RU2351371C1 - Method of treating compulsive overeating - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to psychotherapy, reflexotherapy and concerns treating patients suffering from compulsive overeating. Psychotherapeutic influence is realised by means of individual suggestive influence. Patient is brought into the state of trance and simultaneously their acupuncture points are influenced, before individual suggestive influence, neurolinguistic programming is carried out and new ecological image of "healthy Ego" is formed. Essence transformations of personality are realised and new healthy principles of correct nutrition are formed, prevention of "diet depression" is also realised, individual suggestive influence being directed to psychological support, distraction from persistent thoughts about food, weight and figure, normalisation of food intake, elimination of diet self-restrictions, solution of life difficulties; reflexotherapeutic influence on acupuncture points is realised by infrared photobiostimulation and extremely high-frequency exposure onto corporal points, after which patient is given home task in form of "diary of correct food behavior". Infrared photobiostimulation is performed on point T20, extremely high-frequency exposure is performed on corporal points E36, MC6, GL4, VB8, VC12, RP6. Individual suggestive influence is performed by means of Ericksonian hypnosis. On finishing the course of treatment, psychological support is carried out in form of consultations in order to form and support strategy of correct food behaviour. In process of carrying out reflexotherapy course simultaneously infrared exposure of low intensity and extremely high-frequency exposure are used. Individual suggestive influence, infrared exposure of low intensity and extremely high-frequency exposure are carried out simultaneously.

EFFECT: method lies in increasing treatment efficiency.

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Description

The present invention relates to medicine, namely to psychotherapy, reflexology, and for the treatment of patients suffering from compulsive gluttony.

Compulsive gluttony can manifest itself in the form of obesity or bulimia and is considered as a psychophysiological disease with biological, psychological and social roots.

A known method of treating compulsive gluttony, which includes group and individual psychotherapeutic effects and reflexology, is protected by RF patent No. 2198000, class. A61M 21/00, publ. 2003.02.10.

However, this method, with all its attractiveness, has several fundamental disadvantages. Firstly, this method is very difficult for the conducting staff, because it requires not only special training, but also a specific type of personality (introvert and extrovert). It is known that pure introverts and extroverts do not exist, and this separation is very subjective. Secondly, this type of treatment is associated with unpleasant sensations for patients (the need to stay awake at night) and the deformation of familiar biorhythms, which contributes to the exacerbation of chronic diseases associated with obesity. Thirdly, in the group treatment of patients with obesity, the laws of group psychotherapy of obesity should be adhered to, namely, a group should be no more than 7 people.

At the same time, fear, anxiety and distrust of the group process should be emphasized. This is often confirmed by actual hostile experiences in the group. A large group by itself can create significant frustration mainly due to its size (up to several dozen participants) and the alienating effect of this on each individual member. This frustration breeds hatred: hatred for the therapist, for the group, for oneself and for the whole world.

The formation of new conditioned reflex strategies of proper eating behavior takes an average of 5-6 months and all this time the patient must be in contact with the therapist.

In the known method does not take into account the phase dynamics of group therapy. Based on the phase dynamics of the development of relations in the group, negative trends increase in the group for 3 sessions, because the group is entering a phase of confrontation and breakthrough of real feelings. This leads to frustration of narcissistic needs, so instead of providing an empathic display for individuals and congruent relationships in the group, the group gives experience of neglect, deprivation and self-esteem. This feature of group therapy must be taken into account and must be worked out, because this state of development of the group can lead to aggression, which has a destructive effect, turning the healing process on the pathological and disintegration path.

Because of the above, this method of losing weight, having undoubted advantages, nevertheless leaves unchallenged a huge layer of the population suffering from compulsive gluttony and nevertheless refusing group therapy. The group approach in comparison is regarded as somewhat superficial, interpersonal and transpersonal, insufficiently supported metapsychologically, relatively non-ecological, because in the process there is a scattering of therapeutic efforts on many people at the same time. The proposed psychotherapeutic group effect is somewhat chaotic and in its practical part uses psychotechnics that are mutually incongruent with respect to the patient’s psyche, namely, the simultaneous use of transpersonal psychotechnics and aversive psychotherapy. At the same time, the risk of the formation of iatrogenic anorexia increases sharply.

In addition, there is a certain group of the population that fundamentally refuses group therapy.

It should be borne in mind that acupuncture causes a rebalancing of physiological processes, which under stress can cause depletion of the body's defenses and accordingly cause an exacerbation of chronic diseases associated with obesity. Carrying out acupuncture requires certain requirements, one of which is the creation of a state of psycho-emotional rest and relaxation. The above methodology refers to stress-emotional psychotherapy, which can cause a paradoxical reaction - a reaction to acupuncture. The room in which acupuncture is performed must comply with SES standards.

There is also known a method of treating nutritional and constitutional obesity L. Naumchik, protected by RF patent No. 2136323, class. A61M 21/00, A61K 35/78, A61N 1/18, A61N 1/26, publ. 1999.09.10.

The main disadvantages of the method are:

- when conducting a psychotherapeutic intervention using autogenous training techniques, the morpholinguistic principles of the formation of autogenic suggestions are not taken into account at all, namely, it is not recommended to wish yourself anything negative (to “lose weight” is the derivative of the word “bad” to want to lose weight = want to do something bad, that’s bad) ;

- when forming the formulas of autogenous suggestion, it is necessary to avoid the prefix “not”, because the subconscious mind does not perceive the prefix “not” and autogenous suggestion takes on exactly the opposite meaning;

- in the process of conducting psychotherapy of obesity of any kind, the primary task is to teach patients to distinguish between hunger and appetite, which is not carried out in a known manner;

- the use of simulators and muscle stimulants significantly increases the cost and complicates the technique, requiring significant areas, which is impossible in many medical institutions;

- mass exposure is effective in 15% of cases and only in individuals with increased suggestibility;

- treatment occurs without taking into account the physiological changes in the body that are characteristic of obesity.

From the above it follows that this method is not so much ineffective as dangerous in terms of the development of iatrogenic.

A known method of treating obesity, protected by RF patent No. 2173182, class. A61M 21/00, publ. 2001.09.10, selected as a prototype.

According to the known method, the leading mechanism of psychological defense in the form of a "projection" or "regression" is previously identified. They conduct a psychotherapeutic effect aimed at destroying the revealed mechanism of psychological defense and forming coping behavior options in the cognitive sphere - “problem analysis” or “setting one's own value”, in the emotional sphere - “protest” or “optimism”, in the behavioral sphere - “cooperation "or" constructive activity ". To fix the given settings, acupuncture is additionally carried out, acting on the CI points. 10-Shaw-san, RP. 8-Dji, RP. 6-San-yin-jiao, E. 37-Shan-ju-xu, MS. 4-Xi-Men, MS. 5-jian-shi.

The disadvantages of the method are:

- the method does not take into account the characteristics of the patient’s personal development, since the failure of the mechanism of psychological protection in patients using coping behavior by the type of projection or regression, in patients with neurosis, in patients with preneurotic disorders, as well as in patients with a high risk of psychogenic disorders and somatic diseases from a therapeutic point of view is unjustified and not effective enough, because it leads to a transition from a preneurotic state to a neurotic state and stimulates the occurrence of a psycho niy;

- the method works out the problem at the level of “abilities” and “opportunities” and does not affect the level of personal values and beliefs at all, which limits its effectiveness, i.e. there is a restriction solely on behavioral methods, the underlying causes are not worked out, the specifics of personality changes in the process of the development of the disease are not taken into account;

- the method does not create an atmosphere of psychological safety, because the breakdown of psychological protection by artificially stimulating the state of anxiety, tension, aggression is unethical and in the conditions of short-term psychotherapy is ineffective and, as a rule, causes undesirable complications;

- the method is limited in effectiveness and ineffective in all cases of obesity, except in cases of obesity, due to the formation of a psychological defense mechanism in the form of a "projection" or "regression". In all other cases of obesity, this method is absolutely ineffective, and sometimes harmful, because the protection of the unconscious includes not only projection and regression, but also many other pathological defense mechanisms, such as "self-accusation," humility "," active avoidance ", "Retreat" and others. For example, often when faced with traumatic situations, obese patients avoid and ignore them, feeling confused, blame themselves, suppress their emotions through self-control, tend to seek help from other people, showing coping behavior such as “avoidance” or “retreat”. Avoidance strategy is one of the leading behavioral strategies in the formation of maladaptive, pseudo-controlling behavior, leading to the development of obesity. The use of this strategy is due to the lack of development of personal environmental copying resources and active problem-solving skills. It can be either adequate or inadequate depending on the specific stressful situation, age and condition of the personality resource system, therefore, when conducting psychotherapy aimed at correcting coping behavior, it is necessary to take into account the relationship of coping behavior with coping resources. In the foregoing method, such a relationship is absolutely not taken into account, which in practice forms a pseudo-adaptive dysfunctional coping behavior and contributes to the rapid return of excess weight.

It should be borne in mind that coping behavior by the type of projection and regression as a pseudo-protective reaction can form in individuals with preneurotic, neurotic and psychotic organization of mental processes. A breakdown of the revealed mechanism of psychological protection in individuals with a psychotic organization of mental processes leads to an aggravation of psychopathological processes.

In the case of coping behavior of the type of “active avoidance” and “retreat”, disruption of the defense mechanism using emotional stress therapy is contraindicated, because it leads to confirmation of the patient's pathological belief in his own inferiority and, accordingly, pours water into the mill for the progression of obesity.

In the known method, the concepts of “appetite” and “hunger” are not worked out, the role of a balanced diet and reasonable physical exertion is not explained, and the importance of observing a diet in the first months of the formation of new eating behavior is not completely ignored, and the strategy of a new correct eating behavior is not formed.

The basis of the invention is the task of creating a method of treating compulsive gluttony that meets modern time requirements, including a multi-level psychophysiological effect that provides high-quality relief of the main manifestations of compulsive gluttony, and a new strategy for proper nutritional behavior without the use of drugs, as well as a high-quality rehabilitation program during the recovery period.

The technical result from the use of the invention is to increase the effectiveness of treatment.

This result is achieved by the fact that in the method of treating compulsive gluttony, including psychotherapeutic and reflexotherapy effects, the psychotherapeutic effect is carried out using an individual suggestive effect, introduced into a trance state and simultaneously affects acupuncture points, while neuro-linguistic programming is performed before an individual suggestive effect and a new an environmentally friendly image of a “healthy I”, they carry out essential transformations of personal spices and form healthy principles of proper eating behavior, as well as the prevention of “dietary depression”, with individual suggestive influence directed at psychological support, distraction from relentless thoughts about food, weight and figure, normalization of food intake, elimination of dietary self-restrictions, resolution of everyday difficulties, and reflexotherapy effect on acupuncture points is carried out by infrared photobiostimulation on point T20 and ultra-high-frequency effect on corporal points 36, MS6, GL4, VB8, VC12, RP6, then give the patient a homework "Blog correct feeding behavior."

Individual suggestive exposure is carried out using Ericksonian hypnosis.

At the end of the course of treatment, psychological support is provided in the form of consultations to form and support a strategy for proper eating behavior.

During the course of reflexology, both low-intensity infrared exposure and ultra-high-frequency exposure are used simultaneously.

Individual suggestive exposure, low-intensity infrared exposure and ultra-high-frequency exposure are carried out simultaneously.

An individual approach is considered as “deeper”. The technique proposed by the applicant intrapsychically, metapsychologically is based on an in-depth study of the problems that led to compulsive gluttony, and is technically associated with extracorporeal exposure, enhancing the intrapsychic restructuring of the personality’s internal psychological space during which an artificial illness is cured.

The course of treatment is as follows. In the first procedure, the doctor conducts an initial conversation with the patient, collects an anamnesis, determines the motivation for treatment and creates an oral contract with the patient, at the same time determines the type of pathological eating behavior. During the initial conversation, the doctor determines the patient's representative system and, adjusting to it, creates a state of rapport. Carrying out diagnostics using a computer diagnostic complex according to the Nakatani method, the doctor determines the functional state of the patient’s body and systems that require correction. Subsequently, using the computer diagnostic complex, the dynamics of the therapeutic effect is monitored. The first procedure is aimed at the formation of a resource state of safety and comfort.

During the initial conversation, the doctor conducts “anchoring” neuro-linguistic programming (NLP) followed by “anchor collapse”, emotional states that correspond to the concepts of “food” and “diet” are anchored. As a result, the pathological food dominant is deactivated. At the same time, an explanation of the concepts of appetite and hunger is given, recommendations are given on rational nutrition, taking into account the type of pathological eating behavior. These recommendations are necessary for the formation of patients' habits of meaningful attitude to nutrition.

Recommendations include:

1) diet - 5 times a day,

2) the exclusion from the diet of sugar, solid fats, potatoes, flour products,

3) daily calorie intake - 1000-1200 kcal per day,

4) keeping a diary of proper eating behavior, in which the patient carefully records the amount of food eaten per day, briefly emotional state and in writing performs the task given by the therapist.

At the end of the conversation, they carry out trance suggestion using Ericksonian hypnosis of the type of “resource trance”, during which, using direct and indirect suggestions, they increase motivation to achieve the desired result. The emphasis is not on the number of kilograms dropped, but on increasing self-esteem. In the process of trance they give suggestions that increase the level of internal security and safety. At the same time, during the trance, the procedure of ultrahigh-frequency (EHF) and infrared (IR) exposure to corporate points is performed. Use T20 points (IR exposure). Use points E36, MC6, RP6, GL4, VB8, VC12 (EHF exposure). Simultaneous reflexotherapy and individual suggestive influences help to destroy the existing pathological connections that form the pathological functional system “food-pleasure”. As you know, every habitual action in a person creates a familiar stereotype - a program expressed in the form of stable functional relationships. All programs, including those for compulsive behavior (smoking, alcoholism, obesity), work automatically. The impact on the reflex connections of the skin with the corresponding parts of the brain changes the usual stereotype of pathological eating behavior. At the end of the procedure, the patient is given homework, which includes the development of an individual diet and a set of physical exercises and, if necessary, additional medical advice. Only the independent formation of an individual diet, taking into account the state of health, allows the patient to form a habit of meaningful attitude to nutrition. The creation and conscious execution of a set of dosed physical exercises is one of the prerequisites necessary for successful treatment, because it allows the patient to learn how to get somatic satisfaction and feel the "joy of the body".

The second procedure is devoted to changing the underlying underlying prerequisites for compulsive gluttony and begins with a discussion of the individual diet and nutrition diary. After discussion, NLP-6 step reframing is carried out.

At the end of the NLP procedure, a hypnotic trance is performed using Ericksonian hypnosis techniques. During the trance, the achievement of the desired state is confirmed at a subconscious level, and positive emotions are saturated. During the hypnotic suggestion, both IR and EHF are simultaneously administered to the corporal points. At the end of the procedure, they give homework. In homework, they are asked to answer in writing the questions “how and in what circumstances the patient's appetite increases” and “how does the patient show a feeling of hunger”. This task is necessary for the dissociation of the part of the person responsible for overeating from the healthy part of the person. All homework is done in writing in a diary of proper eating behavior.

In the 3rd procedure, work is underway with significant food products. For this purpose, they conduct NLP - the technique of changing beliefs, then an individual suggestive impact aimed at distracting from relentless thoughts about food and forming a positive image of a "healthy" I ".

At the same time produce IR and EHF exposure. At the end of the procedure, they give homework - to write 5 favorite foods or dishes - to identify situations for which patients awarded themselves food, and to correct family scenarios associated with overeating.

In procedure 4, NLP is carried out - a three-position description technique, during which an internal dialogue is held between the parts of the personality with the creation of an agreement on a new eating behavior and an internal ecological image of a "healthy" I is created with the implementation of an essential personality transformation. Next, an individual suggestive effect is directed, aimed on accepting oneself as an integral personality, with simultaneous IR and EHF exposure, and upon completion give homework aimed at finding and preparing new strategies for eating, and recommendations for further maintaining a food diary.

Then for 6 months they conduct monthly consultations aimed at increasing self-esteem, at forming a strategy and tactics of new eating behavior and at improving adaptation to real life conditions, including working out family scenarios associated with overeating, and gradually adjusting non-adaptive mechanisms of psychological defense in adaptive acceptable.

For this, an individual suggestive effect is used, mediated through Ericksonian hypnosis, rational psychotherapy, indirect suggestions, client-centrist psychotherapy.

This technique takes into account the pathological psychophysiological features of the development of compulsive gluttony and contributes not only to weight loss, but also to the preservation of the achieved result for a sufficiently long time.

The methodology was tested on the basis of the Municipal Unitary Hospital "City Hospital" No. 47 of Nizhny Novgorod.

Example No. 1. Patient K., 28 years old. At the reception, complaints of shortness of breath, joint pain, increased fatigue and weakness. Weight - 110 kg. The increase in weight is associated with the second birth, after which she recovered by 40 kg. Notes an irresistible desire to eat up that occurs in the evening. The diet is evening. In the afternoon, mainly eating sandwiches, drinking coffee. Regularly "sits" on diets. Diets are short-term and the effect is negligible. The treatment was carried out according to the above method.

The diet was formed at the rate of 1200 kcal per day. After a month, the weight is 98 kg. No complaints, notes improvement in well-being. I visited control visits regularly. After 6 months - weight - 71 kg, no complaints. HELL returned to normal.

Example No. 2. Patient I., 39 years old, weight gain for 12 years. Weight - 92 kg, binds to pregnancy and childbirth. At the reception, complaints of increased blood pressure, palpitations, shortness of breath with minor physical exertion, insomnia, pain in the knee joints.

The treatment was carried out according to the above scheme. The diet is 4-5 times a day at the rate of 1000 kcal per day. At the end of the course of treatment no complaints. Weighing 78 kg. Consultation in a month: well-being, diet easy, no complaints. Weight is 73 kg. After half a year, weight 67 kg, good mood, blood pressure normalized, normal sleep, pain in the knee joints disappeared, notes an increase in mood, an improvement in relations with her husband.

Thus, the present invention meets all modern requirements, allows you to qualitatively stop the main manifestations of compulsive gluttony and creates a new strategy for proper eating behavior without the use of drugs, as well as a quality rehabilitation program in the recovery period.

Claims (5)

1. A method of treating compulsive gluttony, including psychotherapeutic and reflexotherapy effects, characterized in that the psychotherapeutic effect is carried out using an individual suggestive effect, introduced into a trance state and simultaneously affects acupuncture points, while neuro-linguistic programming is carried out before an individual suggestive effect and a new environmentally friendly the image of a “healthy I”, they carry out essential transformations of the personality and form healthy marketing principles of proper eating behavior, as well as the prevention of “dietary depression”, with individual suggestive influence directed at psychological support, distraction from relentless thoughts about food, weight and figure, normalization of food intake, elimination of dietary self-restrictions, resolution of everyday difficulties, and reflexotherapy effect on acupuncture points are carried out by infrared photobiostimulation to the T20 point and ultra-high-frequency exposure to corporal points E36, MC6, GL4, VB8, VC12, RP6, pos then the patient is given homework in the form of a "diary of proper eating behavior." 2. The method according to claim 1, characterized in that the individual suggestive effect is carried out using Ericksonian hypnosis. 3. The method according to claim 1, characterized in that at the end of the course of treatment, psychological support is carried out in the form of consultations to form and support the strategy of proper eating behavior. 4. The method according to claim 1, characterized in that during the course of the reflexology course both low-intensity infrared exposure and ultra-high-frequency exposure are used simultaneously. 5. The method according to claim 1, characterized in that the individual suggestive exposure, low-intensity infrared exposure and ultra-high-frequency exposure is carried out simultaneously.