From the author: The article was prepared for publication in the annual collection of articles of the ON-card publishing house Moritz Egetmeyer, published in March 2012 on the website Doctor at work. Metaphorical cards in everyday practice an oncological psychologist is a great help. They allow significant progress in helping the patient in a very short time, being both a diagnostic tool for the condition and a correction tool. In different situations, in different conditions, with different patients, I use different decks or combine decks with each other. In particular, you can use metaphorical cards in situations of preoperative anxiety in patients. Preoperative anxiety is a frequent companion of an oncology patient during the hospital stage. Of course, in order to remove anxiety, it is important to give the patient the most complete information about how the preparation for the operation will take place, the operation itself, what will happen immediately after the operation, what needs to be prepared, put in places that are easily accessible from a lying position, etc. and so on. But often, along with cognitive dissonance, patients experience pronounced autonomic disorders, which are difficult for them to explain, but they either simply create discomfort for the patient or are a temporary contraindication to surgery, further increasing the anxiety state. In these cases, metaphorical cards come to my aid. I usually use an ECCO deck because... I consider it quite universal due to the fact that the images are not structured, there are no fixed situational pictures. Work in the inpatient departments of the Chelyabinsk District Oncology Center is always unexpected, because... assumes that an oncopsychologist simply enters any ward of any department and is actively interested in which of the patients may require psychological support, assistance, or directly in the department one of the doctors asks to go into a specific ward, or to all patients in the ward at once, or to one of the patients specifically. In any case, the oncologist does not know in advance what problems he will have to face when working with inpatients, and there is no technical ability to carry many decks with him. Therefore, I limit myself to the ECCO deck, sometimes I also take the MORENA deck. An example from individual work with a patient who was admitted for surgical treatment of recently diagnosed endometrial cancer 2 days ago and was experiencing severe anxiety due to the stress of being informed of the diagnosis and the fact of hospitalization, unusual and an uncomfortable environment, and from the uncertainty associated with the upcoming operation. During group work with patients in the ward, I noted in this patient stiffness of movements, brevity of statements, involvement in the process of work on a non-verbal level while simultaneously avoiding verbal communication, pronounced tremor of the upper extremities, sallow complexion, acrocyanosis. After a general conversation with the patients in the ward, I approached the patient and asked about her well-being, her thoughts and feelings about the upcoming operation. She confirmed my hypothesis about preoperative anxiety, which she could not explain, but felt on a physical level with poor general health, trembling in her hands and body, palpitations, and dry mouth. Having blindly selected one card, the patient, at my request, began to describe the picture, based on the assumption that it depicted her anxiety, her concern. Due to her age (63 years) and the unusual nature of the task, the patient naturally experienced some difficulties in interpreting the images. But cards have the amazing ability to “talk” to absolutely anyone! Simple questions such as: “Do you like the picture as a whole?”, “What do you like and don’t like in the picture?”, “What feelings do you experience when looking at the picture?” etc. The patient, having begun to describe the picture, directing all her attention to it, already throughI noticeably calmed down for a couple of minutes: the tremors in my hands became less pronounced and my body posture became more relaxed. I drew her attention to the changed physical state with the question: “What is happening to your body now? Something has changed?" The patient realized the changes that had occurred, verbalizing all the changes that I noted visually, adding that she now feels much calmer, and there is no such strong heartbeat as a few minutes ago. To consolidate the result obtained, the patient independently chose from the deck pictures that she liked and were pleasant to look at. She laid out all the selected cards in front of her in the order she wanted. The instructions sounded like this: “Choose from the deck as many cards as you want that you like in some way, go through all the pictures. You can choose as many as you want, I don't limit you. Then place all the selected pictures in front of you so that you just enjoy looking at them. You can remove some of them if you want. You can move them from place to place until it seems to you that everything should lie exactly this way and not otherwise. You can do this slowly, as long as you need. Further, if you want, you can tell me about any card or all the cards that lie in front of you, what you like about them, what you get from them when you look at them.” As a result of this work, which took the patient about 5 minutes, acrocyanosis completely disappeared, her lips turned pink, her complexion became fresher, the patient spontaneously took several deep breaths with a relaxed, deep exhalation. After that, I asked a question about my well-being and those changes in bodily sensations, if they occurred. The patient responded with surprise that the trembling in her body and hands had completely disappeared, her heart was beating evenly and calmly, and she felt some kind of lightness, calmness and pleasant moderate relaxation. To my question about what she now thinks about the upcoming operation, the patient replied that her thoughts are calm, she is confident of a successful outcome, there are only very slight doubts about how the first hours after the operation will go. These doubts were dispelled by reciting standard instructions about what can and cannot be done in the first hours after the operation, reference to the positive experience of neighbors in the ward who could tell in detail how it happened for them, recommendations for organizing the space around oneself for this time after surgery. In conclusion, advice was given to remember the pleasant relaxed state that appeared when looking at the collage of cards, and to remember these muscle sensations in situations when the soul suddenly becomes anxious again. All work to correct the anxiety state took no more than 30 minutes and resulted in a complete change in subjective bodily sensations, emotional coloring and perception of thoughts about the upcoming operation from negative to positive. In other similar cases, at the final stage, instead of making a collage of abstract pictures, you can offer to choose pictures from the MORENA deck, focusing on how you would like to feel or how those who do not need to prepare for surgery feel, who are healthy, or what You will wish yourself well-being in the form of parting words before the operation. Similar work can also take place in a group form. As an example, we can recall group work in a ward with three patients. The fourth roommate was taken to the operating room that day. This circumstance increased the already existing anxiety among the patients remaining in the ward. Until today, anxiety manifested itself in all three of them in high blood pressure and tachycardia, depressed mood, gloomy thoughts, poor sleep (difficulty falling asleep) of varying severity. One of the patients was the first to express the need to correct her own condition, others supported her. Each patient was asked to blindly select one card and, looking at the card, talk about her upcoming operation. Two patients began to describe.