.: asakobrivi krizisi).
aseTive mniSvnelovania e.w socialuri etapebi –
pirovnebis socialuri statusis cvlilebebi
(skolaSi Sesvla, qorwineba, Svilis dabadeba,
warmateba karieraSi da sxva).
adamianis cxovrebis ciklis Taviseburebebis
codna aucilebelia pirovnebis ZiriTadi Tavisebu-
rebebis gagebisaTvis. pirovnebisTvis mniSvnelovani
arc erTi movlena, maT Soris avamyofoba, ar
SeiZleba gagebuli iqnas:
1. individis qronologiuri asakis,
2. socialuri kuTvnilebis,
3. istoriuli periodis da movlenaTa kalenda-
ruli TariRis,
4. subieqtisaTvis movlenis pirovnuli mniSvne-
lobis gareSe.

sicocxlis dasawyisi, adamianis

zrda da ganviTareba
bavSvis ganviTareba misi Casaxvidan iwyeba.
muclad yofnis, mSobiarobis da postnatalur
periodSi nayofze gavlenas axdens mTeli rigi
faqtorebi. ganviTarebul qveynebSi, SemTxvevaTa 90%-
Si orsuloba winawar aris dagegmili. qalis,
rogorc momavali mSoblis, unarianobaze did
gavlenas axdens misive dedis modeli: Tu qalis
deda warmatebiT ver asrulebda dedis rols,
orsuls SesaZlebelia ganuviTardes dedobrivi
funqciebis arasrulfasovnebis gancda, rac
uaryofiTad aisaxeba Cvilis mimarT gamovlenil
mzrunvelobaze. orsulebis guneb-ganwyoba, rogorc
wesi, meryevia, xolo mogvianebiT etapebze Zlierdeba
SegrZneba, rom dakarga fizikuri mimzidveloba. Tu
orsuls guneb-ganwyoba mkveTrad dauqveiTda, isini
naklebad aqceven yuradRebas TviTmovlis Cvevebs,

72
sakvebis miRebas; uCndebaT midrekileba moixmaron
alkoholi, narkotikebi an nikotini, rac TavisTavad
aferxebs nayofis ganviTarebas da safrTxes uqmnis
mis janmrTelobas. zogierT orsulSi sqesobrivi
kavSiris moTxovnileba izrdeba, rac
ganpirobebulia menjis sisxlZarRvebis gadavsebiT.
zogierTi aRniSnavs libidos daqveiTebas, vinaidan
an fizikurad wuxdeba, an nayofis dazianebis eSinia,
an fiqrobs, rom dedoba daqveiTebul sqesobriv
aqtivobas gulisxmobs. swored, sqesobrivi aqtivobis
Sesusteba ojaxuri usiamovnebis mizezi xdeba,
meuRlis orsulobis bolo 3 Tvis manZilze
matulobs mamakacebis mxridan Ralati - qorwinebis
gareSe kavSirebi. eqimebi Tvlian, rom normalurad
mimdinare orsulobisas sqesobrivi cxovrebis
Sewyveta mSobiarobis savaraudo TariRamde 4 kviriT
adre unda moxdes.
mravali qveynaSi, maT Soris, ganviTarebulSic,
urTules socialur problemas warmoadgens
mozardTa orsuloba (mag.: aSS-Si martoxela
dedebis 50% swored mozardebi arian). orsul
mozardebSi upiratesad vxvdebiT dabal akademiur
moswrebas, ganqorwinebul mSoblebs, depresias,
siRaribes. am asakSi maRalia ginekologiuri
garTulebebis ganviTarebis riski. mozardTa
orsulobasTan korelaciaSia naadrevi mSobiaroba,
rac aseve ukavSirdeba dabal socialur-ekonomikur
mdgomareobas da dedis arasrulfasovan kvebas.
zogadad, naadrevi ewodeba mSobiarobas 34 kviramde
an 2500 g-mde wonis nayofiT. naadrevi mSobiaroba
risk-faqtoria iseTi paTologiebis ganviTarebisa-
Tvis, rogoricaa gonebrivi CamorCeniloba, emociuri
da qceviTi aSlilobebi da sensomotoruli
darRvevebi (mag.: dizleqsia).
dedisa da Cvilis urTierToba SesaZloa ara-
srulfasovani iyos, Tu bavSvi mcire wonisaa, avad

73
aris, mSobiarobis Semdeg dedisagan gancal-
kevebulia an ded-mamis urTierTobaSi problemebi
arsebobs. qals, romelic orsulobis periodSi
specialuri fsiqoprofilaqtikuri savarjiSo
programebiT emzadeba, naklebi intensivobis samSo-
biaro tkivilebi da samedicino garTulebebi aqvs,
Tanac CvilTan pirvelive dReebSive karg urTier-
Tobas amyarebs.
gasaTvaliswinebelia is faqtic, rom melo-
gineTa 30-50%-Si SesaZlebelia ganviTardes xanmokle
depresiuli guneb-ganwyoba, rasac mSobiaro-
bisSemdgomi sevda (Baby-blues) ewodeba. amis mizezia
hormonebis Semcvelobis cvlileba, mSobiarobiT
gamowveuli stresi, seriozuli pasuxismgeblobis
gacnobiereba, bavSvis gaCeniT gamowveuli SfoTva an
sasowarkveTilebac ki. guneb-ganwyobis Rrma
daqveiTeba melogineTa 5-10%-Si viTardeba, kidev
ufro mcirea fsiqozebis ganviTarebis albaToba.
mSobiarobis Semdgomi reaqciebi SesaZlebelia
gaxangrZlivdes garkveuli socialuri faqtorebis
arsebobis gamo (bavSvis movlis gamocdilebis
nakleboba; meuRlis an naTesavebis mxridan
socialuri daxmarebis deficiti).
Cvilobis asaki – dabadebidan 15 Tvemde
grZeldeba. am periodis umTavresi fsiqologiuri
mizania piradi ndobis Camoyalibeba dedis an
meurvis mimarT. 6-12 Tvemde dedisa da meurvisagan
daSorebaze Cvili reagirebs xmamaRali tiriliT,
rac garkveuli mijaWvulobis Camoyalibebaze
miuTiTebs. dedisagan xangrZlivad daSoreba
SesaZloa gaxdes e.w. anaklituri depresiis mizezi
da Cvili anelebs ganviTarebas da garemosTan
kontaqts kargavs.
primatebze Catarebulma dakvirvebebma garkve-
uli warmodgena Camoayaliba Cvilobis asakSi

74
ndobis ganviTarebis Sesaxeb. h.harloum (Harry Harlow)
aCvena, rom xelovnuri dedis (erTgvari meqanikuri
mowyobiloba) mier Tavisi msgavsebisagan izoli-
rebul garemoSi aRzrdili axalSobili maimunebi
veRar qmnian wyvilebs, ar aqvT dedobrivi da socia-
luri qcevebi, rac zrdasrul primatebs axasiaTebs.
izolacia ufro metad moqmedebs mamrebze, magram Tu
6 Tvemde asakis maimuns vabrunebT axalgazrda
maimunebTan, maTTan TamaSis procesSi xdeba saWiro
Cvevebis aTviseba. Tu izolacia 6 Tveze met xans
gagrZelda, mdgomareobis gamosworeba SeuZlebelia.
j.boulbim (John Bowlby), akvirdeboda ra dedi-
sagan naadrevad mowyvetili Cvilis ganviTarebas,
aRwera mijaWvulobis qceva, romelic sicocxlis
pirvel wels yalibdeba CvilTan mudmivi fizikuri
kontaqtis safuZvelze.
dedisagan mitovebul bavSvebSi, romlebic
bavSvTa saxlSi izrdebian, r.spitcma (René Spitz)
aRwera fsiqikuri ganviTarebis seriozuli proble-
mebi, susti janmrTeloba, maRali sikvdilianoba. es
aixsneba mzrunvelsa da bavSvs Soris urTierTobis
deficitiT, radgan erT mzrunvelze bevrad meti
bavSvia gapirovnebuli, vidre ojaxis pirobebSi.
marTlac, bavSvTa saxlidan ojaxSi gaSvilebuli
bavSvi ganviTarebas swrafad iwyebs da asakis
Sesabamis maxasiaTeblebsac male aRwevs.
axalSobilis daxasiaTeba
fizikuri ganviTareba: dabadebisas Cvils aqvs
tacebis refleqsi (qreba 2 Tvis asakSi), krTomis anu
moros refleqsi (arsebobs 3-6 Tve) da babinskis
refleqsi, romelic 12 Tvis asakamde gvxvdeba.
Cveulebriv, brunvas iwyebs 5 Tvis asakSi, 6 Tvis
Cvili damoukideblad jdeba, damoukidebel siaruls
ki 12 Tvis asakSi iwyebs.

75
 socialuri ganviTareba: dabadebisas axalSo-
bili Tvals adevnebs adamianis saxes, amitom
iTvleba, rom socializacia dabadebisTanave iwyeba.
amave dros Cndeba refleqsuri Rimili, xolo socia-
luri Rimili, romelic viTardeba 5-8 kviris asakSi,
sxva pirovnebis mimarT Cvilis ndobis pirveli
niSani aris. bavSvi tiris da dedas ebRauWeba, roca
ucnobi adamiani miuaxlovdeba, rasac ucxos mimarT
SfoTvas uwodeben. normaSi, ucxosadmi SfoTva 7-9
Tvis asakSi viTardeba da miuTiTebs dedisadmi
specifikur ndobaze da Cvilis unarze – deda
ganarCios ucnobisagan. zogadad, mravali mzrunve-
lis xelSi gazrdili bavSvi naklebad SfoTavs.
individualuri gansxvavebani: Cvilebi erTmane-
Tisagan gansxvavdebian temperamentis mixedviT da
gamRizianeblebze reagirebis tipiT. es sxvaoba
SesaZlebelia gamoixatos aqtiurobis xarisxiT,
riTmuli qcevis modeliT (mag.: Zil-RviZilis cikli),
axal gamRizianebelze reaqciiTa an mis mimarT
gamovlenili uyuradRebobiT, adaptaciurobiT,
emociuri reaqciebis intensivobiT, kontaqturobiT,
yuradRebis mobilizaciis unariT da sxva.
ganviTarebis Teoriebi: z.froidis mixedviT,
pirveli wlis manZilze axalSobilis siamovnebis
umTavresi adgili aris piri (oraluri faza). erik
eriqsoni aRniSnavda, rom pirveli wlis bolos
Cvils uviTardeba garemosadmi bazisuri ndoba
(undoblobis grZnobis sawinaaRmdegod – Trust vs.
Mistrust). aseTi ndobis CamoyalibebisaTvis aucile-
belia, rom Cvili moelodes, rom misTvis aucile-
bel bazisur moTxovnilebebs gaufrTxildebian
irgvlivmyofebi da rom is SeiZleba daeyrdnos
mzrunvelebs, romlebic mis signalebs samarTlianad
gamoepasuxebian.

76
 m.maleri (Margaret Mahler) adreul ganviTarebas
aRwers, rogorc dedasTan daSorebis Tanmimdevrul
process da Semdeg fazebs gamohyofs:
 normaluri autizmis faza (0-1 Tve) – am
periodSi Cvils aqvs susti urTierToba
garemosTan.
 simbiozis faza (1-5 Tve) – Cvils aqvs de-
dasTan identobis (mTlianobis, igiveobis)
gancda.
 ganSoreba-individualizaciis fazaSi (5-16
Tve) – pirvelad xdeba diferenciacia (5-9
Tve), roca deda pirvelad aRiqmeba, ro-
gorc calke pirovneba. mogvianebiT ki e.w.
praqtikul fazaSi (10-16 Tve) Cvili
Sordeba dedas, magram drodadro kvlav
ubrundeba.
0-24 Tvis periods J.piaJe (Jean Piaget) senso-
motorul stadias uwodebs. am fazaSi bavSvi axdens
garemos asimilacias, garemos axali stimulebis
aRqmas da mas akomodacia uviTardeba. axali gamRi-
zianeblis Sesabamisad bavSvs SeuZlia Seicvalos
qceva. 12-24 Tvis asakSi yalibdeba e.w. sagnis
mudmivoba (object permanence), rac gulisxmobs bavSvis
unars – warmodgenaSi Seinaxos im sagnis gamosa-
xuleba, romelic mxedvelobis velSi ar imyofeba.
balRobis asakis (15 Tve – 2,5 weli) umTavresi
niSania dedasTan daSoreba. bavSvs uyalibdeba
garkveuli distancia (rogorc fizikuri, ise
emociuri) dedisagan da 18 Tvis asakisaTvis iqceva,
rogorc damoukidebeli individi, Tumca
gancalkeveba–individualizaciis procesi sruldeba
3 wlisaTvis. m.maleri am periods moSorebis
periods uwodebs, xolo 16-24 Tvis asaks - ukan

77
dabrunebas komfortisa da uzrunvelobisaTvis,
megobruli urTierTobis ganaxlebisaTvis.
balRoba xasiaTdeba mzardi fizikuri da
inteleqtualuri ganviTarebiT: bavSvs uviTardeba
sakuTar qcevaze kontroli (24 Tve), igi
damoukideblad iqceva, sayvareli sityvaa “ara”
(negativizmis periodi). normaSi, 24 Tvis asakis
bavSvma tualetis moTxovna unda areguliros,
winaaRmdeg SemTxvevaSi mSobelsa da Svils Soris
SeiZleba konfliqti daiwyos. 18-30 TvisaTvis
yalibdeba bazisuri sqesobrivi identifikacia anu
SegrZneba, rom aris qali an mamakaci.
eriksonis mixedviT, 15-30 Tve aris avtonomiis
stadia (sircxvilisa da daurwmuneblobis sapiris-
pirod, Autonomy vs. Shame), roca bavSvi damouki-
deblobas gadawyvets da aRar emorCileba
mSoblebis kontrols. termini “avtonomia” gamoiye-
neba, roca bavSvi sakuTar impulsebs, sakuTar
survilebs emorCileba da dedisagan damoukideb-
lobas aRwevs. Tu gadaWarbebuli mzrunvelobis
gamo bavSvma avtonomias ver miaRwia, mas uCndeba
grZnoba, rom gare samyaro zemodan dascqeris da
sircxvili ipyrobs. am periods z.froidi analur
stadias uwodebs.
skolamdeli asaki (2,5–6 weli): 3 wlis bavSvis
simaRle mozrdilis simaRlis naxevaria. swrafad
ivseba sityvaTa maragi, bavSvi TamaSobs, unawilebs
dedmamiSvilebs saTamaSoebs, Tumca SesaZloa
gamoavlinos metoqeobac. bavSvs SeuZlia gaarCios
erTmaneTisagan fantazia da realoba, Tumca
gamijvnis sazRvari yovelTvis mkveTri rodia. am
asakSi SeiZleba Tavi iCinos Zilis problemebma (mag.:
koSmarebi) da sxvadasxva saxis SiSma (qurdebis,
monstrebis an sxva gardamavali fobiebi). igi
SeiZleba Cafiqrdes Tavis janmrTelobaze da

78
gaazviados sxeulis yvela dazianeba (Sexveuli
xelis simptomi).
sqesis fizikuri gansxvavebiT daintereseba
aisaxeba eqimobanas TamaSSi. zogadad, bavSvuri
TamaSi (anu mozrdilis socialuri urTierTobebis
imitacia) momavalSi Teoriisa da praqtikis harmo-
niuli Serwymis winapirobaa. 2 wlis asakisaTvis
bavSvebi mxolod paralelur TamaSebSi erTvian,
xolo 4 wlisaTvis – Tanamonawileoben TamaSSi. 3-10
wlisaTvis TiTqmis naxevars hyavs warmosaxviTi
amxanagi, romelic exmareba Sesustdes martoobis
gancda da SfoTva.
am asaks, anu adreuli bavSvobis periods
froidi uwodebs falosur an oidiposis fazas.
siamovnebis fokusireba genitaliebSi xdeba. Tavs
iCens oidiposis kompleqsi, rac gulisxmobs
metoqeobas imave sqesis mSoblisadmi da siyvaruls
sapirispiro sqesis mSoblis mimarT. es kompleqsi
nawilobriv cnobieria da cxaddeba metyvelebaSi,
qcevaSi da komunikaciis sxva saxeebSi bavSvobis
dros. zrdasrul asakSi igi ufro xSirad
aracnobieria da SeiZleba gamovlindes qcevaSi,
atitudebSi da obieqtis arCevaSi. zogadad,
falosur-oidiposis etapi wydeba maSin, roca bavSvi
imave sqesis mSobelTan identifikacias moaxdens.
adreul bavSvobaSi xdeba cnobierebis
formireba (froidis mixedviT, super-ego). bavSvi
swavlobs, Tu rogor moiqces garkveul situaciebSi.
igi acnobierebs, rom agresiuli impulsebi SeiZleba
gamoiyenos misaReb formebSi, magaliTad,
SejibrebebSi. eriqsonis mixedviT, es aris
iniciativis stadia (braleulobis sawinaaRmdegod):
bavSvi midis riskze, Tumca SesaZloa hqondes
dasjis SiSi an braleulobis (danaSaulis) gancda.
Tu es stadia warmatebiT gadalaxa, bavSvi izrdeba
damjeri, disciplinirebuli da maRali pasuxismgeb-
lobis mqone mozrdili. piaJes mixedviT 2-7-wlis

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asaki preoperaciuli fazaa, roca bavSvi azrovnebas
simboluri cnebebiT iwyebs. lorens kolbergi
aRwers moralurobis ganviTarebasac.
skolis asakSi (puberta) – 7-11 weli – bavSvs
uviTardeba SesaZlebloba ganaxorcielos rTuli
motoruli davalebebi, igi aqtiuria. sruldeba
cnobierebis formireba da bavSvs uCndeba logikuri
azrovnebis SesaZlebloba (piaJes mixedviT,
konkretuli operirebis stadia). Semdgomi pirov-
nuli ganviTarebisaTvis mniSvnelovania misi
damokidebuleba skolaSi miRweuli warmatebe-
bisadmi. bavSvi grZnobs, rodis aris uflebamosili
samyarosTan urTierTobis procesSi (eriqsonis
mixedviT, bejiTobis, muyaiTobis stadia). bavSvis
urTierTobaTa sivrce, romelic asakTan erTad
farTovdeba gawvdili xelis manZilidan kosmosur
masStabebamde, skolaSi mniSvnelovan saxecvlilebas
ganicdis. ojaxi TandaTan kargavs mniSvnelobas da
gare samyaro (mag.: maswavlebeli, Tanatolebi) ufro
Rirebuli xdeba. bavSvi identifikacias iwyebs
maswavlebelTan, skolis liderTan. am periodi-
saTvis igi identifikacias axdens misive sqesis
mSobelTan da sapirispiro sqesis mSobels siyvaru-
lis obieqtad aRar aRiqvams. bavSvebs Zalian uyvarT
imave sqesis TanatolebTan TamaSi. zogadad, TamaSis
procesSi fantazia da warmodgenebi Warbobs
realobis aRqmas da rogorc ki bavSvis winaSe
problema wamoiWreba (mag.: “rogor davicva Tavi
mtrisagan?”), igi azrovnebs anu eZebs urTierT-
kavSirs, azogadebs, iyenebs gamocdilebas da
amocanis gadaWras cdilobs.
mozardoba (11-20 w.w.) xasiaTdeba biologiuri,
fsiqologiuri da socialuri ganviTarebis Tavise-
burebebiT. kerZod, biologiuri TvalsazrisiT, am
periodSi yuradsaRebia Zvalsaxsrovani sistemis
intensiuri zrda da sqesobrivi ganviTarebis dawyeba
(gogonebSi - menzesi, vaJebSi - pirveli eakulacia,

80
meoradi sasqeso niSnebis gamovlena). fsiqolo-
giurad mozardobis periodSi niSandoblivia
gonebrivi SesaZleblobebis zrda (cognitive development)
da pirovnebis Camoyalibebis procesis dawyeba.
socialuri TvalsazrisiT, mozardoba is xanaa,
roca individi emzadeba ufrosebis samyaroSi
adgilis dasamkvidreblad da sakuTar Tavze
garkveuli pasuxismgeblobis asaRebad. eriqsonis
mixedviT, mozardoba aris sruli individualobis,
identobis formirebis stadia, roca adamians
uyalibdeba piradi damoukideblobis grZnoba.
mozardobas, Cveulebriv, sam periodad yofen:
mozardobis adreuli periodi (11-14 w.w.)
xasiaTdeba gamoxatuli endokrinuli cvlilebebiT,
rac gogonebSi – 11 wlis asakisaTvis, xolo vaJebSi
– 13 w.-sTvis iwyeba. mozards aReniSneba Zlieri
mgrZnobiaroba TanatolTa azris, maTi
gamonaTqvamebis mimarT. normaluri ganviTarebis
nebismierma darRvevam (mag.: sarZeve jirkvlis gviani
ganviTareba, akne) SesaZloa gamoiwvios
fsiqologiuri problemebi. J.piaJes mixedviT,
mozardis azrovnebaSi Tavs iCens abstraqtuli
msjeloba, konceptualuri, logikuri da momavalze
orientirebuli fiqrebi. am periodSi vlindeba
sxvadasxva SemoqmedebiTi niWi, rac, samwuxarod,
zrdasrul asakSi SesaZloa ubralod gaqres.
mozardobis Sua periodSi– 14-17 w.w. – vaJebi
gogonebs uswreben fizikuri monacemebiT (mag.: wona,
simaRle), Zlierdeba interesi sxeulis xatis mimarT,
xdeba mamakacisa Tu qalis stereotipuli rolis
morgeba, gansakuTrebul mniSvnelobas iZens
TanatolTa Soris popularobis moxveWa. sayurad-
Reboa is faqti, rom mozardobis Sua periodSi
axalgazrda pirvelad amyarebs Tamam kavSirebs
ucnob adamianebTan. aqtiurad yalibdeba garkveuli
araformaluri instituciebic, rac efuZneba myar da
emociurad Rirebul urTierTobebs. am jgufebs

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mniSvnelovani roli eniWebaT socialuri zrdisa da
ganviTarebisaTvis. maT zogjer gansazRvruli
struqtura aqvT (mag.: musikaluri bendi, fexburTis
gundi, sakvirao skola) da seriozuli socialuri
wnexis (mag.: konfliqti) dros Tanadgomisa da
mxardaWeris gaweva SeuZliaT.
mozardobis gviani periodi – 17-20 w.w. –
daaxloebiT 3 weli grZeldeba da mTavrdeba maSin,
roca axalgazrda adamiani srulfasovani kavSirebis
damyarebas iwyebs. umetes SemTxvevaSi am periodSi
viTardeba moraluri da eTikuri grZnobebi da
qcevis kontroli. am periodis mTavari mizania: a)
sruli damoukideblobis miRweva; b) “meobis”,
identobis Camoyalibeba. am miznebis ganxorcieleba,
marTalia, iwyeba mozardobisas, magram grZeldeba
mTeli sicocxlis manZilze. gviani mozardobisas
kvlav vlindeba negativizmi – mozardi damouki-
deblobis mopovebas aRwevs mSoblebTan dapiris-
pirebiT (mag.: dedas ar ujerebs megobrebis,
tansacmlis, makiaJis Tu varcxnilobis SerCevisas,
momavlis dagegmvisas). TandaTan mozardi gadis
rTul process – mravali faseulobidan airCios
misTvis misaRebi da misdios maT. mas Semdeg, rac
mozardi ojaxisagan pirovnul damoukideblobas
miaRwevs, kvlav aqtualuri xdeba misTvis sakuTari
TavisaTvis 3-6wlis asakSi erTxel ukve dasmuli
kiTxva: “vin var me?”
eriqsoni 11-20 wlis asaks identobis stadias
(roluri abnevis sawinaaRmdegod) uwodebs. identoba
ganisazRvreba rogorc maxasiaTebelTa erToblioba,
rac ayalibebs pasuxs kiTxvebze : vin aris es
pirovneba da ris gakeTebas apirebs? identoba aris
“me”-s, rogorc unikaluri da SekavSirebuli
organizmis, gancda, romelic stabiluria garemos
cvlilebebis miuxedavad. garkveuli socialuri
jgufis ideebTan da faseulobebTan mierTebac
identobis Camoyalibebis procesia. Cveulebriv,

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gviani mozardobis periodSi adgili aqvs identobis
kriziss. Tu igi ar gadailaxa, mozardi pirovnulad
Zlieri ver gaxdeba, dakargavs individualobas da
ganuviTardeba dabneulobis gancda. aseT
SemTxvevaSi maRalia albaToba, rom mozardebma
sakuTari identifikacia moaxdinon SemTxveviT
pirebTan an realur kriminalur samyarosTan, rasac
iseTi qcevis Camoyalibeba mohyveba, rogoricaa
narkomania, kriminaluroba, an sxvadasxva religiuri
seqtebSi an kultmsaxurebaSi CarTva.

avadoba da sikvdiloba bavSvTa

da mozardTa asakSi
bavSvis reaqcia daavadebaze mWidrod
ukavSirdeba misi ganviTarebis stadiebs. mag.: 3
wlamde asakis hospitalizebul bavSvebSi sWarbobs
mSobelTan ganSorebis SiSi, z.froidis mier
mowodebul falikur stadiaSi ki – sxeulis
dazianebis SiSi (mag.: kastraciis SiSi). maT srulad
ar esmiT sikvdilis arsi. skolis asakSi bavSvebi
xvdebian ganukurnebeli senis mniSvnelobas. am
asakSi ufro upriania gegmiuri operaciuli Careva,
radgan isini ukeTesad itanen hospitalizacias.
mozardebma SeiZleba ugulebelyon samedicino
rCevebi, radgan ar endobian avtoritetebs. mozar-
debs axasiaTebT saxifaTo qcevebisadmi midrekileba
(mag.: manqanis swrafi marTva), rac zrdis sikvdi-
lobas mosaxleobis aRniSnul asakobriv jgufSi.

zrdasruloba
zrdasrul adamians aqvs unari moaxdinos
adaptacia garemos mudmivad cvladi moTxovnile-
bebis mimarT. cxovrebis aRniSnuli etapi dayofilia
adreul (srulasakovnoba), Sua (mowifuloba) da
gvian (xanSiSesuloba/sibere) periodebad. zrda-
sruli adamianis cxovreba gansakuTrebiT mniSvnelo-
vania socialuri TvalsazrisiT, vinaidan am

83
periodSi xdeba SromiTi urTierTobebis dawyeba,
qorwineba, Svilis SeZena, avadoba da sxva stresuli
movlenebi.
mozrdilobis adreul periodSi (srula-
sakovnoba) – 21-40 w.w. – biologiuri ganviTareba
dasrulebulia da adamiani irgebs sxvadasxva
ZiriTad socialur rols. mozardobidan
srulasakovnobaSi gardamavali periodi mraval
mniSvnelovan movlenas aerTianebs: sruldeba
bazisuri ganaTlebis miRebis procesi, myardeba
pirveli SromiTi urTierTobebi, iwyeba seriozuli
urTierTobebi ojaxis Seqmnis mizniT.
eriqsonis mixedviT, es intimurobis (siaxlo-
vis) stadiaa (izolaciis anu gancalkevebulobis
winaaRmdeg), romlis drosac SeiZleba aRmocendes
seriozuli fsiqo-socialuri konfliqti, romlis
gadaWrazec damokidebulia, ramdenad warmatebiT
gaagrZelebs axalgazrda zrdasruli adamiani
garemosTan urTierTobas. megobruli, sqesobrivi da
sxva saxis urTierTobebis ar eSinia im pirovnebas,
romelmac warmatebiT gadalaxa identobis krizisi.
sxvagvarad rom vTqvaT, individs, romelmac zrda-
srulobas roluri abnevis (role confusion) mdgoma-
reobaSi miaRwia, xangrZlivi da myari urTierTo-
bebis damyareba ar ZaluZs. megobris an meuRlis
gareSe aseTi adamiani sakuTar TavSia Caketili da
Sedegad - gare samyarodan misi izolacia, gariyva
xdeba. amrigad, adreuli mozardobis periodSi
xdeba individualobis saboloo formireba
(eriqsonis mixedviT), xolo ganviTarebis am stadiis
miznebia: dasaqmeba (umuSevroba zrdis alkoholiz-
mis, Zaladobis, mkvlelobebisa da TviTmkvlelo-
bebis risks), qorwineba (e.w. “30 wlianebis garda-
maval” krizisul periodSi xSiria rogorc oja-
xuri, ise samsaxurebrivi problemebi), Svilis SeZena.
Sua xnis asaks (40-65 w.w.) k.g.iungi cxovrebis
SuadRes uwodebda. adamiani iwyebs warsulis

84
gadaxedvas, afasebs ganvlil cxovrebas da irebs
gadawyvetilebas, rogori iqneba momavali. dasaqme-
bidan gamomdinare, mravali pirovneba SeiZleba
grZnobdes did ufskruls axalgazrdul miswrafe-
bebsa da realur miRwevebs Soris. icvleba ojaxuri
garemoc – Svilebi damoukideblobas aRweven, rac
mSoblis rols garkveulad cvlis (“carieli budis”
sindromi). yuradsaRebia am periodis sqesTan
dakavSirebuli (genderuli) cvlilebebic. kerZod,
qali, romelic Svilebze zrunviT naklebadaa
datvirTuli, xdeba damoukidebeli, avlens meto-
qeobasa da agresiulobas, xolo mamakacSi Tavs
iCens iseTi Tvisebebi, romelic tradiciulad qale-
bisTvisaa damaxasiaTebeli (emociuroba, gamomsa-
xveloba da morCileba).
eriqsonis mixedviT, 40-65 wlis asakisaTvis
damaxasiaTebelia generaciuloba (mwarmoebluroba)
stagnaciis winaaRmdeg (Generativity vs. Stagnation).
generaciuloba, erTi mxriv, niSnavs STamomavlobaze
zrunvas, meore mxriv - gulisxmobs mniSvnelovan
interesebs ojaxis gareTac (mag.: momavali Taobis
aRzrda, mecnieruli saqmianoba, sazogadoebis
gaumjobesebisaken mimarTuli qmedebebi).
Sua xnis asakSi organizmis biologiuri da
fiziologiuri funqciebis qveiTdeba anu iwyeba
klimaqteriuli cvlilebebi. 50-55 wlebis garda-
mavali periodi sakmaod krizisulia: mamakacs,
romlis samsaxurebrivi karieria pikzea, iseve, ro-
gorc qals, romelic mTlianad Svilebze zrunviT
iyo dakavebuli, SeiZleba gulisgatexvis da uime-
dobis grZnoba daeuflos, roca gaacnobierebs, rom
am prioritetuli mimarTulebiT momavalSi axali
miRwevebi aRar eqneba. moxucebulobaSi gardamaval
periodSi (60-65 w.w.) d.levinsoni yuradRebas
amaxvilebs fizikuri uZlurebis da mokvdavobis
gancdebis arsebobaze, rac kidev ufro mZafrdeba,
roca megobrebsa da naTesavebs Soris xSirdeba

85
sikvdilis faqtebi an vlindeba sxvadasxva mZime
daavadeba. krizisul mdgomareobas aseve aRrmavebs
ganqorwineba, moxuc mSoblebze zrunva, somaturi
daavadebis gamwvaveba da a.S.

moxucebuloba – 65 wlis Semdgomi periodia.

mraval qveyanaSi SeiniSneba, zogadad, mosaxleobis
demografiuli daberebis tendencia, amasTan, qalebi
saSualod 15 wliT ufro met xans coxloben, vidre
mamakacebi. es asakobrivi periodi orad iyofa:
moxucebulobis adreuli periodi (xanSiSesuli) -
65-74 w.w. da sibere – 75 weli da meti.
gerontologia (mecniereba siberis Sesaxeb) ganviTa-
rebul qveynebSi damoukidebel specializaciadac ki
iqca.
daberebis procesi mimdinareobs rogorc
ujredul doneze (mag.: ujredis organelebis degene-
racia, dnm-is da rnm-is struqturis cvlilebebi,
neironuli degeneracia da a.S.), ise Seexeba
sxvadasxva sistemebs, rogoricaa imunuri, endokri-
nuli, nervuli, Zvalsaxsrovani, gulsisxlZarRvTa
da Sardsasqeso sistemebi. gansakuTrebiT yurad-
saRebia cvlilebebi fsiqikaSic – marTalia, 80 wlis
asakamde inteleqtis koeficienti (IQ) ucvleli
rCeba, magram mniSvnelovnad qveiTdeba axali
masalis aTvisebis unari, Raribdeba metyveleba.
eriqsonis mixedviT, 65 wels zemoT asakSi
dgeba integraciis stadia (Integrity vs. Despair & Isolation),
roca pirovneba kmayofilia ganvlili cxovrebiT da
mas ar ipyrobs sasowarkveTilebis gancda, rom misi
cxovreba amao da uazro iyo.
B.Neugarten-ma aRwera moxucebulobis asakis
konfliqti, romelic ganpirobebulia gavlenis da
damkvidrebuli poziciis dakargviT da pirovneba
sakuTari unarebis, gamocdilebis da Zveli miRwe-
vebisa gadafasebas iwyebs.

86
 z.froidis Teoriis mixedviT, roca pirovneba
momwifdeba, Zlierdeba kontroli ego-sa da id-ze,
rac damoukideblobis (avtonomiurobis) safuZvels
qmnis. daberebis procesSi adgili aqvs msgavsi
kontrolis dakargvas da regresias, rac aZlierebs
SedarebiT primitiul impulsebs da amitomac,
moxucebSi Tavs iCens primitiuli agresiuli da
seqsualuri ltolva (motivaciuri Zalebi, romle-
bic dasabams aZleven qcevas). superego-s funqcio-
nirebis regresia aseve SeiZleba gamovlindes
sakuTari Tavis usazRvro dadanaSaulebiT an
piriqiT, sxvadasxva konfliqtur situaciebSi pirov-
nebam SeiZleba saerTod dakargos bralis gancda.
moxucebulobaSi mniSvnelovania “me”-obis da
TviTwarmodgenis SenarCuneba, rac SesaZlebelia
sxvadasxva faqtoriT:
1. ekonomikuri usafrTxoeba, rac pirovnebas
bazisuri moTxovnilebebis dakmayofilebis
saSualebas aZlevs;
2. damxmare pirebi, romlebic mas izolaci-
isagan icaven;
3. fsiqologiuri janmrTeloba, rac gulis-
xmobs srulyofili TavdacviTi meqanizmebis
normalur funqcionirebas;
4. fizikuri janmrTeloba, rac pirovnebas
saSualebas aZlevs CarTuli iyos misTvis
sasiamovno aqtivobebSi.

normaluri seqsualobis ganviTareba

pirovnebis seqsualobis ganviTarebis procesze
mravali faqtori axdens gavlenas: socialuri
urTierTobebi, cxovrebiseuli gamocdileba,
kulturuli garemo, agreTve biologiuri da pirov-
nuli faqtorebi, rac qmnis sakuTari me-s aRqmas: “me
qali an kaci var”.
pirovneba da misi sqesi imdenad erTiania, rom
Znelia isaubro sqesze, rogorc damoukidebel

87
fenomenze. TviT termini “fsiqoseqsualoba” –
gulisxmobs, rom ganviTarebis da funqcionirebis
procesSi pirovnebaze moqmedebs individualuri
seqsualoba. amgvarad es cneba ar aris Semofarg-
luli mxolod sqesobrivi qceviT, azrebiT an
libidoTi.
fsiqologiaSi motivi aris ganzraxuli moqme-
debis da mis gansaxorcieleblad miznebis dasaxvis
mastimulirebeli fenomeni anu is, ris safuZvelzec
adamiani ganizraxavs ama Tu im moqmedebis
Sesrulebas. zogadad, nebismieri gadawyvetilebis
miRebis procesSi adamiani ramdenime motiviT
xelmZRvanelobs. amdenad, motivi Segnebuli, mizanmi-
marTuli, nebiTi, araimpulsuri moqmedebis
safuZveli xdeba. motivis wyaro adamianis
pirovnuli moTxovnilebebia. konkretuli motivis
safuZvelze adamianma SesaZloa Zlieri vitaluri
moTxovnilebebis winaaRmdegac ki imoqmedos (mag:
Tavi Seswiros samSoblos, aitanos mtkivneuli
samedicino manipulacia janmrTelobis gasaumjobe-
seblad da a.S.). adamiani socialuri arsebaa da mas,
garda biologiuri sasicocxlo moTxovnilebebisa,
aqvs maRali, zogadpirovnuli moTxovnilebebic da
maT safuZvelze SemuSavebuli interesebi, Sexedu-
lebebi, msoflmxedveloba da garkveuli xasiaTic,
rac misi qcevis Taviseburebebsac gansazRvravs.
motivacia SesaZloa iyos mimarTuli pirovnebis
rogorc biologiuri moTxovnilebebis dakmayofi-
lebisaken (mag.: darRveuli homeostazis aRdgena
xdeba Sesabamisi centraluri da periferiuli
maregulirebeli meqanizmebis mobilizaciis
Sedegad), aseve socialuri moTxovnilebebis dakma-
yofilebisaken (mag.: profesiuli warmateba, ojaxis
Seqmna). amave dros, pirovnebam garkveuli saWi-
roebebis misaRwevad SeiZleba gamoiyenos sqesobrivi
qcevac (mag.: agresiuloba statusis misaRwevad).

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 bavSvebi sqesobriv ganaTlebas, upiratesad,
mSoblebis Carevis gareSe iReben, magram bavSvis
sqesobriv cnobierebaze did gavlenas axdens
mSoblebis qceva. biWebi ufro energiulad unda
marTon mSoblebma, vidre gogonebi, romlebsac
dayvaveba sWirdebaT. mamebma meti dro unda dauTmon
vaJebs, raTa bolomde Caswvdnen maT problemebs.
amasTan, mamebs praqtikulad ar esmiT gogonebis
SfoTvis mizezebi. biWebi fizikurad ufro discip-
linirebulni arian. bavSvis biologiuri sqesi aseve
gansazRvravs mSoblebis tolerantobas agresi-
isadmi, maT Zaldatanebas, bavSvis aqtivobis an
pasiurobis daTrgunvas. sqesi aseve gansazRvravs
bavSvis inteleqtualur, esTetikur da sportul
interesebs. bavSvebze dakvirvebam cxadhyo, rom
sxvadasxva situaciebSi genitaliebiT daintereseba
da maTi Sexeba normaluri ganviTarebis Semadgeneli
nawili aris, rac momavalSi heteroseqsualuri
kontaqtis damyarebis erT-erTi winapirobaa.
fsiqoseqsualuri faqtorebi anu is faqtorebi,
romelic pirovnebis seqsualobas gansazRvravs aris
sqesobrivi identifikacia, genderuli identifikacia
da seqsualuri qceva. es faqtorebi moqmedeben
pirovnebis zrda-ganviTarebasa da mis aqtiurobaze.
seqsualoba ufro metia, vidre biologiuri sqesi da
ufro mcire, vidre qcevis nebismieri aspeqti,
mimarTuli siamovnebis miRebisaken. genderuli
identifikacia gulisxmobs pirovnebis SegrZnebas
rom is aris qali an mamakaci. sqesobrivi identi-
fikacia miekuTvneba sqesis biologiur maxasiaTeb-
lebs. qromosomebi, garegani da Sinagani sasqeso
organoebi, hormonebi, gonadebi, meoradi sasqeso
niSnebi normaluri ganviTarebis pirobebSi qmnian
imgvar paterns (models), rom adamians eWvi ar
uCndeba sakuTari sqesis mimarT. Tanamedrove
embriologiam daadgina, rom ganviTarebis adreul
etapze yvela ZuZumwovris embrioni mdedrobiTi

89
sqesis aris. Semdgomi diferencirebis mizezi ki
xdeba fetaluri androgeni da es procesi me-6
kviridan iwyeba, xolo sruldeba III Tvis bolos.
nayofi am periodSi SeiZleba daziandes ekzogenurad
miRebuli androgeniT (mag.: Tu deda orsulobis
pirvel trimestrSi iRebs androgens, mdedrobiTi
sqesis nayofs SesaZloa ganuviTardes mamakacis
msgavsi genitaliebi). 2-3 wlis asakisaTvis yvela
bavSvi sakuTar sqesSi darwmunebuli unda iyos.
miuxedavad amisa, pirovnebas mainc aqvs miznad
ganiviTaros qalurobis an mamakacobis grZnoba.
genderuli da sqesobrivi identifikaciebi
SesaZlebelia konfliqturad (urTierTSeusabamod)
ganviTardes. genderuli identuroba mTeli rigi
miniSnebebis safuZvelze yalibdeba. individi am
miniSnebebs ojaxis wevrebisagan, maswavleblebisagan,
TanamSromlebisagan iRebs, amasTan - garkveul rols
TamaSobs kulturuli fenomenebi. biologiuri
sqesisaTvis damaxasiaTebeli fizikuri maxasia-
Teblebi (mag.: sxeulis forma, zogadi fizikuri
mdgomareoba) ibneva stimulebis absurdul sistemaSi
(maT Soris, Seqeba, dasja, mSobelTa sqesobrivi
etiketi), raTa pirovnebam sakuTari sqesobrivi
identifikacia moaxdinos.
genderuli identifikaciis formireba emyareba
mSoblebis da garemos damokidebulebaze, genetikur
fonze, romelic fiziologiurad aqtiurdeba me-6
kviris nayofSi. sqesis Sesabamisi qceva anu roli –
dabadebis momentSi ukve Camoyalibebulia. gende-
ruli identurobis da rolis kongruentoba (Sesaba-
misoba) standartuli da janmrTeli gamosavalia.
qal-vaJebis sqesobrivi gansxvavebebis Seswavlam
gviCvena, rom arsebobs mravali fsiqologiuri
msgavseba. mag.: 2 welze ufrosi vaJebi sityvier da
fizikur agresias ufro iCenen, vidre gogonebi,
ufro mcire asakSi ki maT Soris gansxvaveba ar

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aris, Tumca biWebi ufro advilad reagireben
garegan stimulebze (feTqebadoba).
zogi mkvlevaris azriT, agresiuloba daswav-
lili qcevaa, Tanac mamakacis hormonebs SeuZliaT
vaJebis nervuli warmonaqmnebis mgrZnobelobis
gazrda, raTa gogonebze ukeT aiTvison agresiu-
lobis “gakveTilebi”.
roli da identuroba SeiZleba urTierT-
sawinaaRmdego aRmoCndes. individma SesaZloa
moaxdinos sqesis identifikacia, magram, sapirispiro
sqesisaTvis damaxasiaTebeli Tmis varcxniloba
gaikeTos an tansacmeli Caicvas. an piriqiT,
moaxdinos identifikacia sapirispiro sqesTan, xolo
qceva Seesabamebodes mis biologiur sqess.
sqesobrivi qceva - 15-19 Tvis asakSi orive
sqesis bavSvebi iwyeben sakuTari genitaliebis
TviTstimulacias. am periodisaTvis bavSvs sakuTari
sxeuli ukve Seswavlili aqvs. mas uCndeba interesi,
Seiswavlos sxvebis (mag.: bavSvis, cxovelis) sasqeso
organoebi. bavSvobis da mozardobis asakSi
gansakuTrebiT Cveuli qcevaa masturbacia
(fsiqologebis monacemebiT, mas mimarTaven yvela
mamakaci da 3/4 qali), rac obieqtTan dakavSirebuli
normaluri sqesobrivi qcevis ganviTarebis winapi-
robaa. ojaxobanas TamaSs xSirad Tan sdevs eqshibi-
cionizmi da warmosaxviTi ojaxis wevris sasqeso
organoebiT daintereseba.
pubertas asakSi, hormonebis zemoqmedebiT
iwyeba meoradi sasqeso niSnebis Camoyalibeba,
intensiuri xdeba sqesobrivi cnobismoyvareoba, matu-
lobs TviTstimulaciis survili. mozards fizi-
kurad ZaluZs koitusi da orgazmi, magram socia-
lurad SezRudulia. is imyofeba ormagi da, xSirad,
urTierTsawinaaRmdego zewolis qveS, raTa
moaxdinos sqesobrivi identifikacia da kontroli
gauwios sqesobriv impulsebs. am mdgomareobaSi
mozardi daZabulia da saWiroebs garkveul

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Tanadgomas. mniSvnelovani emociuri gansxvaveba
pubertas asakis bavSvebsa da mozardebs Soris aris
mozardebSi koitaluri fantaziebis arseboba,
gansakuTrebiT masturbaciisas. am dros mozardi
swavlobs iTamaSos zrdasruli adamianis roli.
autoereqtiuli aqtivoba zrdasrul pirebSic
aRiniSneba adreul asakSi da mogvianebiT igi
srulad Canacvldeba koitusiT. zrdasrulebSi
masturbacia kvlav SeiZleba gamovlindes, roca
sqesobrivi kavSiri arasrulfasovania, partniori
avadaa da a.S. am SemTxvevaSi igi adaptaciuri mizne-
bisaTvis gamoiyeneba, rasac Tan sdevs daZabulobis
moxsna. moraluri tabu, zogadad, krZalavs
masturbacias da mas fsiqikuri da sqesobrivi
potencialis daqveiTebis mizezad asaxelebs. es asec
aris, roca TviTstimulacia akviatebis rangSi adis.

sqesobrivi aqtis fazebi

I faza - Appetitive - “madis aRZvra” – xasiaTdeba
seqsualuri Sinaarsis fantaziebiT da sqesobrivi
aqtivobis surviliT.
II faza – Excitement – “aRtaceba/aRtkineba” –
fsiqologiuri stimulacia (fantazia da/an
Seyvarebulis arseboba) an fiziologiuri
stimulacia (kocna, moxveva) an maTi kombinacia
iwvevs sasqeso organoebSi Sesabamis SegrZnebebs.
sawyisi etapi ramdenime wuTidan ramdenime saaTamde
SesaZloa gagrZeldes, xolo misi piki – 30 wm-dan
ramdenime wuTamde.
III faza – Orgasm - orgazmi – siamovnebis piki
riTmuli spazmebiT. fazis xangrZlivobaa 3-25 wm da
axasiaTebs cnobierebis msubuqi dabindva. am dros
wneva matulobs 20-40 mm-iT, majiscemaa – 160 wT-Si.
IV faza – Resolution – “aRdgena” – sisxli
gadanawildeba genitaliebidan. aRdgenis faza
grZeldeba 2-6 saaTi da SesaZloa axasiaTebdes
gamRizianebloba da diskomfortic.
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 Tavi V

eqimis da pacientis
urTierTobis fsiqologiuri Taviseburebani

jandacvis msoflio organizaciis (WHO)

preambulaSi janmrTeloba ganmartebulia, rogorc
“mdgomareoba, rodesac adamians ar gaaCnia raime
fizikuri an fsiqikuri daavadeba an nakli, igi
mkafiod grZnobs sakuTar fizikur da sulier
keTildReobas, Rirsebas da mniSvnelobas; gaaCnia
unari kontroli gauwios sakuTar azrebs da
moqmedebebs; gadalaxos yofiTi siZneleebi da
sakuTar Tavze aiRos garkveuli pasuxismgebloba;
daamyaros, SeinarCunos da ganaviTaros
urTierTobebi sxva adamianebTan”.
fizikuri da fsiqikuri janmrTelobis
konkretuli kriteriumebi dReisaTvis bolomde
Seswavlili ar aris. miuxedavad amisa, arsebobs
mravali obieqturi klinikuri da e.w. “paraklinikuri
monacemi” (ZiriTadad laboratoriuli), romelic
eqims mianiSnebs adamianis organizmis calkeuli
funqciuri sistemebis, organoebis disfunqciaze an
dazianebaze, rac janmrTelobis Sesustebas an
darRvevas iwvevs.
janmrTelobis aRdgenisken mimarTuli
RonisZiebebi tradiciulad xorcieldeba eqimisa da
samedicino personalis mier da igi moicavs
ramdenime ZiriTad process:
1. diagnostika – avadmyofobis gamovlena misi
subieqturi da obieqturi niSnebis (simpto-
mebis da sindromebis), samedicino anamnezis
da, saWiroebis SemTxvevaSi, paraklinikuri
gamokvlevebis gziT.

93
 2. mkurnaloba – RonisZiebaTa rigi, romelic
mimarTulia avadmyofobis mizezebis, kli-
nikuri simptomebis mosaxsnelad. mkurnaloba
SesaZloa iyos konservaciuli (ZiriTadad,
medikamenturi) da qirurgiuli.
3. reabilitacia – samkurnalo, balneologiuri,
kurortuli, sportul-gamajansaRebeli da
sxva saxis RonisZiebebi, mimarTuli avadm-
yofis damoukidebeli aqtivobis maqsimaluri
aRdgenisaken gadatanili travmis an
avadmyofobis Semdeg.
adamianis janmrTelobis SenarCunebiskenaa
mimarTuli e.w. profilaqtikuri RonisZiebebi,
romelTa mizania daavadebis Tavidan acileba, misi
prevencia. magaliTad, profilaqtikuri acrebi
infeqciuri daavadebebis Tavidan acilebis mizniT,
jansaRi cxovrebis wesis danergva da sxva.
ZiriTadi socialuri da fsiqologiuri
procesi, romelic mimdinareobs samedicino
daxmarebis dros, es aris, upirveles yovlisa,
urTierToba eqimsa da pacients Soris. eqimi da
pacienti praqtikulad erTad wyveten erT amocanas –
avadmyofobis damarcxebas da am saqmeSi
aucilebelia maTi TanamSromloba, urTierTgageba
da ndoba. es urTierToba mniSvnelovnad Seicvala
XX saukunis 30-40 wlebidan, rodesac aSkara gaxda
fsiqikuri faqtorebis roli avadmyofobaTa etio-
paTogenezSi, klinikuri suraTis CamoyalibebaSi,
mkurnalobis efeqturobaSi. fsiqosomaturi swav-
lebis damkvidrebam principuli cvlilebebi Seitana
samedicino azrovnebaSi.
XIX saukunidan medicinaSi damkvidrebuli
nozologiuri principis meTodologia eqims mimar-
Tavda avadmyofobis mkurnalobisaken (nozocent-
ruli modeli). avadmyofi iyo avadmyofobis
matarebeli pasiuri obieqti. eqimis funqcia iyo
sneulebis daZleva da gankurneba. fsiqosomaturma

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meTodologiurma midgomam Camoayaliba anTropo-
centruli modeli – orientacia avadmyofze, mis
pirovnebaze, mis problemebze. garda avadmyofis
pirovnuli Taviseburebebisa, dResaTvis gansakuT-
rebuli mniSvneloba uniWeba iseT aqtualur
faqtorebs, rogoricaa socialuri garemo,
ekonomikuri mdgomareoba, pirovnebis interperso-
naluri kavSirebi. amdenad saubari gvaqvs avadmyo-
fobis sociocentrul modelze.
yvelaferi es Tanamedrove eqims, Tavis saqmia-
nobaSi, uyenebs axal moTxovnilebebs, aiZulebs
axleburad Sexedos pacients, Cawvdes avadmyofobis
ara mxolod biologiur, aramed fsiqologiur da
socialur mizezebs.
eqimi, upirveles yovlisa, eZebs avadmyofobis
obieqtur niSnebs. magram, Tavad pacientisaTvis wina
planze yovelTvis gamodis avadmyofobis subieq-
turi, mis mier gancdili suraTi. avadmyofobis
autoplastiuri xati – avadmyofis mier misi
mdgomareobis subieqturi aRqmis Sedegad miRebuli
suraTia. mas aqvs Semdegi aspeqtebi:
1. senzitiuri (lokaluri SegrZnebebi, tkivili,
wva, zewolis SegrZneba da a.S.). es is
ZiriTadi subieqturi Civilebia, rasac
avadmyofi udgens eqims masTan Sexvedrisas.
2. emociuri (SiSi, SfoTva, imedi da a.S.). es aris
im situaciis emociuri Sefaseba, romelsac
avadmyofoba iwvevs. avadmyofobis formis, misi
simZimis, gankurnebis perspeqtivis, samedicino
Carevis saxis, Tavad senzitiuri komponentis
xasiaTis Sesabamisad avadmyofi avlens
subieqtur damokidebulebas da igi gamovlin-
deba sxvadasxva saxis emociur reagirebaSi.
3. nebiTi (daavadebis daZlevisaken mimarTuli
qmedeba). aq gaerTianebulia im mizanmimarTuli
qcevebis erToblioba, romelic ubiZgebs avad-
myofs, mimarTos eqims, gaiaros yvela saWiro

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 procedura da gamokvleva an Tavi aaridos
mkurnalobas.
4. racionaluri da informaciuli (codna
daavadebis Sesaxeb da misi Sefaseba). es
komponenti erT-erTi umniSvnelovanesia
avadmyofobis mizanmimarTuli profilaqtikis,
mkurnalobis da reabilitaciis procesebSi.
miuxedavad aseTi sqematuri dayofisa, avadmyo-
fobis autoplastiuri xati erTiania da masSi gadax-
larTulia inteleqtualuri, nebiTi da emociuri
komponentebi.

avadmyofobis “negatiuri” da “pozitiuri”

aspeqtebi. tradiciulad, daavadeba fasdeba rogorc
uciloblad negatiuri fenomeni – arasasiamovno da
xSirad mZime fizikuri TviTgrZnoba, aqtiurobis
SezRudva, SfoTva da SiSi sakuTari keTildReobis
da sicocxlis gamo. magram, amasTan erTad,
avadmyofoba atarebs pirovnebisaTvis garkveul
pozitiur aspeqtebsac. es aspeqtebi ZiriTadad
aracnobieria. esaa: pasuxismgeblobis acileba,
yuradRebis centrSi moxvedra, zrunvis obieqtad
gadaqceva. rig SemTxvevebSi daavadeba xdeba fari
pirovnebis ambiciebis, prestiJis da socialuri
konfliqtebis gadaWrisas.
“avadmyofobis kulti” – XX saukunis meore
naxevris fenomenia. igi socialuri movlenaa,
romelic dakavSirebulia avadmyofobis mimarT
damokidebulebis SecvliT. Znelia istoriaSi moi-
naxos periodi, rodesac avadmyofobaze Riad
saubari mowonebuli an miRebuli yofiliyo
sazogadoebaSi. avadmyofuri Civilebi ganixileboda
rogorc ukiduresad intimuri, piradi. gasul
saukuneSi mniSvnelovnad gaizarda fsiqo-socialuri
faqtorebiT gamowveuli daavadebebi, samedicino
gamokvlevebis, mkurnalobisa da diagnostikis
problemebi presisa d sxva media-saSualebebis

96
ganxilvis popularuli Tema gaxda. amitomac, stre-
sebiT aRsavse socialur garemoSi avadmyofobis
Tema gaxda erT-erTi yvelaze aqtualuri da popula-
ruli. SeiZleba vifiqroT, rom sakuTari fizikuri
Tu fsiqikuri Civilebis wina planze wamoweva xdeba
garkveuli dacviTi meqanizmi TviTdamkvidrebis an
socialuri mxardaWeris mopovebisaTvis.

daavadebis autoplastiuri xatis ganmapirobe-

beli faqtorebidan SesaZloa gamovyoT sami:
1. daavadebis xasiaTi (qronikuli, mwvave,
konservaciuli Tu operatiuli Careva, Zlieri
tkivilebi, moZraobis SezRudva da a.S.),
2. viTareba, romelSic mimdinareobs daavadeba
(socialur-ekonomikuri situacia,
mikrosociumi, daavadebis mizezi),
3. premorbiduli tipi (asaki, konstitucia, pirov-
nuli faseulobebi, samedicino “ganaTleba” da
gamocdileba da a.S.).

yvela es piroba da faqtori ayalibebs

damokidebulebas avadmyofobis mimarT, romelic
SesaZloa iyos:
1. normaluri, romelic Seesabameba avadmyofis
mier miRebul informacias misi mdgomareobisa
da Casatarebeli mkurnalobis Sesaxeb.
pacienti garkveulia Tavisi avadmyofobis
arsSi, kompetenciis farglebSi esmis
mkurnalobis mniSvneloba da mosalodneli
efeqti, aqtiurad Tanamromlobs eqimTan da
asrulebs mis rekomendaciebsa da miTiTebebs.
2. zedapiruli, rodesac adamiani ver afasebs
mdgomareobis seriozulobas. igi ar icavs
eqimis rekomendaciebsa da mkurnalobis reJims.
3. “davadebis uaryofa” – pirovneba ar aqcevs
yuradRebas daavadebas, ar mimarTavs eqims,
Tavidan icilebs avadmyofobaze fiqrs. miaCnia,

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 rom diagnozi mcdaria da igi sinamdvileSi
janmrTelia (am mdgomareobaSi Sedis
disimulaciac).
4. “nozofobia” – daavadebis araadekvaturi SiSi.
es mdgomareoba ganixileba, rogorc fsiqikuri
darReva. pirovnebas aqvs dasnebovnebis
absoluturad usafuZvlo SiSi. igi sxvadasxva
saxiT cdilobs aaridos Tavi daavadebas –
svams mxolod anaduRar wyals, zedmetad
xSirad ibans xelebs, akeTebs yofiTi sagnebis
sterilizacias da sxva.
5. “nozofilia” – garkveuli damSvideba,
siamovneba daavadebis arsebobiT. avadmyofi
maqsimalurad “iyenebs” avadmyofobis pozi-
tiur fsiqologiur da socialur faqtorebs.
igi Tavisufldeba Semawuxebeli socialuri
valdebulebebisagan, mudmivad imyofeba
yuradRebis da zrunvis centrSi.
6. “ipoqondria” – eWvi an darwmuneba seriozuli
daavadebis arsebobaSi. pirovneba darwmu-
nebulia, rom mas gacilebiT ufro seriozuli
da mZime daavadeba aqvs, vidre es eqimebma
daudgines. es viTareba ubiZgebs mas xSirad
gamoicvalos eqimi, Caitaros uamravi gamokv-
leva, raTa “daadas-turos” mZime sneulebis
arseboba.
7. “utilitarul” anu gamoyenebiT damokide-
bulebas avadmyofobis mimarT SesaZloa
sxvadasxva mizezebi hqondes: TanagrZnobis da
yuradRebis miReba, arasasiamovno viTarebidan
Tavis daRweva an materialuri mogeba (pensia,
kompensacia).

utilitaruli reaqcia SesaZloa iyos met-

naklebad gacnobierebuli da ganviTardes, rogorc
aramZime daavadebis fonze, aseve janmrTel
adamianSi. am mxriv arCeven sami tipis reaqcias:

98
 agravacia – avadmyofobis niSnebis gazvia-
debaa. aseTi gazviadeba SesaZloa iyos sruliad
gacnobierebuli da mizanmimarTuli an
ganpirobebuli emociuri, siRrmiseuli motivebiT
(SiSiT, undoblobiT, uimedobiT).
simulacia (laT. simulatio – moCvenebiTi qceva)
fsiqikuri da somaturi simptomebis gacnobierebuli
da mizandasaxuli warmoCineba, garSemomyofebis
SecdomaSi Seyvanis mizniT. mas yovelTvis aqvs
konkretuli mizani da SemdgomSi e.w. “sargebeli”
disimulacia - avadmyofobis arsebuli
niSnebis damalva. es reaqcia ZiriTadad gvxvdeba
iseTi avadmyofobebis dros, romelTa arsebobas
pirovnebisTvis subieqturi an obieqturi arasaxar-
bielo Sedegebi moaqvs (fsiqikuri daavadebebi,
tuberkulozi, veneriuli sneulebani).
rogorc mravali avtori aRniSnavs, daavadebis
suraTze seriozul gavlenas axdens pacientis
samedicino cnobiereba, rac vlindeba avadmyofobis
da sakuTari situaciis realuri Sefasebis unarSi.
aseTi Sefaseba bavSvobaSi yalibdeba. mSoblebi
Tavisi gamoTqmebiT avadmyofobis, eqimebis,
medicinisa da mkurnalobis Sesaxeb xels uwyoben
bavSvi problemuri Sexedulebebis aRzrdas. mas
aseve amdidrebs bavSvis sakuTari gamocdileba:
uaryofiTi gancdebi iwvevs SiSsa da momaval
situaciebSi daurwmuneblobas da, piriqiT – Tu
daavadebas “sargebeli” moaqvs, daavadeba SeiZleba
gaRrmavdes an ganmeordes. samedicino cnobierebis
gamdidrebis wyaros warmoadgens mosaxleobis
sanitaruli ganaTleba – daavadebebis Sesaxeb
popularuli informaciis miwodeba.

im zogadbiologiuri fenomenebidan, romelic

uxSiresad Tan erTvis sxvadasxva avadmyofobebs
aris tkivili. tkivili – cocxali organizmebis mier
evoluciis procesSi SeZenili erT-erTi umniSvnelo-

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vanesi Tvisebaa. tkivili warmoadgens fsiqikur
mdgomareobas, romelic aRmocendeba organizmi-
saTvis iseTi Zlieri zemoqmedebis Sedegad, romelic
safrTxes uqmnis mis mTlianobas an arsebobas.
tkivils, rogorc normaluri fiziologiuri proce-
sebis darRvevis signals, udidesi klinikuri
mniSvneloba aqvs. igi jer kidev avadmyofobis
garegani, aSkara niSnebis gamovlenamde SegrZnebebis
registrSi miuTiTebs adamianis organizmSi
mimdinare paTologiur procesebze. emociuri
Sefasebis aspeqtSi tkivili dakavSirebulia tanjvas-
Tan, magram amave dros aris dacviTi reaqciebis
stimuli.
eqimisTvis tkivils aqvs rogorc dadebiTi,
aseve uaryofiTi klinikuri mniSvneloba. tkivilis,
rogorc diagnostikuri niSnis gamoyenebis
magaliTia e.w. “mwvave muceli”. am dros tkivilis
moxsna ar aris rekomendebuli gamokvlevebis dasru-
lebamde, raTa am simptomis intensivobis Secvlam ar
gamoiwvios sirTuleebi diagnostikaSi. tkivilis
garkveul negatiur aspeqtebze diagnostikis dros
SesaZlebelia visaubroT im SemTxvevebSi, rodesac
es SegrZneba ar aris paTologiuri procesis
“adekvaturi”. magaliTad, tkivilis ararseboba
tuberkulozis zogierTi mZime formis dros, kbilis
tkivili an muclis “kolika”. mniSvnelovan
garemoebas warmoadgens is, rom tkivilis gancda
garkveulwilad subieqturia: saomar viTarebaSi
miRebuli seriozuli Wrilobac ki jariskacebis
mier adekvaturi reaqciis gareSe aRiqmeba, vinaidan
moaswavebs evakuacias brZolis velidan da
usafrTxo garemoSi gadasvlas; sportuli Sejibre-
bebisas (krivi, regbi, fexburTi) miRebuli travmis
dros tkivili subieqturad gacilebiT dabali
intensivobiT iCens Tavs.
tkivili mniSvnelovan funqciur cvlilebebs
iwvevs adamianis organizmSi, gansakuTrebiT vegeta-

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tur sistemaSi. gugebis gafarToveba, civi ofli,
taqikardia, arteriuli wnevis mateba am simptomis
intensivobis kriteriumia, rac eqimisaTvis garkveul
diagnostikur mniSvnelobas iZens. tkivilis
zogierTi saxe dakavSirebulia SfoTvasTan da
sikvdilis SiSTan. uecarma, Zlierma tkivilma
SesaZloa gamoiwvios Zlieri fsiqikuri reaqcia.

SiSi – es aris emocia, romelic Cndeba pirov-

nebis biologiuri an socialuri arsebobisaTvis
saSiS situaciaSi an am situaciis arsebobis
safrTxis dros. Tu safrTxe daukonkretebeli da
gaucnobierebelia, maSin viTardeba SfoTva. SfoTva
– difuzuri, generalizirebuli anu usagno SiSia.
avadmyofs, romelsac ar aqvs unari realurad da
obieqturad Seafasos avadmyofobasTan dakavSire-
buli subieqturi gancdebi, xSirad eufleba SfoTva.
SiSi da SfoTva SesaZloa ukavSirdebodes awmyo
situacias (“ra mWirs?”) da momavlis perspeqtivas
(“ra meSveleba?”). Tavad am emociurma gancdebma
SesaZloa daamZimos pacientis mdgomareoba –
vegetatiuri komponentis xarjze, xeli SeuSalos
pacientis gamokvlevas eqimis mier da sxvadasxva
samedicino manipulaciebis Catarebas.
sayuradReboa, rom zogierTi daavadebis dros
SfoTva SesaZloa gamoCndes rogorc pirveladi
simptomi da ara - meoradi fsiqikuri reaqcia.
magaliTad, kardialuri asTmis, miokardiumis
infarqtis, filtvis emboliis dros.
Zalian xSirad, rogorc avadmyofuri
mdgomareobisa da masTan dakavSirebuli socialuri
perspeqivebis Sefaseba, avadmyofs SesaZloa
Camouyalibdes arasrulfasovnebis gancda. es gancda
uSualod araa dakavSirebuli avadmyofur
simptomebTan, aramed warmoadgens im damokidebule-
bis subieqtur asaxvas, romelic viTardeba
pirovnebis garSemo da mis “SigniT” (avadmyofobis

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autoplastiuri xati, damokidebuleba ojaxis
wevrebTan, axloblebTan, samedicino personalTan).
arasrulfasovnebis gancda pirdapir proporciulia
avadmyofobis struqturisa (simwvave, qronizacia,
fizikuri da socialuri SezRudvis xarisxi da
sxva). arasrulfasovnebis paTologiuri gancda
viTardeba im SemTxvevaSi, rodesac am tipis Sefaseba
avadmyofobis xarisxis da formis aradekvaturia.
aseTi TviTSefasebis safuZveli SesaZlebelia
veZeboT pacientis cxovrebis adreul periodSi,
gansakuTrebiT bavSvobis asakis fsiqologiur
gancdebSi. igi garkveulwilad dakavSirebulia
aRzrdasTan, sxvadasxva fizikur defeqtebTan an
TaviseburebebTan: simsuqne, metyvelebis
Tandayolili nakli. arasrulfasovnebis gancdis
kompensacia yalibdeba damSvidebis fsiqologiuri
wyaros ganviTarebiT an CamoyalibebiT. am procesSi
wamyvani roli eqims miuZRvis. kompensacia ufro
harmoniuli da efeqturia axalgazrda asakSi,
rodesac organizmi da fsiqika advilad egueba
cvlilebebs. xandazmul asakSi es procesebi ufro
mZimed midis da SesaZloa miiRos paTologiuri
xasiaTi.
eqims arasdros ara aqvs saqme abstraqtul
avadmyofobasTan, igi pirovnebis (“Homo patiens”)
pirispir dgas. avadmyofoba droSi viTardeba da am
ganviTarebas Tavis etapebi aqvs.
1. presamedicino faza pirvelad Cndeba, rogorc
wesi umniSvnelo, TiTqmis SeumCneveli
subieqturi niSnebi, rasac moyveba kiTxvebi:
“ra vqna?”, “avad xom ar var?”, “mivide
eqimTan?”. iSviaTad avadmyofs aReniSneba
moCvenebiTi udardeloba – repudiacia.
2. mkurnalobis faza dgeba stacionaruli an
ambulatoruli mkurnalobis dawyebis Semdeg.
avadmyofi izolirebulia ojaxidan,
samsaxuridan, tanjavs daurwmunebloba da

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 eWvebi. pacienti eqimisa da medpersonalisagan
yuradRebas da TanagrZnobas iTxovs.
3. aqtiuri adaptacia viTardeba avadmyofobis
mwvave simptomebis SedarebiTi reduqciis
fonze. pacienti SedarebiT mSviddeba, vinaidan
egueba axal situacias ojaxSi (ambulato-
riuli mkurnalobisas) da stacionarSi. sta-
tistikuri gamokvlevebiT srulyofil adap-
tacias stacionirebul pacientTa 75% axdens.
pacientis adaptacia hospitaluri pirobebis
mimarT, misi gamojanmrTelebis SemTxvevaSi,
SesaZloa eqimisTvis seriozul problemad
iqces (hospitalizmis sindromi). saavadmyofos
mSvid da usafrTxo garemos Seguebuli
pacienti cdilobs gaixangrZlivos iq yofna.
Tu mdgomareoba uaresdeba, avadmyofma
SesaZloa ganicados dekompensacia.
4. fsiqologiuri dekompensacia. avadmyofs
eufleba imedgacrueba, SiSi, SfoTva, umwvav-
deba avadmyofobis subieqturi suraTi. igi
kargavs gamojanmrTelebis imeds da aRar
endoba eqims. xdeba impulsuri, mouTmeneli,
Wirveuli, konfliqturi. xSirad am
mdgomareobas mosdevs kapitulacia.
5. pasiuri adaptacia da kapitulacia. avadmyofi
egueba Tavis beds, kargavs avadmyofobasTan
fsiqologiuri brZolis unars. xdeba ganurCe-
veli da sevdiani. am mdgomareobis umTavresi
problema is, rom eqimi da samedicino perso-
nali, romelsac aqtiuri fsiqologiuri da
fsiqoTerapiuli CareviT SeuZlia xeli Seuw-
yos pacients am mdgomareobis daZlevaSi,
xSirad pasiurobs da amiT xels uSlis
SesaZlo aqtiuri adaptaciis process.

edvar sakmanma aRwera avadmyofobis dros

pacientis qcevis 5 stadia:

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 1. simptomebis SegrZnebis stadia, romelzec
pacienti iRebs gadawyvetilebas, rom mis
organizmSi “raRac xdeba”;
2. avadmyofis rolis morgebis stadia,
romelzec pacienti iRebs gadawyvetilebas,
rom igi avadaa da profesionalis daxmareba
esaWiroeba;
3. samedicino dawesebulebasTan kontaqtis
stadia – profesiuli daxmarebis moZieba;
4. damokidebuli pacientis rolis stadia –
pirovneba iRebs gadawyvetilebas, rom
kontroli gadasces eqims da mihyves mis
daniSnulebas, mkurnalobis sqemebs;
5. gamojanmrTelebis an reabilitaciis stadia,
roca pacienti iRebs gadawyvetilebas, rom
gamovides avadmyofis rolidan.
avadmyofobis procesSi pirovnebis qceva
SesaZlebelia winaswar ganvsazRvroT, Tu
gaviTvaliswinebT Semdeg sakiTxebs:
- avadobis sxva epizodebi, gansakuTrebiT -
standartuli simwvavis mqone mdgomareobebi
(mag.: Tirkmlis kenWovani daavadeba, mSobia-
roba an qirurgiuli operaciebi).
- ramdenad iTxovs kultura pirovnebisagan
stoicizms;
- specifikuri problemebis Sesaxeb kulturaSi
arsebuli Sexedulebebi;
- konkretuli problemis Sesaxeb pirovnebis
Sexeduleba.

adamianis arsebobis, misi “egzistenciis” erT-

erT umniSnelovanes filosofiur problemas sikvdi-
li wamoadgens. sikvdili damTrgunvelia Tavisi
gardauvalobiTa da, amave dros, moulodnelobiT.
janmrTeli an mokle droiT avadmyofi adamiani
gandevnis fsiqikidan azrebs sikvdilis Sesaxeb. igi
motivirebulia awmyos konkretuli problemebiT da

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axlo momavlis socialuri gegmebiT. Tanatofobia –
sikvdilis dauZleveli SiSia, romelic adamians
uCndeba viTarebSi, rodesac amis realuri safrTxe
ar aris.
eqimi sikvdilis problemas ZiriTadad mZime,
ganukurnebeli seniT daavadebul avadmyofebTan
kontaqtisas xvdeba. klinikis pirobebSi, swored
eqimi, eqTani da praqtikulad nebismieri TanamSro-
meli iRebs sakuTar Tavze pacientis sulieri
nugeSis funqcias, mis momzadebas gardauvali
dasasrulis mSvidad misaRebad. kvlevebma gvaCvena,
rom uSualod sikvdilis dadgomas win, rogorc
wesi, mZime socialuri an emociuri stresi uZRvis,
romelmac SesaZloa daaCqaros Sinagani fsiqolo-
giuri kapitulacia.
Tu gavaanalizebT reaqcias sikvdilis safrT-
xeze, SesaZloa gamovyoT Semdegi tipebi:
1. gardauvali dasasrulis mSvidi da morCili
miReba. aseTi tipis reaqciaSi wamyvan rols
religiuri rwmena TamaSobs. rwmena, romelic,
Tavis mxriv, sulis simtkicisa da simyaris
safuZvelia, ar aZlevs adamians saSualebas
sasowarkveTilebaSi Cavardes. sikvdili
morwmunisTvis gardauvali, magram ara
tragikuli, movlenaa.
2. pasiuri kapitulacia vlindeba apaTiasa da
adinamiaSi. pacienti srul prostraciaSia,
praqtikulad ar reagirebs aranair movlenaze,
gamqrali aqvs interesi yvelasa da yvelafris
mimarT.
3. gansvla yofiT problemebSi. pacienti
mTlianad erTvis socialur da viwro ojaxur
Tu yofiT problemebSi. fizikuri SesaZleb-
lobidan gamomdinare, igi ar wyvets muSaobas,
saqmianobas, saubarSi arasdros exeba Tavisi
avadmyofobis Temas.

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 4. negatiuri tipis kompensacia gamoixateba
socialuri funqcionirebis aqtiuri SenarCu-
nebis fonze loTobis an toqsikomaniis Camo-
yalibeba, seqsualuri eqscesebisadmi gamoxa-
tuli midrekileba, Warbi kveba.

reaqcia moaxloebul sikvdilze

an mZime diagnozze
adamianis reaqcia mZime diagnozze da, zogadad,
moaxloebul sikvdilze araerTi mkvlevaris
interesis sferoSi moxvda. am reaqciebis garkveul
sistemaSi moqceva warmatebiT SesZlo fsiqiatrma da
Tanatologma elizabet kubler-rosma (Kübler-Ross E:
On Death and Dying. Macmillan, NY, 1969), romelmac xuTi
etapi gamohyo:
pirveli etapi – Soki da uaryofa. pacients,
romelmac Seityo fataluri daavadebis arsebobis
Sesaxeb, Tavdapirvelad Sokuri reaqcia aReniSneba.
igi SeiZleba araTu daeWvdes diagnozis sizusteSi,
aramed arc ki daijeros, rom avadaa. zogi avadmyofi
sxvadasxva specialistTan siaruls iwyebs da
SesaZloa iseTi eqimic “aRmoaCinos”, romelic mis
mosazrebas gaamyarebs. Tu daavadebis miuReblobis
motiviT pacienti uars ambobs mkurnalobis
gagrZelebaze, eqimi valdebulia Rirsebis
Seulaxavad, magram pirdapiri formiT, auxsnas mas
da misi ojaxis wevrebs daavadebis arsi, prognozi
da SesTavazos mkurnalobis variantebi.
meore etapi – brazi. rogorc wesi, pacienti
gawbilebulia, gaRizianebuli da gabrazebuli. mas
ar asvenebs sakraluri kiTxva – “ratom me?” brazi
SeiZleba gamoxatos RmerTis, bed-iRblis, megobris
an ojaxis wevris mimarT, Tumca SeiZleba gamoTqvas
TviTbraldebis azrebic. pacientma brazi SeiZleba
mimarTos saavadmyofos personalzec, rac arTulebs
mkurnalobas. eqimma, romelic ver gaigebs, rom es
brazi – reaqciaa moaxloebul sikvdilze, SeiZleba

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pacienti sxva eqims gadaabaros. aseTi pacientis
marTva saWiroebs empaTiis gamoxatvas, raTa eqimma
moaxdinos pacientis refokusireba ufro Rrma
emociebze (mag.: martooba, glova, SiSi), rac brazis
safuZvels qmnis.
mesame etapi – “garigeba”. pacienti cdilobs
garigeba daiwyos eqimTan, megobrebTan, TviT
RmerTTanac ki. klasikuri formulireba ase JRers:
Tu gadavrCebi, me qvelmoqmedebas an eklesiur
cxovrebas daviwyeb. “vaWrobis” erT-erTi formaa,
roca pacients swams – Tu igi usityvod
daemorCileba eqims, iqneba xalisiani da zedmet
kiTxvebs ar dasvams, eqimi mas ukeT moepyroba da
ukeTesad mixedavs.
meoTxe etapi – depresia. am etapze pacienti
warmoadgens klasikur depresiul simptomebs,
rogoricaa: fsiqomotoruli Sekaveba, Zilis
darRvevebi, uimedoba, TviTmkvlelobis azrebi.
depresiis mizezi SeiZleba iyos, erTi mxriv – ga-
cnobiereba imisa, rom cxovreba mTavrdeba, xolo
meore mxriv – daavadebis gamo ganviTarebuli
sxvadasxva cxovrebiseuli cvlilebebi (mag.:
ekonomikuri siduxWire, megobrebisa da Cveuli
garemosagan izolacia, samsaxuris dakargva). eqimma
unda SesZlos Rrma depresiuli mdgomareobis
garCeva daqveiTebuli guneb-ganwyobisagan, rac
normaluri movlenaa mZime daavadebebis SemTxvevaSi.
mexuTe etapi – “miReba”. pacienti acnobierebs,
rom sikvdili gardauvalia da igi iRebs am
universalur gardauvalobas. emociuri sfero
SeiZleba meryeobdes neitraluridan eiforiulamde
(msubuqad aweuli guneb-ganwyoba). idealur
variantSi, pacienti pirovnulad gadaamuSavebs ra
sikvdilTan miaxloebis Temas, Tavad iwyebs saubars
sikvdilze. am etapze Zalze mniSvnelovania reli-
giuri rwmenis simtkice. morwmunes ar eSinia sikvdi-

107
lis – is fiqrobs maTze, vinc sasufeveli daim-
kvidra da ufals avedrebs momaval Taobebs.

Cven ganvixileT pacientis fsiqikuri

mdgomareobisa da reaqciebis sxvadasxva tipebi,
magram mkurnalobis procesi warmoudgenelia meore
figuris – eqims gareSe. ganvixiloT samedicino
daxmarebis gawevis procesSi eqimis fsiqologiuri
reagirebis Taviseburebani anu eqimis fsiqologia.
eqimis profesia metad rTuli da
sapasuxismgebloa – mas adamianis sicocxle da
janmrTeloba abaria. amitomac eqims, garda profe-
siuli codnisa, unda hqondes garkveuli pirovnuli
Tvisebebi. am Tvisebebis nawili Tandayolilia. es,
upirveles yovlisa, aris Sinagani interesi eqimis
profesiis mimarT. motivacia, romelic ubiZgebs
axalgazrdebs airCios es profesia sxvadasxvaa.
ZiriTadad, es aris humanisturi motivacia – aqtiuri
daxmarebis, Tanadgomis Sinagani moTxovnileba. Sua
saukuneebis holandielma eqimma val tiulpma Tavisi
profesiis gerbad anTebuli sanTeli, xolo devizad
“viwvi sxvebisaTvis naTebaSi” airCia. am motiviTa da
suliskveTebiT moRvawe eqimebi yovelTvis xdebian
ara marto profesiuli, aramed eTikuri da
moqalaqeobrivi qcevis etalonebi.
axalgazrda, damwyebi eqimis fsiqikur
dayenebebSi, misi samedicino karieris pirveli
nabijebisas, Warbobs emociuri mxare. amitomac igi
fsiqologiurad ufro axlosaa pacientTan, ganicdis
mis problemebs. es damokidebuleba garkveulilad
“amaxinjebs” obieqtur da efeqtur urTierTobas. am
fenomens eqimis deluzia ewodeba. magram eqimis
damokidebuleba ar unda Semoifarglos mxolod
emociebiT. eqimis qceva, gansakuTrebiT im
SemTxvevebSi, rodesac igi valdebulia moqmedebdes
swrafad da gabedulad, garegnulad SesaZloa civad
da gulgrilad mogveCvenos. eqimis pacientisadmi

108
humanuri damokidebuleba gamoixateba, ra Tqma unda,
ra mxolod misi subieqturi gancdebis STagrZnobaSi
(empaTia), aramed samedicino daxmarebis srulyofil
da maRalkvalifirebul miwodebaSi. SesaZloa
samedicino Carevis forma da xasiaTi xSirad ar
pasuxobdes pacientis emociur gancdebs, magram
mkurnalobis Sedegi amarTlebs diskomforts mkur-
nalobis garkveul etapze. deluziis sxvagvari
formaa pacientisadmi iseTi damokidebuleba,
romlis drosac eqimi masSi xedavs mxolod
“SemTxvevas”, ver grZnobs mis gancdebs, ar avlens
sakmaris siTbos da empaTias.
erT-erTi mniSvnelovani safrTxe, romelic
SesaZlebelia gaCndes eqimis pacientTan araswori
fsiqologiuri midgmis gamo aris iatrogenia.
zogadad, iatrogenia aris gamokvlevis, profilaq-
tikuri RonisZiebebis an mkurnalobis dros eqimis
mier pacientisadmi zianis miyeneba. arCeven somatur
iatrogenias – rodesac pacients ziani adgeba
araswori medikamenturi mkurnalobis Sedegad,
meqanikurs – qirurgiuli manipulaciiT gamowveuls
da fsiqologiurs – rodesac fsiqologiuri
zemoqmedebiT, magaliTad, pacientTan an pacientis
gasagonad personalTan iseT faqtebze saubari,
romelic pacientis fsiqogenuri reaqciis mizezi
xdeba. fsiqikuri iatrogenia fsiqogenuri reaqciis
erT-erTi saxea. eqimis avtoritetiT ganpirobebuli
araswori fsiqologiuri zemoqmedeba (ZiriTadad,
STagonebaze damyarebuli) SesaZloa gaxdes
daavadebis niSnebis gamwvavebis an sruliad axali
avadmyofuri simptomebis ganviTarebis mizezi.
sxvagvarad, iatrogenia – negatiuri fsiqoTerapiaa.
iatrogeniis mizezi, rogorc wesi, eqimis mier
pacientis fsiqologiis arcodna, pacientis
gancdebisadmi zerele damokidebuleba, Tavis
saqcielsa da metyvelebaze naklebi kontrolia.
iatrogenis mizezi SesaZloa gaxdes arasworad

109
warmoebuli samedicino-saganmanaTleblo RonisZie-
bebi (avadmyofobis Sesaxeb informaciis zedmeti
dramatizeba, specialuri terminebis umizno xmareba
da sxva), formaluri da civi damokidebuleba
pacientTan, pacientis TandaswrebiT kolegebs Soris
diskusia da sxva.
eqimisa da pacientis fsiqologiuri urTier-
Tobis ZiriTad safuZvels warmoadgens eqimis
kvalifikacia, gamocdileba da xelovneba. eqimis
codnisa da gamocdilebis amaRlebisa da
gaRrmavebis umniSvnelovanes pirobas warmoadgens
codnis mudmivi gaRmaveba, uwyveti samedicino
ganaTleba ara marto mis viwro specialobaSi,
aramed medicinis momijnave dargebSi, samedicino
eTikis problemebsa da kanonmdeblobaSi.
eqimi mxolod maSin xdeba avtoritetuli
pacientisaTvis, rodesac igi harmoniuli, mSvidi,
Tavis TavSi darwmunebuli da gabeduli pirovnebaa.
eqimisa da pacientis urTierTobis procesSi
viTardeba Taviseburi, siRrmiseuli fsiqikuri
procesebiT ganpirobebuli fsiqologiuri fenome-
nebi. es procesebi aRwera da Seiswavla fsiqoa-
nalizis fuZemdebelma zigmund froidma. misi
koncepciiT eqimsa da pacients Soris Terapiis
procesSi yalibdeba myari, aracnobieri emociuri
urTierToba. am dros pacienti qvecnobier emociur
doneze, aigivebs eqims bavSvobis asakSi misTvis
mniSvnelovan, avtoritetul figurasTan (ZiriTadad,
mamasTan an dedasTan). es ki iwvevs eqimTan
urTierTobisas analogiuri tendenciebis da
urTierTobis stereotipebis Camoyalibebas – imedi,
ndoba, siyvaruli an mtruli ganwyoba. am fenomens
froidma “transferi” uwoda, xolo sapirispiro –
eqimidan pacientze mimarTul emociur ganwyomas
“kontrtransferi”.
avadmyofTan kontaqtisas didi mniSvneloba
aqvs pirvel STabeWdilebas, romelsac eqimi axdens

110
pacientze. magram, garda amisa, avadmyofze moqmedebs
agreTve is garemoc, romelSic xvdeba. administra-
ciuli muSakebis, samedicino personalis damoki-
debuleba pacientis mimarT, Tavad klinikis iersaxe,
yofiTi pirobebi ayalibebs mis saerTo ganwyobas
mkurnalobis mimarT.
pacientis ndobis, misi keTilganwyobis miRweva
SesaZlebelia mxolod mis gancdebsa da
problemebSi Rrma emociuri wvdomiT. empaTia –
STagrZnoba, emociuri mdgomareobaa, rodesac
adamianebs Soris xdeba gancdebisa da grZnobebis
gulaxdili gaziareba. Terapiuli TvalsazrisiT
empaTia, eqimsa da pacients Soris urTierTobis,
yvelaze efeqturi saSualebaa. empaTiis sawyiss
avadmyofis “fsiqikuri ventilaciis” mdgomareoba
warmoadgens anu rodesac mas aqvs saSualeba
Tavisuflad, yovelgvari SeCerebis an gawyvetis
gareSe isaubros Tavis mdgomareobaze, problemebze,
gancdebze. eqimma unda Seuqmnas avadmyofs sruli
STabeWdileba imisa, rom igi mTlianad aris
“Cafluli” mis gancdebSi, axdens pirovnul
“rezonanss”. swored am tipis urTierToba ayalibebs
pacientis eqimisadmi ndobas.
eqimisa da pacientis urTierTobis tipebi
Camoayaliba amerikelma mecnierma vitCim (1986).
socialur urTierTobebsa da EeTikuri principebze
dayrdnobiT man oTxi modeli gamohyo:
1. eqimi – inJineri. swavluli, mecnieri,
specialisti, romelic ikvlevs avadmyofs
da acnobs mas srul informacias misi
avadmyofobs Sesaxeb. eqimis valia gaacnos
pacients sruli informacia misi avadmyo-
fobis Sesaxeb. pacientma unda icodes ara
marto gamokvlevebis, mkurnalobisa da
reabilitaciis strategia, aramed sava-
raudo garTulebebi da prognozi. am
informaciaze dayrdnobiT pacienti damo-

111
 ukideblad iRebs gadawyvetilebas da eqimis
roli am urTierTobaSi maqsimalurad
pasiuria. urTierTobis am models informa-
ciulsac uwodeben.
2. eqimi – RvTis msaxuri. “mSoblisa” da
“Svilis” urTierTobis principze damya-
rebuli kontaqtebi, eqimis sruli
“kontroli” pacientze, “misive
interesebidan gamomdinare”. eqimi pacientze
“mSobliur” zrunvas ganaxorcielebs. igi
Tavad swyvets mkurnalobis strategias da
pacientis monawileoba am procesSi
maqsimaluradaa SezRuduli. aseT damokide-
bulebas paternalisturs uwodeben.
3. eqimi – kolega. partnioruli tipis modeli,
sadac wamyvania urTierTTanamSromloba,
interesTa Tanxvedra avadmyofobis
dasaZlevad. informaciuli tipisgan
gansxvavebiT, am SemTxvevaSi xdeba eqimTan
erTad pacientis janmrTelobasTan
dakavSirebuli yvela problemis ganxilva,
analizi. pacienti Tavad irCevs
mkurnalobis strategias, magram eqimi
gacilebiT ufro aqtiurad monawileobs
gadawyvetilebis miRebaSi. am SemTxvevaSi
pacientis ndobas eqimisadmi wamyvani roli
eniWeba. am models interpretaciuls
uwodeben.
4. saxelSekrulebo modeli. iuridiul
kontraqtze dafuZnebuli urTierToba
eqimsa da pacients Soris, sadac gansazRv-
rulia orive mxaris movaleobebi da
uflebebi. eqimisa da pacientis urTierToba
mimdinareobs mkacrad reglamentirebul
CarCoebSi. wamyvania pacientis deklari-
rebuli uflebebi da eqimis movaleobebis
zusti gansazRvra. es modeli farTodaa

112
 gamoyenebuli sadazRvevo medicinis
pirobebSi, ris gamoc mas SeiZleba
sadazRvevo modeli uwodoT.

amerikeli specialistebi eqim-pacientis

urTierTobaSi gamohyofen agreTve 4 specifikur
models:
1. aqtiur-pasiuri modeli gulisxmobs pacientis
pasiur rols da masze eqimis mzrunvelobas.
am dros avadmyofi srul pasuxismgeblobas
eqims akisrebs da ar monawileobs
mkurnalobis procesSi. es modeli misaRebia,
roca pacienti ugonodaa, bodviT mdgo-
mareobaSia an moZraoba ar SeuZlia.
2. pedagogi-studentis (mSobeli-Svili) modeli -
gulisxmobs mkurnalobis yvela etapze
medikosis srul dominirebas. eqimi mentoris,
mamis anu e.w. paternalistur rols irgebs da
akontrolebs pacients da es ukanasknelic
srul ndobas ucxadebs medikoss. es modeli
xSirad SeiniSneba operaciis Semdgom,
gamojansaRebis periodSi.
3. ormxrivi TanamSromlobis modeli niSnavs
eqimisa da pacientis Tanasworuflebianobas –
orive mxare damokidebulia TiToeulis mier
Setanil wvlilze. es modeli gansakuTrebiT
Rirebulia iseTi qronikuli daavadebebisas,
rogoricaa diabeti da Tirkmlismieri ukmari-
soba, radgan pacientis codna daavadebis
Sesaxeb da mkurnalobis mimRebloba, gadam-
wyvetia daavadebis keTilsaimedo gamosav-
lisaTvis. aRniSnuli modeli garkveulad
efeqturia Semparavi daavadebebisaTvisac, maga-
liTad, pnevmoniisas.
4. megobruli modeli. eqim-pacientis megobruli
urTierToba, zogadad, disfunqciurad da,
ufro metic, araeTikurad iTvleba. igi miu-

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 TiTebs, rom eqims garkveuli fsiqologiuri
problema aqvs, ris gamoc uCndeba emociuri
moTxovnileba, pacientze mzrunveloba gadai-
tanos informaciis da siyvarulis urTierTga-
dacvlis formaSi. am models mivyavarT
gadauWrel, samudamo urTierTobebTan, radgan
sazRvari eqimsa da pacients, profesio-
nalizmsa da intimurobas Soris bundovania.

eqimi pacientis rolSi

kontrtransferensi gansakuTrebiT aqtualobas
iZens, rodesac eqimi avad xdeba. xSirad avadmyofi
eqimi moelis, rom Tavad imkurnalebs da, amave dros
eSinia, kolegebma kiTxvis niSnis qveS ar daayenon
misi profesionalizmi an kompetenciia. avadmyofi
eqimi yvelaze “cudi”, daumorCilebeli da jiuti
pacientia, radgan icis, rogor akontrolis samedi-
cino situacia da amasTan, daxelovnebulia eqim-
pacientis urTierTobis xelovnebaSi. eqimisaTvis
pacientis rolSi yofna niSnavs: SeeSvas
TviTkontrols; gadavides daqvemdebarebulis
rolSi; gaxdes mowyvladi da SeSinebuli, risi
daTrgunvac Tavad SeuZlia. amitomac igi, erTi
mxriv, winaaRmdegobas uwevs kolegebs, misTvis
samedicino daxmarebis aRmoCenaSi an, meores mxriv,
aris dabneuli – saTanado kiTxvebs ver svams imis
SiSiT, rom ucodinari ar gamoCndes. am viTarebaSi
kolegis mkurnali eqimis mxridan, Tu pacientSi
sakuTar Tavs xedavs, SeiZleba gamovlindes Tavis
aridebis an uaryofis meqanizmebi.

dialogi pacientTan – samedicino interviu

eqimisaTvis Zalze mniSvnelovania samedicino
intervius efeqturad warmoebis unari. gamocdil
eqims ZaluZs Seagrovos pacientis diagnostikisa da
mkurnalobis taqtikis gansazRvrisaTvis saWiro
monacemebi, amave dros – daexmaros pacients sru-

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lad gaacnobieros eqimis rCevis da mkurnalobis
reJimisaTvis damorCileblobis mniSvneloba.
nebismier intervius 3 komponenti aqvs:
Sesavali, TviT interviu da dasasruli. pacientis
pasuxebi mTlianad damokidebulia eqimis unarze,
marTos dialogi. zogadi moTxovnaa, rom medikosi
iyos dainteresebuli, yuradRebiani, saTno da
arakritikuli. intervius msvlelobaze gavlenas
axdens mravali faqtori:
1. pacientis pirovnuli Tvisebebi da xasiaTi,
rac garkveuli formis transferis reaqciebs
ayalibebs;
2. emociuri situacia, romelSic inter-
viuúmimdinareobs;
3. gansxvavebuli klinikuri situaciebi (anu sad
vxvdebiT pacients – saavadmyofoSi, ambula-
toriaSi Tu fsiqiatriul palataSi), rac
ayalibebs kiTxvebsac da misacemi
rekomendaciebis Sinaarssac;
4. teqnikuri faqtorebi (mag.: saubris gawyveta
satelefono zaris gamo an Canaweris
warmoeba);
5. avadmyofobis simwvave, misi stadia;
6. eqimis stili, orientacia da gamocdileba.

nebismier standartul intevius Semdegi funq-

ciebi akisria:
a. janmrTelobis problemis bunebis gansazRvra,
romlis Sedegad klinicisti svavs diagnozs an
niSnavs Semdgom diagnostikur procedurebs, an
irCevs mkurnalobis sqemas.
b. ganaviTaros da ganamtkicos Terapiuli
aliansi, romlis mizania:
1. pacientis misces informacia daavadebis
Sesaxeb;
2. Seumsubuqos fizikuri da fsiqologiuri
distresi;

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 3. gauRvivos pacients survili, raTa miiRos
SeTavazebuli mkurnaloba an daiwyos eqimTan
“molaparakebis” procesi;
4. pacientis kmayofileba;
5. eqimis kmayofileba.
g. gasces informacia da danergos mkurnalobis
sqema, ris Sedegadac:
1. pacientma unda gaacnobieros daavadebis arsi;
2. pacientma unda gaacnobieros SeTavazebuli
diagnostikuri procedurebis aucilebloba;
3. pacientma unda gaacnobieros mkurnalobis
SesaZleblobebi;
4. eqimsa da pacients Soris miRweuli iqneba
konsensusi zemoaRniSnul sam sakiTxSi;
5. miRebuli iqneba informirebuli Tanxmoba;
6. gaZlierdeba problemis daZlevis meqanizmebi
(coping abilities);
7. Seicvleba cxovrebis stili.

garkveuli normatiuli moTxovnebis garda

(mag.: sapasporto da demografiuli monacemebi)
intervius dros gamoyenebulia specifikuri teqnika:
 Ria da daxuruli kiTxvebis monacvleoba.
daxuruli kiTxvebi saWiroeben erTmniSvnelo-
van pasuxs “diax” an “ara” daxuruli kiTxvebi
saWiroeben erTmniSvnelovan pasuxs “diax” an
“ara” da mwir informacis gvawvdis (mag. gaqvT
Tu ara SiSi?). Ria kiTxvebi informaciis
zondirebis saukeTeso saSualebaa da, amasTan,
amomwuravi (mag.: gTxovT, momiyeveT Tqveni
tkivilis Sesaxeb...) zogadad, intervius da-
sawyisSi mizanSewonilia Ria kiTxvebis dasma.
 refleqsia – eqimi imeorebs mosmenils, raTa
darwmundes, rom sworad gaigo pacientis
naTqvami. meore mxriv, avadmyofi rwmundeba,
rom eqimi kargad usmens da misi wuxili esmis.

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 facilitacia – eqimi exmareba pacients
rogorc verbaluri, ise araverbaluri
miniSnebebiT (mag.: Tavis daqneva an sityvebiT:
diax, Semdeg?)
 siCume zogjer ufro mets “gveubneba”, vidre
normaluri saubari. igi SeiZleba iyos
konstruqciuli pacientisaTvis, radgan
saSualeba aqvs an itiros, an ijdes
keTilganwyobil garemoSi da ifiqros.
 konfrontacia – eqimi uxsnis pacients, rom
misi azriT, avadmyofi raRac momentebs
yuradRebas ar aqcevs, raRac moTxovnebs ar
asrulebs. konfrontacia saWiroebs eqimis
seriozul kvalifikacias, winaaRmdeg
SemTxvevaSi pacienti SeiZleba mtrad
moekidos.
 klarifikacia (naTelyofa) – eqimi sTxovs
pacients meti detalebi miawodos simptomebis
an sxva sakiTxebis irgvliv.
 interpretacia (ganmarteba) – teqnika
gamoiyeneba, roca eqimi msjelobs pacientis im
qcevaze an gamonaTqvamebze, rasac pacienti ver
acnobierebs.
 Sejameba – xdeba intervius msvlelobaSi,
garkveuli etapas amowurvis Semdeg.
 axsna – eqimi uxsnis avadmyofs mkurnalobis
taqtikas gasagebi eniT da sTxovs, dausvas
kiTxvebi, Tu raime damatebiT ganmartebas
saWiroebs.
 gadasvla – saSualebas aZlevs eqims pacienti
gadaiyvanos sxva sakiTxze, roca erTi
sakiTxis irgvlic sakmao informacia miiRo.
 gaxsniloba – zogjer aucilebelia eqimma
Tavi aaridos an ar miawodos informacia
pacients piradi cxovrebis Sesaxeb (mag.: gyavT
coli?).

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  pozitiuri ganmtkiceba (reinforsmenti) – es
teqnika saSualebas aZlevs pacients Tavi
komfortulad igrZnos eqimTan nebismier
Temaze saubrisas. eqimi amxnevebs mas, rom
Tamamad uTxras yvelaferi, rac awuxebs (mag.:
Sewyvita wamlebis miReba). medikosis
profesionalizmi imaSi mdgomareobs, rom
avadmyofma igrZnos, rom mas iReben iseTs,
rogoric aris da miuxedavad Taviseburebebisa
(problemebisa) – mas ar kicxaven, aramed,
piriqiT, aRiareben TiToeuli pirovnebis
ganumeoreblobas da Rirsebas.
 imedis micema - WeSmariti gadarwmuneba
pacientSi iwvevs ndobis Camoyalibebas da
viTardeba empaTia eqimis mimarT. mcdeloba,
cru imedi misces pacients, eqimis mimarT
undoblobas ayalibebs da mkurnalobisadmi
daumorCileblobis mizezi xdeba (mag.:
terminalur mdgomareobaSi myofis kiTxvaze:
“kargad viqnebi, eqimo?” pasuxi “raRa Tqma
unda, yvelaferi rigzea”.)
 rCevis, rekomendaciis micema mraval
situaciaSi araTu misaRebia, aramed sasurve-
licaa, magram umjobesia rCeva eqimma misces
Terapiuli aliansis Camoyalibebis Semdeg.

efeqturi mosmenis xelovneba

adamianebi Tavs ukeT grZnoben, roca miecemaT
SesaZlebloba isaubron da sxvas gauziaron
sakuTari problemebi. sakuTari grZnobebis “SigniT”
Sesanaxva SesaZloa gaxdes rogorc emociuri, aseve
fizikuri diskomfortis mizezi. emociebi, Sinagani
sevdis an sulieri tkivilis ignorireba, Tavis
arideba an uaryofa SesaZloa iqces Zlieri stresis
mizezad. depresiis, interpersonaluri kontaqtebis
damyarebis problemis, gaurkveveli xasiaTis SiSebis
da araorganuli warmoSobis fizikuri tkivilebis

118
gamomwvevad xSirad gauziarebeli uaryofiTi
gancdebi gvevlineba. pirveladi daxmarebis
saukeTeso formaa mivceT pirovnebas saSualeba
gamoxatos sakuTari emociebi, rasac mxolod kargi
msmeneli sWirdeba. adamiani did Svebas SeigrZnobs
sakuTari problemebis irgvliv gaxsnili saubris
Semdgom, vinaidan mas araTu mousmina sxva
pirovnebam, aramed pacientma aseve moaxdina
arsebuli problemis pirovnuli xatis miRma gatana.
arsebobs elementaruli rCevebi, Tu rogor
davamyaroT pacientTan pirveli kontaqti: ecadeT
dasxdeT pirispir; pirovnebas ucqireT TvalebSi;
usmineT gulisyuriT; ar grZnobinoT, rom
geCqarebaT; moaxdineT yuradRebis mobilizacia - ar
daibneT; agrZnobineT, rom usmenT (CarTvebiT –
“diax”, “mesmis”), raTa ar dakargoT pacientis ndoba.
amave dros ar misceT Tqvens Tavs ufleba, gaakeToT
komentari an SeafasoT sxvisi naTqvami sityvebiT “me
vxvdebi, rasac grZnobT”. aRniSneT, rom Tqven gesmiT,
Tu ras grZnobs pirovneba da ara is, Tu ras
grZnobT Tqven. magaliTad, roca pacienti giyvebaT
tkivilis Sesaxeb, SegiZliaT gaakeToT Semdegi tipis
komentari “me mesmis,. rogori mZime asatania es
tkivili TqvenTvis” da ara – “o, es saSinelebaa,
mosmenac ki mzaravs!”
izruneT imazec, rom Tqveni zedmeti
mgrZnobelobisa da dainteresebis gamo, pacientma ar
igrZnos diskomforti da ar Sewyvitos informaciis
mowodeba, saubari an Tundac - emociebis gamoxatva.
gamoiCineT gulisxmiereba da SeuqmeniT
mosaubres komforti!!! arsebobs sxvadasxva saSua-
leba, agrZnobinoT pacients, rom Tqven gesmiT ara
mxolod misi sityvebi, aramed misi emociebic. Tqveni
wrfeli, WeSmaritad emociuri reaqcia SesaZloa
Zalze mniSvnelovani gaxdes mosaubrisaTvis. gamo-
xateT empaTia Tu Tvalze cremli mogerevaT, ar Sei-
kavoT), umjobesia saubari emociurad maJorul

119
notebze daasruloT, magram fuWi dapirebebi ar
misceT.

“rTuli” pacienti
am terminiT eqimebi aRniSnaven im avadmyofebs,
romlebic stresul viTarebas qmnian samkurnalo
dawesebulebaSi, Tu maTi mdgomareobis marTva
efeqturi ar aris. am situaciis marTvaSi
kritikulia eqimis mier pacientis janmrTelobis
mdgomareobis Tanmxlebi, magram dafaruli
emociebis, SiSebis da konfliqtebis amocnoba.
mniSvnelovania avxsnaT, Tu ra dgas SfoTvis,
gaRizianebis Tu siZulvilis ukan, raTa Careva
efeqturi gaxdes. ganvixiloT zogierTi, SedarebiT
xSirad gamovlenili SemTxveva:
isteriuli pacienti cdilobs moxiblos eqimi,
raTa darwmundes, rom avadmyofobaSic ki
mimzidvelia. eqimma unda moTmineba gamoiCinos,
dauyvavos pacients da yovelgvari flirtis gareSe
Caunergos rwmena.
momTxovni da daqvemdebarebuli pacienti
cdilobs yuradRebis miqcevas ganmeorebiTi zarebiT,
vizitebiT. igi Riziandeba, roca eqimi seriozulad
ar iRebs mis Civilebsa Tu problemebs. eqimi unda
moemzados, rom dauwesos reglamenti anu
SezRudvebi, magram pacientis survilis Sesabamisad,
unda mousminos da izrunos masze.
momTxovni da impulsuri pacienti axali
problemis aRmocemebisTanave cdilobs diskomforti
momentalurad moiSoros. is advilad Riziandeba da
agresiulobas avlens (mag.: TviTdestruqciuli
qceva), rac yuradRebis mipyrobis an manipulaciis
mcdelobad aRiqmeba. aseT pacients pativiscema da
zrunva esaWiroeba, magram eqimma mas sakuTar qcevaze
pasuxismgebloba unda daakisros.
narcistuli pacienti yvelas, TviT eqimsac,
zevidan dahyurebs, amitom SeiZleba iyos qedmaRali,

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uzrdeli da mouridebeli. Tavdapirvelad igi
aRmerTebs eqims (unda rom misi eqimi idealuri iyos,
rogorc Tavadaa), magram SeiZleba Zalian male
zurgi aqcios, roca aRmoaCens rom eqimi
Cveulebrivi mokvdavia. misi zedapiruli qedmaRloba
faravs ususurobas, sica-rielesa da SiSs, rom
sxvebma ar SeamCnion es Tvisebebi.
obsesuri da makontrolebeli pacienti gegma-
zomieri, organizebuli, punqtualuri da detalebze
zedmetad koncentrirebulia. is SeiZleba iyos
uemocio, civi. igi winaaRmdegobas uwevs eqimisagan
gamoCenil nebismieri saxis kontrols, radgan
sakuTar garemocvaSi Tavad arian makontroleblebi.
sinamdvileSi aseT pacientebs kontrolis dakargvis
da ususur, daqvemdebarebul mdgomareobaSi
gadasvlis eSiniaT. eqimi mzad unda iyos pacients
gauZlieros makontroleblis funqcia sakuTar
mkurnalobaze. maT detalurad unda avuxsnaT, ra
keTdeba da rogor.
paranoiduli niSnebis mqone pacientebs eSiniaT,
rom garemocva maT zains miayenebs. isini
SeTqmulebas an SeniRbvas amCneven neitralur,
Cveulebriv movlenebSi. arian kritikulebi da
iWvneulebi, eqims ar endobian da mraval kiTxvas
svamen. obsesiuri pacientis msgavsad, aqac saWiroa
axsna-ganmartebis micema yovel nabijze, yovel
proceduraze.
izolirebul da martosul pacients zogjer
Sizoiduri pirovnebis saxeliTac moixsenieben.
ganmartoebulsa da adamianebisagan gandgomil
pacients, TiTqos ar surs kontaqti sazogado-
ebasTan. eqimma, SeZlebisdagvarad, pativi unda sces
maT martoobas da ar unda moelodes gamoCenil
mzurnvelobaze maTgan adekvatur reaqcias.
mowuwune, tanjuli da pasiur-agresiuli
pacienti eqimTan mxolod saCivrebiTa da ukmayofi-
lebis gamoTqmiT urTierTobs. isini janmrtelobis

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Tu sxva saxis problemebSi sxvebs adanaSauleben; ar
SeuZliaT sakuTari uaryofiTi emociebis da
gancdebis pirdapir gamoxatva da maT niRbaven –
agvianeben vizitze, mkurnalobis safasurs gvian
ixdian da a.S. aracnobierad maT SesaZloa swamdeT,
rom mxolod maSin afaseben an uyvarT, roca avad
arian. eqimma aseTi pacientis Civilebi unda miiRos,
magram avadmyofis rolis morgebaze ar waaxalisos.
eqims moTmineba da didi Zalisxmeva sWirdeba,
magaliTad, mizanSewonilia mkveTrad SezRudos
Sexvedrebis raodenoba, magram, amave dros, daarw-
munos avadmyofi, rom mousmens dagegmili vizitisas.
am tipis pacientis ojaxic rTul viTarebaSia,
amitom saWiroa ojaxis wevrebTan TanamSromlobac.
sociopaTia da simulacia - pacients ar aqvs
danaSaulis gancda; garegnulad momxiblavi,
sazogadoebaSi miRebuli da inteligenturi Cans,
magram ar icis, sad da rogor moiqces. anamnezSi
xSiria kriminaluri qmedebebi, tyilebi, TviTde-
struqciuli qceva da sxvebisaTvis zianis miyenebis
mcdeloba; garkveuli sargeblis miRebis mizniT
mimarTavs simulacias. aseTi pacienti saWiroebs
pativiscemiT mopyrobas, magram eqimis mxridan
sifxizlea saWiro. Tu eqimma safrTxe igrZno,
umjobesia pacientTan marto ar darCes, daawesos
mkacri limiti medikamentebze, stacionirebaze da
a.S. Tu Seusabamo qcevas gamovlens, eqimi unda
daupirispirdes saTanado argumentebiT, magram
gaRizianebis gareSe; unda agrZnobinos pacients
pasuxismgebloba maT saqcielze.

rogor mivawodoT pacients cudi informacia?

xSirad eqims pacientTan saubari uwevs mZime
diagnozis an prognozis Sesaxeb. bevri eqimi did
sirTuled miiCnevs cudi informaciis miwodebas,
gansakuTrebiT, Tu saqme exeba sicocxlesTan
SeuTavsebel diagnozs. zogi Tvlis, rom Sesabamisi

122
kvalifikacia ar aqvs; sxvebs ki eSiniaT, rom ambavi
distresuli iqneba da negatiurad imoqmedebs
pacientze. miuxedavad amisa, dasavleTis qveynebSi
pacientebis umetesobam icis, rom sicocxlisaTvis
saSiSi daavadeba aqvs. im SemTxvevaSic ki, Tu
samarTlebrivi da kulturuli Taviseburebebi
garkveul problemebs gviqmnis, cudi ambis pirdapir
da TanagrZnobiT Setyobinebam SesaZloa gaaumjo-
besos pacientis mier momavlis dagegmvis SesaZleb-
loba da brZolisunarianoba, gaaZlieros realis-
turi miznebi da avtonomiuroba, emociurad daexma-
ros pacients, gaamyaros eqim-pacientis urTierToba
da ganaviTaros TanamSromloba pacients, mis ojaxs,
eqimebs da sxva profesionalebs Soris.
robert bukmanma SeimuSava 6-safexuriani
Tanmimdevruli procedura, Tu rogor mivawodoT
pacients “cudi ambavi”.
1. dasawyisi.
sanam nebismieri xasiaTis komunikacias daiw-
yebT, dagegmeT, ra unda ganixiloT. daazusteT
samedicino faqtebi avadmyofobis istoriidan.
darwmundiT, rom yvela saWiro informacias flobT.
Tu es TqvenTvis pirveli SemTxvevaa, winaswar
gaiareT repeticia, Tu ra unda TqvaT. am misiis
sxvaze delegireba ar moaxdinoT. efeqturi
komunikaciisaTvis SeqmeniT garemo, magaliTad,
bavSvi-pacientisaTvis aucileblad gyavdeT damxmare,
sanam mSoblebs informacias awvdiT. uzrunvelyaviT
ganmartoeba da moxerxebuli savarZeli. erTjeradi
cxvirsaxocebic moimarageT. dro sakmarisad
gqondeT – es Sexvedra ar moaqcioTYsxva
mniSvnelovan davalebebs Soris. ecadeT, ar Segawyve-
tinon. gamorTeT telefonic. hkiTxeT pacients, kidev
vin unda, rom am saubars daeswros?

123
 2. ra icis pacientma?
dialogi daiwyeT imis gaarkveviT, Tu ra icis
pacientma da misma ojaxma avadmyofis janmrTelobis
Sesaxeb. es dagexmarebaT gaarkvioT, Tu SeZlebs
pacienti an misi ojaxi cudi informaciis
gacnobierebas. kiTxvebi SeiZleba ase JRerdes:
 ra iciT Tqveni avadmyofobis Sesaxeb?
 rogor aRwerT Tqveni janmrTelobis
mdgomareobas?
 ras geubnebodnen sxva eqimebi?
 roca pirveli simptomi SeniSneT, ra
ifiqreT?
 gifiqriaT, rom saqme ufro seriozuladaa?

TandaTan pacienti (an bavSvis mSobeli)

gaCumdeba da sruliad moumzadeblis, dabneulis
STabeWdilebas datovebs. mdgomareobis gantvirTvis
mizniT, SeecadeT gaarkvioT, ra esmis pacients misi
avadmyofobis istoriis da Catarebuli gamokvle-
vebis Sesaxeb. Tu es araefeqturi aRmoCndeba da
pacienti an dumils agrZelebs, an TvliT, rom mas
meti Tanadgoma sWirdeba – Sexvedra sxva
droisaTvis gadadeT.

3. ra moculobis informacia unda pacients, rom

icodes?
gaarkvieT, ra da ra moculobiT unda pacients
(an bavSvis mSobels), rom icodes. adamianebs
informacia sxvadasxvagvarad gadaaqvT, rac
damokidebulia eTnikur, kulturul, religiur
kuTvnilebasa da socialur-ekonomikur
mdgomareobaze. yovel adamians aqvs ufleba
nebayoflobiT Tqvas uari informaciis miRebaze an
rwmunebulad sxva adamiani airCios. hkiTxeT ojaxs,
rogor surs informaciis miReba. SesaZlo kiTxvebia:
 Tu Tqveni mdgomareoba seriozuli aRmoCnda,
gindaT es icodeT?

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  surT, rom yvela detali giTxraT Tqveni
mdgomareobis Sesaxeb? Tu ara, vis SeiZleba
amaze vesaubro?
 gsurT, rom visaubro gamokvlevebis Sedegebze
da isic giTxraT, ras vfiqrob?
 visTan SeiZleba am Temebze visaubro?

am momentamde yvela dasmuli kiTxva avadmyofs

Semdgomi kritikuli gamokvlevebisa Tu
manipulaciebisaTvis amzadebs, xolo eqims
saSualebas aZlevs gansazRvros, ra icis ukve
avadmyofma da rogor unda informaciis miReba.
saqarTveloSi mravali ojaxi uars ambobs
pacientisaTvis diagnozis Sesaxeb informaciis
miwodebaze. vinaidan eqimis samarTlebrivi valde-
bulebaa - miiRos informirebuli Tanxmoba
pacientisagan, efeqturi Terapiuli urTierTo-
bisaTvis ojaxTan megobruli aliansia saWiro.
maTTan konfrontaciiis nacvlad (“me valdebuli var
pacients vuTxra!”), umjobesia ikiTxoT: ratom ar
undaT, rom avadmyofma simarTle gaigos? risi
eSiniaT? amdenad, Tqven gaarkvevT, rasTan gaqvT
saqme – pirovnul, kulturul Tu religiur
momentebTan. SesTavazeT, rom pacients maTi
TandaswrebiT hkiTxavT – ramdenad unda mas, icodes
sakuTari janmrTelobis Sesaxeb. roca pacienti
bavSvia, mSoblebma SesaZloa ar isurvon bavSvis
saqmis kursSi Cayeneba. es dacviTi instinqti
gasagebia, magram problemuri. mkurnalobis da
procedurebis Catarebisas bavSvi dainaxavs prob-
lemas da Tavs ufro daTrgunul-daeWvebulad
igrZnobs. amdenad, umjobesia mSoblebs daexmaroT,
raTa dagegmon es etapic da, Tu saWiroa, bavSvTa
fsiqologs daakavSireT.
msgavsi situaciebi garkveul SeTanxmebas
(xandaxan gamoiyeneba termini – garigeba) saWiroebs.
magaliTad, pacientTan SeTanxmebiT, SeiZleba

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gadawydes, rom momavalSi diagnozis, prognozis da
mkurnalobis detalebs mxolod ojaxis wevrebTan
ganixilavT. amasTan, Tu pacients ar aRuniSnavs, rom
ar surs informaciis miReba, misTvis diagnozis,
prognozis, mkurnalobis Sesaxeb an sxva
mniSvnelovani informaciis dafarva arc eTikuria
da arc samarTlebrivad marTebuli. Tu ojaxi da
eqimi ver Tanxmdebian, eqims SeuZlia pacientis
marTva sxva specialists gadasces.

4. informaciis gacvla.
informacia miawodeT delikaturad, magram
pirdapir. daasruleT da gaCerdiT. Tavi aarideT
informaciis miwodebas monotonuri monologis
saxiT. gamoiyeneT martivi sityvebi, rom advilad
gasagebi iyos. ar gamoiyenoT arc teqnikuri Jargoni,
arc maRalfardovneba. xSirad gaakeTeT pauza,
gamoiyeneT siCume da sxeulis ena, rom diskusia
daaCqaroT. ar SeamsubuqoT situacia. erideT
mobodiSebas, radgan SeiZleba pacientma CaTvalos,
rom eqimi pasuxs agebs negatiur situaciaze.
umjobesia, pacients vuTxraT: “samwuxarod,
TqvenTvis arasasiamovno informacia maqvs” an
“mimZims, rom es unda giTxraT.”

5. pasuxi pacientisa da ojaxis gancdebze.

pacientebi (da ojaxebi) cud informaciaze
gansxvavebulad reagireben: emociuri reaqcia
SeiZleba gamovlindes cremlebiT, gaRizianebiT,
mowyenilobiT, SfoTviT, Svebis SegrZnebiT,
siyvaruliT an sxva formiT. zogi pacienti uaryofs
problemis arsebobas, adanaSaulebs sxvebs an Tavis
Tavs, ar ijerebs, xSiria SiSis an danaklisis
gancda, Tumca arian iseTebic, romlebic iwyeben
fiqrs – ratom daemarTaT daavadeba. zogierTs
aReniSneba refleqsuri fsiqofiziologiuri
reaqcia, romelsac uwodeben “brZola an gaqceva”-s.

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magaliTad, pacienti SesaZloa oTaxidan gaqcevas
Seecados an sakuTar TavSi Caiketos. Zlieri
emociuri agzneba eqims diskomforts uqmnis.
pacients (da ojaxs) dro mieciT reagirebisaTvis.
mousmineT mSvidad da yuradRebiT. pativi eciT mis
emociebs da sTxoveT, aRweros – ras ganicdis:
 Tqven gabrazebuli xarT. SegiZliaT miTxraT,
ras grZnobT?
 SegaSinaT am ambavma?
 ra gawuxebT yvelaze metad?
 me Sevecdebi dagexmaroT
 xom ar gindaT, vinmes davureko?
 me dagexmarebiT, rom es uTxraT Tqvens Svils
SeaxseneT maT, rom maT normaluri reaqcia
aqvT. araverbaluri komunikaciebi Zalze
dagexmarebaT, magaliTad, qaRaldis cxvirsaxocis
miwodeba, gamamxnevebeli Sexeba mxarze, wylis an
Cais SeTavazeba. dro mieciT pacients (mis ojaxs)
gamoxatos grZnobebi. roca emociebi daixarjeba,
adamianebis umravlesoba agrZelebs eqimTan saubars,
rac safuZvels uyris efeqtur TanamSromlobas da
momavlis swori dagegmvis sawindaria.

6. dagegmva da monitoringi.
dasaxeT gegma Semdgomi nabijebisaTvis. es
SesaZloa iyos damatebiTi gamokvlevebi an mkurna-
lobis sqemis SerCeva. umkurnaleT arsebul simpto-
mebs. kargad auxseniT momavali gamokvlevebis
mizani. imsjeleT emociuri da praqtikuli
daxmarebis potenciur resursebze (mag.: ojaxi,
megobari, socialuri muSaki, fsiqoTerapevti,
hospisi da sxva). Tu avadmyofi bavSvia, yuradReba
gaamaxvileT misi da-Zmebis (siblingebis)
daxmarebazec. daarwmuneT pacienti, rom eqimi
misTvis misawvdomi iqneba da dauzusteT, rogor
dagikavSirdeT, Tu mas axali kiTxvebi gauCndeba.
daniSneT Semdegi vizitis dro.

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 darwmundiT, rom pacients safrTxe ar elis,
roca Tqveni kabinetidan gava. magaliTad: SeuZlia
damoukideblad marTos avtomanqana? xom ar aris
suicidis riski? damxmare Tu daxvdeba saxlSi?
momavali vizitisas bevr pacients (an ojaxs)
informaciis ganmeoreba sWirdeba, raTa srulad
gaerkves situaciaSi. isini prognozTan dakavSirebiT
mraval kiTxvas svamen, romlebze pasuxic damoki-
debulia maT molodinebTan. magaliTad, pacienti,
romelsac cxovrebis dagegmva surs, detalur
informacias iTxovs. SeSinebul pacients, umjobesia,
zogadad vupasuxoT. konkretuli pasuxebi (mag.: 6
Tvis sicocxle dagrCaT) zrdis imedgacruebas, Tu
es periodi ufro mcirea, vidre pacienti moeloda.
mizanSewonilia dro zogadi frazebiT
ganvsazRvroT, magaliTad, “ramdenime saaTidan
ramdenime dRemde”, “ramdenime dRidan ramdenime
kviramde”, “ramdenime kviridan ramdenime Tvemde” da
a.S. amave dros, miuTiTeT, rom “pacientebis mesamedi
Tavs kargad grZnobs erTi wlis Semdeg, naxevarma
SesaZloa icocxlos daaxloebiT 6 Tve, Tqveni
mdgomareobis Sesaxeb ki me verafers davakonkreteb.
unda vifiqroT saukeTeso gamosavalze. magram
vemzadoT cudisTvisac. modiT, pasuxi dros da
mkurnalobas mivandoT”. yovelTvis daexmareT
pacients, rom saswaulebs ki ar elodos, aramed
realurad Seafasos sakuTari mdgomareoba.

personalis “gadawva”
zogadad, eqimis profesias safuZvlad udevs
pacientisadmi sibraluliT damokidebulebasa da
uemocio obieqturobas Soris balansirebis idea.
medikoss xSirad uxdeba sakmaod mZime da mtkivneuli
gadawyvetilebebis miReba, rac, zog SemTxvevaSi,
saSualebas ar aZlevs zemoaRniSnuli wonasworoba
daicvas. amitomac eqimis profesia sakmaod stresul
profesiad iTvleba.

128
 “fsiqikuri gadawvis” qveS igulisxmeba
fizikuri, emociuri da inteleqtualuri ganlevis
mdgomareoba, romelic upiratesad vlindeba
samedicino da socialuri sferos profesiebSi.
gadawva ganixileba, rogorc profesiuli krizisis
mdgomareoba da SeiZleba aRmocendes rogorc
individualur, ise dawesebulebis doneze. gadawvis
fenomeni aris Sinagani fsiqologiuri gancda,
romelic moicavs grZnobebs, interpersonalur
urTierTobebs, motivebs, momavlis imeds. amave dros
igi negatiuri gamocdilebaa, romlis drosac wina
planzea wamoweuli problemebi, distresi,
diskomforti, disfunqcia, uaryofiTi Sedegebi da
a.S. am fenomenis damaxasiaTebeli simptomebia:
emociuri gamofitva, depersonalizacia (cinikuri
damokidebuleba saqmis mimarT, gulgriloba
pacientebis mimarT), profesiuli araefeqturoba
(pirovnuli miRwevebis daqveiTeba, warumateblobis
an arakompetenturobis gancda)
gadawvis fenomenis gamomwvev mizezebSi
ganixileba, erTi mxriv, individualuri faqtorebi,
rogoricaa pirovnuli Taviseburebebi (mag.: emociaTa
TviTkontrolis unari), asaki (mowyvladia 19w.-mde
da 40 wlis zemoT asaki), sqesi (Warbobs mamakacebSi,
xasiaTdeba cinizmis elementebiT), staJi, ojaxuri
mdgomareoba (dauqorwinebeli mamakacebi), ganaTleba.
meore mxriv, mizezi SeiZleba veZioT samuSao
garemoSi (datvirTva, samuSao pirobebi, drois
araswori marTva – deficiti, samuSao dRis
xangrZlivoba, Sinaarsobrivi mxare, pacientebis
raodenoba, maTi problemebis simwvave, avadmyofTan
urTierTobis siRrme, gadawyvetilebebis miRebaSi
monawileoba, ukukavSiri).
yuradsaRebia is faqtic, rom personalis
gadawvisas simptomebi polimorfulia da SesaZloa
warmodgenili iyos sxvadasxva saxiT. kerZod,
fizikuri xasiaTis Civilebia: gamofitva, energiis

129
daqveiTeba, qronikuli daRliloba, saerTo sisuste,
xSiri Tavis tkivili, gulisrevis SegrZneba, kun-
Tebis tkivili, zurgis tkivili, Zilis darRvevebi
da sxva. emociuri sferos mxriv SesaZlebelia iyos
depresiuli guneb-ganwyoba, uimedoba, urTier-
Tobebis gamwvaveba garemocvasTan, konfliqturoba,
mouTmenloba, gamRizianebloba da sxva. fsiqikuri
sferos mxriv: yuradRebas iqcevs daukmayofileb-
lobis grZnoba, uaryofiTi interpersonaluri
urTierTobebi, negatiuri damokidebuleba
dakisrebuli valdebulebebis mimarT da sxva.
gadawvis gamo eqimis araefeqturi saqmianoba
saWiroebs sxvadasxva tipis Carevas. magaliTad,
rekomendebulia profesiuli ganaTlebis srulyofa
da samsaxureobrivi waxaliseba; pirovnul da
organizaciul doneze stresorTa identificireba
da adeqvaturi adaptaciuri meqanizmebis gamonaxva;
yoveli samuSao kviris bolos an, sul cota,
yovelTviurad emociaTa “ventilacia”.

fsiqologiuri ”dasveneba”
“gadawvis” Tavidan asacileblad misaRebia
Semdegi teqnikebis gamoyeneba:
 racionalizacia.
 moifiqreT ram gamoiwvia Tqveni gaRizianeba,
gabrazeba, gaaanalizeT.
 rCeva sTxoveT gamocdil kolegas.
 gaarkvieT es problema koleqtivSi.
 waikiTxeT literatura am sakiTxze.
 vizualizacia.
 warmoidgineT, rom negatiuri energia Tqvengan
miwaSi Cadis.
 warmoidgineT Tqveni Tavi Tbil wvimaSi an
tbis napiras.
 SeecadeT dainaxoT laJvardovani ca,
SeisunTqoT balaxis, yvavilis aromatuli
surneli.
130
 relaqsacia.
 SesruleT msubuqi varjiSi an sasrgeblo
fizikuri SromiT daisaqmeT Tavi.
 ramdenjerme Rrmad CaisunTqeT da amoisunT-
qeT.
 sarkeSi Tavs gauRimeT.

131
 Tavi VI.

samedicino eTikis da deontologiis sakiTxebi

filosofiur disciplinas, romelic morals

da zneobas Seiswavlis, eTika (berZn. ethika/ethos –
zne) ewodeba. samedicino eTika, rogorc profesiuli
eTikis saxeoba, akonkretebs zogad eTikur
principebsa da normebs samedicino moRvaweobis
specifikasTan mimarTebaSi. sxva sityvebiT rom
vTqvaT, igi Seiswavlis samedicino dargis muSakebis
pacientTan da kolegebTan urTierTobis,
profesiuli qcevis normebs. samedicino eTikis
yvela norma, principi Tu Sefaseba orientirebulia
adamianis janmrTelobaze, mis gaumjobesebasa da
SenarCunebaze.
samedicino eTikis ZiriTad principebs Rrma
istoriuli fesvebi aqvs. jer kidev Cvens
welTaRricxvamde 1500 wliT adre indoeli eqimebi
profesiul fics debdnen. gansakuTrebiT
aRsaniSnavia hipokrates fici, rac sxva profesiul-
moraluri samedicino kodeqsebis SeqmnisaTvis
amosavali wertili gaxda. hipokrates droidan
medicinis muSakTa gulmowyaleba vlindeboda
yoveli adamianis sicocxlis umaRles faseulobad
upirobo aRiarebaSi. medikosTa humanizmis erT-erTi
gamovlinebaa swored gulmowyale damokidebuleba
im adamianis mimarT, romelic tkivils ganicdis.
magaliTad, n. pirogovi, romelmac qirurgiul
praqtikaSi erT-erTma pirvelma gamoiyena gautki-
vareba, Tvlida, rom narkozma zneobrivi gavlena
iqonia “tkiviliT gatanjul” kacobriobaze.
dReisaTvis miRebulia, rom humanuri mosazrebidan
gamomdinare, eqimi valdebulia pacients Seumsubuqos
tkivili, Tu igi sasignalo mniSvnelobis ar aris.

132
amasTan, saWiroa avuxsnaT avadmyofs, rom zogierT
tkivilgamayuCebels fizikuri da fsiqikuri
damokidebulebis ganviTareba axasiaTebs.
meoce saukunis Sua periodidan samedicino
eTikis ganviTarebaze mniSvnelovani gavlena
moaxdina samedicino codnis gavrcelebam da samec-
niero-teqnikurma revoluciam. seriozuli Sedegebi
hqonda faSisturi antimedicinis danaSaulebrivi
faqtebis gamoaSkaravebas, rac dagmo progresulma
kacobriobam. swored am periodSi mraval qveyanaSi
axali eTikuri kodeqsebi Seiqmna. magaliTad,
msoflio samedicino asociaciam 1948 wels
Camoayaliba “Jenevis deklaracia”, xolo 1949 wels
SeimuSava ufro detaluri - “samedicino eTikis
saerTaSoriso kodeqsi”. Jenevis deklaraciam, rac
hipokrates ficis Tanamedrove variants warmoadgens,
araTu daadastura medicinaSi humanisturi
idealebis umTavresi roli, aramed iqca
damoukidebeli samedicino profesiis moralur-
eTikur garantad, TviT politikuri reJimebisa da
ideologiuri diqtatis pirobebSi.
cnobilia, rom samedicino saswavleblebis
kursdamTavrebulebi sazeimod deben eqimis fics,
romelSic asaxulia medikosisadmi wayenebuli
maRalmoraluri moTxovnebi, magaliTad, mudmivi
swrafva profesiuli srulyofisaken, kolegiurobis
normebisa da samedicino saidumlos dacva
(konfidenciuroba). am ZiriTadi principebis dacva
uzrunvelyofilia saqarTvelos kanoniT “pacientis
uflebebis Sesaxeb”, romlis Tanaxmad samedicino
momsaxurebis gamwevma pirma ar unda gasces
avadmyofis Sesaxeb mis xelT arsebuli informacia
(mag.: diagnozi, dafaruli fizikuri an fsiqikuri
defeqtebi, anamnezuri cnobebi da sxva) rogorc
pacientis sicocxleSi, ise misi sikvdilis Semdeg. am
informaciis gamJRavneba dasaSvebia gamonaklis
SemTxvevebSi, kerZod, roca miRebulia pacientis

133
Tanxmoba; informaciis gaumJRavnebloba safrTxes
uqmnis mesame piris (romlis vinaobac cnobilia)
sicocxles an janmrTelobas; saswavlo an
samecniero mizniT (magram am SemTxvevaSi pirovnebis
identifikacia SeuZlebeli unda iyos).
samedicino eTika mudam ganaxlebadi da
ganviTarebadi dargia. mis farglebSi Seiswavlian
samedicino wreSi realurad arsebul zneobriv
aspeqtebs, kerZod – eqimis pacientTan damoki-
debulebas, dapirispirebis savaraudo mizezebs, aseve
– ukve warmoSobil konfliqtebs. didi yuradReba
eTmoba avadmyofis zneobriv-eTikur poziciasac.
Tanamedrove pacienti ufro aqtiuria, ufro meti
pasuxismgeblobiT ekideba sakuTar janmrTelobas,
TanamSromlobs eqimTan yvela im gadawyvetilebis
miRebaSi, rac mis janmrTelobas exeba.
deontologia, zogadad, eTikis is nawilia,
romlis Seiswavlis adamianis pasuxismgeblobas sxva
adamianebis da mTlianad, sazogadoebis winaSe.
samedicino deontologia ki Seiswavlis medicinis
dargis muSakebis profesiul qcevas, rac xels
uwyobs avadmyofis gamojanmrTelebisaTvis gansakuT-
rebiT xelsayreli garemos Seqmnas. amdenad, deonto-
logiis Teoriuli safuZvelia samedicino eTika,
xolo TviT deontologia gulisxmobs samedicino
eTikis principebis praqtikul gamoyenebas. termini
“deontologia”, mowodebuli ingliseli
filosofosis i.bentamis (1748-1832) mier, saTaves
iRebs berZnuli sityvidan “deon” (movaleoba).
anTebuli sanTeli – simboluri emblema, romelic
jer kidev XVII saukuneSi gamoiyena van tulpsim,
medikosis profesiuli qcevis arsis amsaxvelia.
deontologiis ZiriTadi kiTxvebia: ra aris
Cemi moraluri movaleoba? ra aris Cemi moraluri
valdebuleba? rogor avwono erTi moraluri
movaleoba meoris mimarT?

134
zogadad, gadawyvetilebis miRebisas samedicino
profesiis warmomadgenelma situacia eTikurad unda
Seafasos da ixelmZRvanelos eqvsi ZiriTadi
principiT:
 gulisxmiereba - imoqmedos pacientis intere-
sebidan gamomdinare (Salus aegroti suprema lex).
 zianis miyeneba – “upirvelesad, ar avno”
(Primum non nocere).
 avtonomiuroba – pacientis ufleba airCios an
uari Tqvas mkurnalobaze (Voluntas aegroti suprema
lex).
 samarTlianoba (Iustum)– gulisxmobs jandacvis
SezRuduli resursebis ganawilebas da aseve
– samarTlian gadawyvetilebas, Tu vin da ra
moculobis daxmarebas miiRebs.
 Rirseba (Honorum)- pacients (iseve, rogorc
samedicino momsaxurebis gamwevs) pativisa da
Rirsebis xelSeuxeblobis ufleba aqvs.
 simarTle da patiosneba (Verum) – pacients ar
uTxraT tyuili: mas aqvs ufleba miiRos
sruli, obieqturi da marTali informacia
misi daavadebis da mkurnalobis Sesaxeb.

aRniSnuli principebi, marTalia, ar pasuxobs

kiTxvas, rogor davareguliroT konkretuli situa-
cia, magram karnaxobs eqims, Tu romeli principi
SeiZleba miusadagos arsebul realur mdgomareobas.
principebi zogjer winaaRmdegobrivia, rasac eTikur
dilemamde mivyavarT. magaliTad, avtonomiurobis da
gulisxmierebis principebi urTierTgamomricxavia,
roca sicocxlesTan SeuTavsebel mdgomareobaSi
pacienti uars ambobs sisxlis gadasxmaze. msgavsi
problema Cndeba, roca eqimi iyenebs placebos,
magram amave dros valdebulia, simarTle uTxras
pacients. urTierTsawinaaRmdego principebis
SeTanxmebisaTvis bernard gertma wamoayena
mosazreba, rom medicinis muSakma, Tu igi ZiriTadi
135
moraluri principebis darRvevas apirebs (magali-
Tad, eqimis fics arRvevs, raTa sicocxle
SeunarCunos pacients), sakuTari qmedeba sajaro
ganxilviT unda daicvas.
rac Seexeba bioeTikas, termini damkvidrda
bioeTikis evropuli konvenciis miRebis Semdeg. igi
samedicino eTikis ganviTarebis Tanamedrove etapad
SeiZleba CavTvaloT. misi mizania Seiswavlos axali
biologiuri aRmoCenebisa Tu biosamedicino
miRwevebis eTikuri da zneobrivi Sedegebi. medicinis
garkveuli mimarTulebebis ganviTarebasTan erTad,
Cndeba axali eTikuri problemebi. magaliTad,
cocxali donorisagan Tirkmlis transplantaciis
dros, eqimi arRvevs princips “Primum non nocere – ar
avno”, Tumca mizani – humanuria.
meoce saukunis umniSvnelovanesi samedicino
miRwevebi, rogoricaa genuri inJineria, organoTa da
qsovilTa gadanergva, eqstrakorporaluri ganayo-
fiereba, klonireba, genuri Terapia, evTanazia –
aucilebels xdis, rom ganvsazRvroT, romeli
qmedeba CaiTvleba, moraluri TvalsazrisiT,
cocxali individis mimarT dasaSvebad. dRes,
dasavleTis wamyvan klinikebSi bioeTikis eqspertebi
monawileoben terminalur mdgomareobaSi myofi
pacientebis Sesaxeb gadawyvetilebis miRebaSi, aseve
SezRuduli resursebis ganawilebis sakiTxebSi.
amdenad, samedicino eTikis da bioeTikis moTxovnebi
TandaTan gavrcelda jandacvis sistemis
infrastruqturaze, samedicino daxmarebis sferoSi
politikuri, ekonomikuri Tu programuli
gadawyvetilebebis miRebis procesze.
gansakuTrebuli gansjis Temaa eqimis eTika da
reklama. eqimi ar unda monawileobdes profi-
laqtikis, diagnostikis da mkurnalobis meTodebis
da, gansakuTrebiT, samkurnalwamlo saSualebebis,
aseve narkotikuli saSualebebis, alkoholis,
Tambaqos reklamaSi. samedicino xasiaTis

136
gamocemebSi, samecniero forumebze gamosvlebSi, mas-
mediis saSualebebiT saganmanaTleblo moRvaweobaSi
eqimebi uzadoebi unda iyvnen eTikuri TvalsazrisiT,
anu iZleodnen mxolod samecniero-praqtikul
informacias, romelic ar Seicavs reklamasa da
TviTreklamas. sainformacio xasiaTis RonisZiebaSi,
romelsac farmakologiuri firma atarebs, eqimi
valdebulia orientacia moaxdinos mxolod
informaciul mxareze da piradad ar awarmoos
sareklamo muSaoba avadmyofebTan, aRniSnuli
wamlebis SeZenaze.

137
 Tavi VII.

pacientis uflebebi
saerTaSoriso da saqarTvelos kanonmdeblobaSi

eqimisa da pacientis, eqimisa da sazogadoebis,

eqimTa Soris kolegialuri urTierTobebis mraval-
waxnagovani, mravalferovani da xSirad winaaRmde-
gobebiT aRsavse formebis mowesrigebis, humanisturi
principebis gansazRvrisa da dakanonebisaTvis,
urTierTobebaSi adamianurobisa da urTierTpativis-
cemis damkvidrebisaTvis da, agreTve, qcevis
garkveuli normebis gansazRvris mizniT,
aucilebeli xdeba, erTi mxriv, am urTierTobaTa
samarTlebrivi CarCoebis Camoyalibeba, xolo, meore
mxriv, eqimis profesiuli saqmianobis normebis
damkvidreba.
eqimis profesiuli saqmianobis sakanonmdeblo
regulacias didi istoria aqvs. sakmarisia
moviyvanoT ori magaliTi (romelTa Soris 3500 wlis
intervalia), rom gavigoT ramdenad aqtualuri iyo
es problema adamianebisaTvis. pirveli magaliTia
babilonis mefis hamurabis kanonTa kodeqsi (1750
Zv.w.), romelSic mkafiodaa gansazRvruli mkurnalis
mier pacientis gankurnebisaTvis gansazRvruli
jildoc da warumatebeli mkurnalobis SemTxvevaSi
- sasjelis zomac. meore - napoleonis mier 1803
wels gamocemuli specialuri kanoni, romelic
profesiuli kompetenciis uzrunvelsayofad, eqims
profesiuli Cvevebis mudmiv gaumjobesebas da
srulyofas avaldebulebda.
saeqimo saqmianobis samarTlebrivi regula-
ciis, misi uflebebisa da movaleobebis mkafio
gansazRvris aucilebloba aSkara gaxda faSist
damnaSaveebze ganxorcielebuli saerTaSoriso
sasamarTlos, e.w. “niurnbergis procesis” msvlelo-

138
bisas. gamoirkva, rom nacisti eqimebi gaugonar
eqsperimentebs atarebdnen samxedro tyveebsa da
sakoncentracio banakebis patimrebze, maTi neba-
survilis gareSe. eqspertTa jgufma Seqmna
dokumenti – “niurnbergis kodeqsi”, sadac pirvelad
Camoyalibda adamianze samedicino eqsperimentebis
Catarebis eTikur-samarTlebrivi principebi.
kodeqsiT dafiqsirebulia pirovnebis, rogorc
eqsperimentis obieqtis, savaldebulo gacnobiere-
buli Tanxmoba, agreTe ufleba – uari ganacxados
kvlevaSi monawileobisagan. “niurnbergis kodeqss”
ar hqonda saerTaSoriso iuridiuli dokumentis
statusi, ris gamoc gagrZelda muSaoba saeqimo
saqmianobis eTikuri normebis sakanonmdeblo
safuZvlebis dasaxvewad. 1964 wels msoflio
samedicino asociaciam miiRo “helsinkis deklara-
cia”, romelmac gacilebiT srulyo saeqimo
saqmianobis EeTikuri da samaTlebrivi safuZvlebi.
“deklaraciaSi” mkafiod aris gamijnuli
diagnostikuri da samkurnalo mizniT warmoebuli
samedicino da biologiuri kvlevebi, romlebic
tardeba pacientis janmrTelobis interesebidan
gamomdinare da wminda mecnieruli miznebiT
warmoebuli gamokvlevebi. SemuSavebulia yvela im
normatiuli dokumentis forma (piris Tanxmoba,
kvlevis oqmis forma, kvlevis Sinaarsi da a.S.),
gansazRvrulia yvela aucilebeli piroba (winaswari
kvlevebis arseboba cxovelebze, mkvlevarTa profe-
siuli kvalifikaciis damadasturebuli
dokumentacia).
medicinis da, saerTod, biologiuri mecnie-
rebebis swrafi ganviTarebis periodSi, dReisaTvis
gansakuTrebiT aqtualuri xdeba saeqimo saqmianobis,
rogorc sakanonmdeblo safuZvlebis gamyareba da
samarTlebrivi regulacia, aseve am saqmianobis
eTikuri principebis damkvidreba.

139
 saqarTvelo, rogorc gaeros wevri qveyana,
miuerTda mraval saerTaSoriso deklaraciasa da
xelSekrulebas, riTac gamoxata Tavisi damokide-
buleba civilizebuli samyarosaTvis misaRebi
normebisa da kanonebis mimarT. maT Soris aris
ramdenime saerTaSoriso dokumenti, romelic
bazisuria saeqimo eTikis da eqim-pacientis urTier-
TobaTa kuTxiT. aseT dokumentebs Soris
gansakuTrebiT mniSvnelovania:
1. “gaerTianebuli erebis organizacia. samedi-
cino eTikis principebi”, miRebulia 1983 w.
2. “msoflio samedicino asociacia. samedicino
eTikis saerTaSoriso kodeqsi”, miRebulia
1949w.
3. “lisabonis deklaracia pacientTa uflebebis
Sesaxeb” 1981 w.
4. “debuleba cocxali organoebiT vaWrobis
Sesaxeb”, miRebulia msoflio samedicino
asambleis mier 1985 w.
5. “maltis deklaracia moSimSileTa Sesaxeb”,
1992 w.
6. “evrosabWos konvencia adamianis uflebebisa
da biomedicinis Sesaxeb”, 1991 w.
7. “msoflio samedicino asociaciis helsinkis
deklaracia”, saxelmZRvanelo rekomendaciebi
eqimTaTvis adamianze Catarebuli samedicino-
biologiuri kvlevebis Sesaxeb, 1996 w.
8. “msoflio samedicino asociaciis tokios
deklaracia”, saxelmZRvanelo rekomendaciebi
eqimTaTvis dakavebuli pirebis da patimrebis
wamebis da sxva sastiki, araadamianuri da
Rirsebis Semlaxveli mopyrobis an dasjis
SemTxvevaSi, 1975 w.
9. “iuneskos (gaeros samecniero da kulturuli
organizacia) universaluri deklaracia
adamianis genomisa da adamianis uflebebis
Sesaxeb”, 2001 w.

140
es aris mxolod mciredi CamonaTvali im
saerTaSoriso samarTlebrivi dokumentebisa,
romlebic aregulireben saeqimo saqmianobasTan
dakavSirebul problemebs.

mogvyavs ori fuZemdebluri dokumentis sruli

teqsti.

msoflio samedicino asociacia

samedicino eTikis saerTaSoriso kodeqsi

miRebulia msoflio samedicino asociaciis

generaluri asambleis mier, londoni, inglisi, 1949
wlis oqtomberi

eqimis zogadi movaleobebi

eqimi yovelTvis unda amkvidrebdes profesiuli
saqmianobis umaRles standartebs.
Si:finansurma interesebma ar unda moaxdinon
gavlena damoukidebeli da Tavisufali, pacientis
interesebis Sesabamisi profesiuli gadawyveti-
lebis miRebaze.
eqimi, miuxedavad saqmianobis saxisa, samedicino
daxmarebas unda atarebdes TavdadebiT, sruli
teqnikuri da moraluri damoukideblobiT,
TanagrZnobiTa da adamianis Rirsebis
pativiscemiT.
eqimi patiosani unda iyos pacientebTan da kole-
gebTan urTierTobaSi, unda ebrZolos sxva
eqimebis profesiul d pirovnul nakls, unda
amxeldes sicruesa da TaRliTobas.

araeTikurad unda iqnes miCnuli

TviTreklama, garda im SemTxvevebisa, roca
es daSvebulia mocemuli qveynis kanondeblobiT
da erovnuli samedicino asociaciis eTikuri
kodeqsiT.

141
 nebismieri saxis sazRauris gadaxda an
miReba mxolod sxvisi rekomendaciiT an mimarT-
viT pacientis miRebisTvis da pacientis sxva
specialistTan gagzavnisTvis.
eqimma pativi unda sces pacientis, kolegis, sxva
samedicino personalis uflebebs, agreTve, ar
unda gaamJRavnos konfidencialuri informacia
pacientis Sesaxeb. im SemTxvevaSi, Tu eqimi
iyenebs samedicino daxmarebis iseT formebs,
romelTac SeiZleba gaauareson pacientis fizi-
kuri an fsiqikuri mdgomareoba, eqimma unda
imoqmedos mxolod pacientis interesebis
Sesabamisad.
eqimma unda gamoiCinos udidesi sifrTxile
aRmoCenebis, axali teqnologiebis an samkurnalo
meTodebis araprofesiuli arxebiT gavrcelebisas.
eqimma unda daadasturos mxolod is, rac Tavad
Seamowma.

eqimis movaleobebi avadmyofis winaSe

eqims yovelTvis unda axsovdes, rom igi movalea
daicvas adamianis sicocxle.
eqimi movalea uerTgulos pacients da mTeli
Tavisi codna moaxmaros mas. Tu eqims ara aqvs
gamokvlevis an mkurnalobis saSualeba, man
saamisod unda mouxmos sxva eqims, romelsac es
saSualeba gaaCnia.
eqimma saidumlod unda Seinaxos yovelive Tavisi
pacientis Sesaxeb, am ukanasknels sikvdlis
Semdegac ki.
gadaudebeli samedicino daxmarebis aRmoCena
eqimis humanitaruli movaleobaa im SemTxvevaSi,
Tu igi ar aris darwmunebuli, rom aseTi
daxmarebis gawevis survili an SesaZleblba
sxvebsac gaaCniaT.

eqimebis movaleobebi erTmaneTis winaSe

eqimi ise unda moeqces Tavis kolegebs, rogorc
igi isurvebda, rom mas moqceodnen.

142
eqimma ar unda gadaibiros Tavisi kolegebis
pacienebi.

lisabonis deklaracia
pacientis uflebebis Sesaxeb

miRebulia 34-e msoflio samedicino asambleis mier,

lisaboni, portugalia, 1981 wlis
seqtemberi/oqtomberi

praqtikuli, iuridiuli da eTikuri sirTuleebis

aRmocenebis SesaZleblobis gacnobierebisas eqimi
yovelTvis unda moqmedebdes sindisis karnaxiT da
pacientis interesebis uzenaesobis gaTvalis-
winebiT. winamdebare deklaraciaSi asaxulia
pacientis zogierTi ZiriTadi ufleba, romelTa
dacva eqimis valia. im SemTxvevaSi, Tu kanonmeb-
loba an xelisufleba ar aRiarebs am uflebebs,
eqimebi unda ecadnen, uzrunvelyon an Sesabamisi
saSualebebiT daamkvidron am uflebebis dacva.
a) pacients ufleba aqvs Tavisuflad
amoirCios mkurnali eqimi.
b) pacients ufleba aqvs miiRos daxareba im
eqimisagan, romelic Tavisufalia yovelgvari
gareSe zegavlenisagan klinikuri an eTikuri
gadawyetilebebismiRebisas.
g) pacients, adekvaturi informaciis miRebis
Semdeg, ufleba aqvs daTanxmdes an uari Tqvas
mkurnalobaze.
d) pacients ufleba aqvs moelodes, rom eqimi
pativs scems misi samedicino da piraduli
monacemebis konfidencialurobas.
e) pacients aqvs Rirseuli sikvdilis ufleba.
v) pacients ufleba aqvs miiRos an uaryos
sulieri da moraluri Tanadgoma, Sesabamisi
aRmsareblobis RvTismsaxuris daxmarebis
CaTvliT.

143
 2001 wels ZalaSi Sevida saqarTvelos kanoni
“saeqimo saqmianobis Sesaxeb”, romelic uzrunvel-
yofs damoukidebeli saeqimo saqmianobis sakanon-
mdeblo safuZvlebs. kanoni aregulirebs samarT-
lebriv urTierTobebs saeqimo personalsa da
pacientebs, saxelmwifo organoebsa da iuridiul
pirebs Soris.
kanoni “saeqimo saqmianobis Sesaxeb”
gansazRvravs im pirobebs, romliTac pirs eZleva
saeqimo saqmianobis ufleba. II Tavis me-7 muxlis 1
da 2 punqti ase gansazRvravs am uflebas:
“1. damoukidebel saeqimo saqmianobis ufleba
aqvs saqarTvelos an ucxo qveynis moqalaqes an
moqalaqeobis armqone pirs, romelmac daamTavra
saqarTvelos saxelmwifo akreditaciis mqone
umaRlesi samedicino saswavlebeli da am kanoniT
dadgenili wesiT miiRo damoukidebeli samedicino
saqmianobis uflebis damadasturebeli saxelmwifo
sertifikati ”.
“2. damoukidebel saeqimo saqmianobis ufleba
am muxlis pirvel punqtSi miTiTebul pirs aqvs
mxolod saxelmwifo sertifikatSi aRniSnuli
specialobiT, garda kanniT gavaliswinebuli gamo-
naklisebisa”.
kanoni ganazRvravs agreTve saeqimo saqmia-
nobis sxva samarTlebrivs sakiTxebs, rogoricaa
ucxoeTSi samedicino ganaTlebis miRebis SemTxve-
vebi, ucxo qveynis specialistis droebiTi muSaoba
Cvens qveyanaSi, saxelmwifo sertifikatiT
gaTvaliswinebis garda sxva saeqimo spcialobiT
saqmianobis ufleba, eqimis funqciis Sesruleba
rezidenturaSi an doqtoranturaSi swavlis dros.
kanonis III Tavi gansazRvravs saxelmwifo
sertifikatis samarTlebriv xarisxs da
sertificirebis proceduras.
kanonis V TavSi mocemulia damoukidebeli
saeqimo saqmianobis subieqtis movaleoba pacientis

144
mimarT. am Tavis debulebebi eyrdnoba im
saerTaSoriso deklaraciebisa da konvenciebis
principebs, romlebic ZiriTadad iqna ganxiluli
Cvens mier. am Tavis 38-e muxlSi aRniSnulia, rom:
“damoukidebeli samedicino saqmianobis
subieqti profesiuli movaleobis aRsrulebisas
unda:
a) pacientsa da sazogadoebaSi piradi magali-
TiT amkvidrebdes jansaRi cxovrebis wess;
b) xelmZRvanelobdes mxolod profesiuli
stndartebiT, humanzmis principebiT,
saqarTvelos kanonmdeblobiT, pativs
scemdes pacientis Rirsebas, aRmsareblobasa
da tradiciebs;
g) maqsimalurad iTvaliswinebdes pacietis
janmrTelobis interesebs;
d) iyos uangaro, profesiuli gadawyveti-
lebebis miRebisas – Tavisufali da damouki-
debeli;
e) piruTvnelad asrulebdes eqimis fics.”
kanonis es muxli gansazRvravs pacientisaTvis
informaciis miwodebis, informaciuli Tanxmobis,
informaciis konfidencialobis da sxva
samarTlebriv pirobebs.
VI TavSi mocemulia eqimis movaleobebi patim-
ris, dakavebulis an datyvevebulisaTvis samedicino
daxmarebis gawevis sakanonmdeblo regulacia.
saqarTvelos kanoni “saeqimo saqmianobis
Sesaxeb” gansazRvravs agreTve eqimis saqmianobasTan
dakavSirebul iseT sakiTxebs, rogoricaa: samedi-
cino Canawerebis warmoeba (Tavi VII), movaleoba
kolegebis mimarT (Tavi VIII), saxelmwifo zedamxed-
veloba saeqimo saqmianobaze (Tavi IX), profesiuli
pauxismgebloba (Tavi X) da sxva.
meore aranakleb mniSvnelovani sakanonmdeblo
aqtia saqarTvelos kanoni “pacientis uflebebis
Sesaxeb”. kanonis mizania moqalaqeTa uflebebis,

145
maTi pativisa da Rirsebis dacva samedicino
momsaxurebis dros. kanonSi deklarirebulia, rom
janmrTelobis dacvis sferoSi moqalaqis uflebebs
upiratesi mniSvneloba eniWeba samedicino
mecnierebis interesebTan SedarebiT.
“pacientis uflebebis Sesaxeb” kanonis II
TavSi ganazRvrulia pacientis ufleba mkurna-
lobasa da janmrTelobis problemebTan
dakavSirebul socialur daxmarebaze. pacients aqvs
ufleba miRos drouli, obieqturi, mkafio infor-
macia Tavisi janmrTelobis Sesaxeb (Tavi III). samedi-
cino daxmarebis gawevisaTvis saWiroa pacientis
informirebuli Tanxmoba yvela samedicino proce-
duraze, im gamonaklisi SemTxvevebis garda,
romlebic gaTvaliswinebulia kanoniT (Tavi IV).
amave kanoniT daculia misi piradi cxovrebis konfi-
denciuroba da xelSeuxebloba. calkeuli muxlebi
gansazRvravs pacientTa iseTi gansakuTrebuli
kategoriebis uflebebs, rogoricaa arasrulwlov-
nebi, orsulebi, tusaRebi.

146
 eqimis fici

miRebulia msoflio samedicino asociaciis

generaluri asambleis mier (1948). ganaxlebulia: 22-e
msoflio samedicino asambleis mier (1968); 35-e
msoflio samedicino asambleis mier (1983), msoflio
samedicino asociaciis 46-e generaluri asambleis
mier (1994).

vxdebi ra samedicino profesiis warmomadgeneli,

sazeimod vficav:
 Cemi cxovreba mivuZRvna adamianis samsaxurs;
 Rirseuli pativi da madliereba mivago Cems
maswavleblebs;
 keTilsindisierad da Rirseulad Sevasrulo
Cemi profesiuli movaleoba;
 pacientis janmrTeloba gavixado Cems
umTavres sazrunavad;
 Sevinaxo CemTvis mindobili saidumlo
pacientis sikvdilis Semdegac ki;
 SeZlebisdagvarad davamkvidro saeqimo
profesiis keTilSobiluri tradiciebi;
 kolegebi miviCnio Zmebad da debad;
 ar davuSva pacientis asakis, janmrTelobis
mdgomareobis, aRmsareblobis, rasis, sqesis,
erovnebis, politikuri Sexedulebebis,
seqsualuri orientaciis, socialuri
mdgomareobis zegavlena Cemi profesiuli
movaleobis aRsrulebaze;
 kvlav usazRvro pativi vce adamianis
sicocxles misi CasaxvisTanave, veraviTarma
Zalam ver maiZulos gamoviyeno samedicino
codna kacTmoyvareobis kanonebis winaaRmdeg;

am aRTqmas vdeb sazeimod, nebayoflobiT da

uangarod.

147
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* nusxaSi mocemulia is ZiriTadi literaturuli

wyaroebi, romlebic gamoyenebulia saxelmZRvanelos
Sedgenisas.

150