Arman Begoyan

Opening up World of Psychology, Removing Stigma in Armenia

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YEREVAN — Psychology and psychological services have undergone drastic changes in Armenia, not only in the implementation of new trends and tendencies but also in the elimination of prejudice about the field.

Recently, Arman Begoyan, psychologist, certified psychotherapist, supervisor, and trainer, sat down for an interview. Begoyan is an international affiliate of American Psychological Association, a full member of the Polish Federation for Psychotherapy, the Ethical Body of Eye Movement Desensitization and Reprocessing (EMDR) Psychotherapists’ Association of Armenia, Chief specialist at Hilfmann Psychological Services, and head of Clinical Psychology and Psychotherapy Department of Harmand Hilfmann School of Professional Psychology, a member of the editorial boards of Theory and Practice of Mental Health Care (Russian Federation), Psychopathology and Addictive Medicine (Russian Federation), and Abused Child. Theory, Research, Practice (Poland) peer-review journals.

Stigma

One of the positive trends Begoyan addresses, is the diminishing stigma of seeking help for mental health issues in Armenia. There was a time when asking for psychological help was regarded as something demeaning. However, this perception has changed, and the perception towards psychological issues as a stigma is rarely circulated.

“We must understand that the more we repeat these old concepts, the slower they disappear. During the 44-day war, when I and many of my colleagues volunteered in various medical institutions, there were parents from all parts of Armenia and Artsakh, small towns and distant villages, who were not ashamed to request the help of a psychologist for their wounded sons. With this example, I want to reassure everyone that this stigma is wrong,” said Begoyan.

He noted that some people do not clearly understand what psychologists do or simply regard their work merely as holding a conversation.

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“Psychotherapy is more than just a conversation. Especially evidence-based therapies, such as cognitive-behavioral therapy, have very specific protocols and guidelines for each problem that include behavioral methods, mindfulness methods, relational methods, and much more,” he said.

In his 15 years working, Begoyan has seen a trend where people from the provinces, and not just the capital, seek out his services openly to deal with a variety of issues. “Nowadays people go to a psychologists with much greater willingness. A key tendency is decentralization. In the past seven years, clients have been coming not only from the capital Yerevan but also from regions. People of almost all ages, from teenagers to retirees, request help. More than ten years ago, people in the LGBT + community were trying to get psychological services anonymously. I even had a client who was joining our sessions from a fake account. Now people apply for help more openly.”

In terms of specialists, there is a huge amount of willingness to open an office, with all the financial risk it entails. Now psychological centers are gradually being transformed from NGOs to private enterprises. Professionals now focus more on their development, continuing professional education, and investing more in their career growth.

“A major drawback that still prevails is connected to doing business – ensuring the full cycle, from pricing, advertising, and packaging services to delivering them. Years ago many psychologists were ashamed to talk about money,” Begoyan noted.

Impostors vs Good Specialists

One concern in Armenia is finding qualified professionals rather than people who misrepresent themselves as world-class specialists. Years ago, Begoyan wrote the article “How to distinguish a professional psychologist from a self-proclaimed one?” where he raised this issue and gave clear guidelines for choosing a professional.

When asked about a positive shift in this issue in Armenia, he states that there would have been much more changes if the community of psychologists had not been so forgiving.

He explained, “Nowadays more and more people are becoming interested in psychological services. They are starting to study, comparing Armenian practice with the services available in countries, to get an idea of the quality or usefulness of this or that method or therapeutic direction. However, we still meet specialists who openly voice anti-scientific methods.”

One example of a pseudoscientific method is conversion therapy that helps to change a person’s sexual orientation, a practice that has long been rejected since the 1970s. “If you are a psychologist working in the United States, and someone asks for help to change sexual orientation, you must explain that this is impossible and unethical,” he said.

Another matter of concern that distinguishes nonprofessionals is their blatant hate speech, chauvinistic and radical ideas. “When it comes to practicing psychologists providing psychotherapy and counseling, emphasizing any kind of discrimination, justifying one party, or demonizing the other is not ethically correct. The psychologist has no right to show open hatred towards any group,” he added.

Psychology as an academic discipline is relatively new in Armenia. After the collapse of the USSR in the 1990s, there were no practices nor  guidelines compared to the ones that had been developed in the West. The older generation of local specialists gathered knowledge from various psychologists who arrived in Armenia after Spitak’s earthquake. That is why there is a certain background difference between the generations. “Currently at Hilfmann we also voluntarily work on enriching professional literature, and psychologists are writing books to help future specialists and reduce the scarcity of professional materials in Armenian,” said Begoyan.

Anxiety and Gambling

Anxiety and depressive disorders are frequently seen in Armenia as well as around the world. Unfortunately, there are no official statistics for Armenia, but Begoyan is convinced that anxiety disorders prevail.

“Looking around, I see how anxious we are. Everything we have seen in the last hundred years — from the genocide and wars to earthquakes, the collapse of the Soviet Union —  has contributed to that. I wrote two books on anxiety – “#Bye_Bye_Anxiety” and a handbook version of it (Տագնապամարիչ, translated as “Anxiolytic”).

Another concern in Armenia is gambling, but there are few solid statistics about people addicted to it. However the recent amendments to the Law on Advertising adopted by the Armenian parliament, banning all kinds of gambling advertisements, indicates there is a problem. “In recent years, especially when everything went online, the problem started to spread quickly. The options and diversity of such gambling activities have increased. Moreover, very few percent of the players apply to a specialist, very few percent come to the second session. My book Gambling: How to overcome is more of a workbook that you can try to use on your own or start a session with it.”

Begoyan believes that when we talk about who should be responsible for making society more aware and ready to coexist with people with psychological problems, the answer is both simple and complex. “It is clear as everyone should care, the difficult part is how we should do that. The problem is which format is most effective. For example, if a psychologist shares content about post-traumatic stress disorder (PTSD) on YouTube, there are people who do not use YouTube. Besides, not all professionals are can be performers to grab the interest of people.”

Begoyan has recently come up with a social initiative for the temporary ban of fireworks in residential areas. He believes that this is not only a question of awareness but a question of norms of coexistence. “If people know and understand the interconnection of fireworks and PTSD, they will not do that,” he said.

Arman Begoyan

Digitalization of psychology

Psychological services are successfully embracing digitalization, just like many other fields and activities, especially in the post-COVID era. However, the implementation of new technologies in psychology has deep roots. “When I was a student, I tried to read a lot of American literature. I have been a member of the American Psychological Association since 2005 and receive their ‘Monitor Psychology’ newsletter every month. Back in the 2000s, there were articles claiming how effective internet-based therapy is and that it is not inferior to in person sessions, and what is more in some cases the use of virtual reality is more effective,” said Begoyan. He recalled his first online session in 2006, when the Internet in Armenia was through dial-up. “Holding a video call was a big problem, and the session was via chat. But I remember how skeptical some of my colleagues were towards online therapies.

VR technologies have been used in psychology for 20 years. Initially, these technologies were used both for the organization of the session and for modeling the environment to solve a specific problem, for example, modeling certain triggers that can’t be exposed in vivo. Begoyan believes that the further development of VR/AR technologies and their availability will change the format of psychological services.

“In general, the centers for psychological services will cease to exist, whereas the number of private practice cabinets and one-person centers will increase. Not everyone can afford to have an office, so this will also save money,” he explained.

Begoyan remembers that back in 2015 the idea of creating an integrated platform for psychological services crossed his mind. “I have been thinking of it as a virtual entity where specialists can register and match certain criteria (given that there is no license for psychologists in Armenia), clients can find and choose specialists, and all the therapy tools will be in one place: video, audio call, text, file sharing, payment. Then my brother and I came up with the name PsyGuard. In 2016, we even participated in the Armenian Startup Cup and made it to the semi-finals,” he said.

For years, Begoyan could not find a team that would create software solutions for the platform. A group of his programmer friends said it was interesting, but nothing more. And when the pandemic occurred, in three months Begoyan received six offers to implement the idea in a variety of formats. The platform will be free of charge to the Ministry of Emergency Situations or to certain NGOs that deal with vulnerable groups, such as domestic violence issues.

Future Endeavors

The platform is still under construction, but this doesn’t stop its cofounder from dreaming big and having ambitious plans for the future. “Our primary market includes Russian-speaking post-Soviet countries, and I do believe that the platform has the potential to become a pipeline for exporting psychological services. In this regard we as a nation have a huge advantage – we are pretty good at learning and mastering foreign languages.”

Begoyan also emphasized the importance of advocating the rights of both clients and specialists. The effectiveness of the therapy should be measured and wrapped up in feedback only after a certain number of sessions. He also believes that this platform will also contribute to raising the quality of education in Armenia, as the demand for good specialists will impose greater expectations from universities.

 

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