RU2438725C1 - Method of extra weight reduction - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to field of medical psychology, in particular, to method of psychotherapy for extra weight reduction. Psychotherapeutic contract, which obliges patient to observe rational diet, is concluded and course of psychotherapy, including, at least, four full-time group sessions with total duration from 4 to 7 days, between which patient fulfils correspondence self-study, using methodological recommendations on psychology and nutrition of rational food behaviour, are carried out, as well as control meeting, after, at least 25 days from course beginning. In case of side effects and/or detection of diet violation, correcting psychotherapy, which includes cognitive-behavioral psychotherapy in combination with audiovisual stimulation (AVS) is administered. At each session rational psychotherapy is carried out, at the first session presentation of target strategies of rational food behaviour is carried out, at the following sessions target food behaviour is supported and/or behaviour deviating from target behaviour is corrected, and at the last session, as aim, suggested is confidence in independent realisation of target strategies. In the course of correspondence self-study during the first interval between sessions, actualised are positive effects of weight reduction. After that actualised are positive effects of overeating and extra weight, and, finally, list of alternative sources of enjoyment, which are not connected with food consumption, is formed. At the first session problem of extra weight is disidentified with patient personality by method of psychosynthesis, first three sessions indirect psychotherapy, which includes physiotherapeutic impact and suggestion to patient that it contributes to weight reduction, is carried out. At the second and third sessions suggestion is supported by induction of changed consciousness state (CCS) by means of holotropic breathing. At the second session formed is aversion with respect to imagined product, inducing neurotic desire, and at the third session - with respect to real product, inducing neurotic desire, on condition of its further application in diet in process of weight reduction. At each session, at least, once in combination with AVS CCS is induced by method of directed visualisation, by means of relaxation and/or meditation. At, at least, one of said sessions earlier applied suggestions and/or aims are consolidated, correcting psychotherapy in it cognitive-behavioral psychotherapy in combination with AVS.

EFFECT: method makes it possible to form skills of self-control for supporting achieved result in correction of patient's body weight during long period of time and reduction of impact of psychotherapist's personal characteristics on efficiency of carried out therapy.

17 cl, 5 tbl, 3 ex

Description

FIELD OF THE INVENTION

The invention relates to medicine, in particular, to a method of psychotherapy for reducing excess weight.

BACKGROUND

The problem of overweight and obesity concerns the general population with different income levels in economically developed and developing countries. The health damage caused by obesity is comparable to the harm caused by smoking and drinking alcohol. Being overweight increases the risk of developing cardiovascular diseases, type 2 diabetes, diseases of the digestive system, liver and pancreas, worsens the quality of life, reduces self-esteem and negatively affects life expectancy.

The prevalence of organic disorders that cause overweight during normal eating behavior is negligible and does not exceed 1-2% of the total number of overweight people. The main causes of obesity are overnutrition and a sedentary lifestyle.

The most important target for the treatment of obesity and overweight correction is lifestyle and irrational eating behavior, in particular, compulsive eating behavior, chronic overeating, unbalanced in calorie content and component composition nutrition.

Known methods of correcting overweight do not lead to a long-term effect, and medication and surgical methods of treatment are unsafe, and the use of intense physical activity is contraindicated in many chronic diseases, in old and old age. In contrast, psychotherapeutic methods have virtually no contraindications, do not cause negative side effects and are highly effective (90% and higher). Thus, psychotherapy aimed at changing eating behavior is currently the preferred means of safe and long-term weight correction.

Known psychotherapeutic methods of weight correction induce the patient to observe an effective diet and increase the level of physical activity. According to the recommendations of the World Health Organization from 1970, to normalize body weight provides: fractional balanced diet, preferably 6 times a day, limiting the energy value of food, moderate exercise, giving up alcohol, constant monitoring (self-control) of body weight.

The usual arsenal of psychotherapeutic techniques used for this purpose includes, in particular, hypnosis, including non-directive (Erickson), transpersonal psychotherapy, including holotropic breathing, various types of indirect psychotherapy, including seed therapy based on the placebo effect.

A known method of weight correction, in which the psychotherapeutic effect is carried out once in a state of wakefulness and hypnotic sleep, form negative emotions for abuse of food with high energy value and prescribe a diet with an energy value of 800-900 kcal per day for 8 weeks (RF patent No. 2019996). The disadvantage of this method, which prevents the achievement of the technical result indicated below, is that the patient develops an aversion to high-calorie food, in addition, a prolonged low-calorie diet leads to severe stress and withdrawal symptoms.

There is a known method of weight correction, in which psychotherapy is carried out against the background of an altered state of consciousness, weight loss motivation is reinforced and strengthened by verbal suggestion, an autogeteresuggestive effect is carried out in the wakeful state and in the state of autogenic immersion, for which information on the digestive system function, properties and composition of food , then, taking into account information about personal characteristics and individual nutritional behavior of the patient, they formulate self-hypnosis and form a verbal Before bedtime, the information received is recorded by means of a visuomotor reaction in the form of filling out a diary and repeatedly writing self-hypnosis formulas with the left hand, and after waking up the self-hypnosis formulas are reproduced using ideomotor hand movements, the procedures are repeated daily for 7-10 days, and for 6 months, the diary is continued to be maintained and analyzed and self-hypnosis formulas are reproduced before bedtime and after waking up (patent from the acquisition of the Russian Federation No. 2033199). The disadvantage of this method, preventing the achievement of the following technical result, is its duration and complexity.

A known method of treating obesity, including psychotherapy and color exposure, in which psychotherapy is carried out in a cabin, painted or lit with orange light, the patient is offered food and at the same time include table lamps on both sides of the cutlery, on the one hand red, on the other green, thus so that the light from them does not fall on the patient's face (RF patent No. 2122441). This method does not allow to achieve persistent changes in stereotypes of eating behavior.

A known method of treating nutritional obesity, which includes conducting psychotherapy in a state of meditation, followed by withdrawal of the patient from this state, in which psychotherapy is previously carried out in a wakeful state, for this purpose, verbal suggestion reinforces and strengthens the motivation for weight loss, and then the patient is brought into a meditation state , they carry out an autoheterosuggestive effect, inspire an indifferent attitude to food, cause anorexic-dysphagic sensations, strengthen them mechanically m irritation of the anterior projection of the stomach and repeat the session after 1-2 days, the next session begins with irritation using the acupuncture or acupressure method of reflexogenic zones or points of the hypothalamic-pituitary system, autonomic nervous system and gastrointestinal tract. The program for introducing into a meditative state includes a weight loss program, which is preliminarily calculated taking into account the parameters of weight loss in the first two sessions and the autoheterosuggestive effect is repeated against the background of irritation of reflexogenic zones (RF patent No.2008028). This method does not allow to achieve a lasting effect.

A known method for the psychocorrection of obesity, including hypnotic psychotherapy against the background of the required psychoemotional state, inhibiting psychological dependence, accompanying verbal information with light, and / or color, and / or sound effects, in which the correction is carried out in the form of three night psychotherapeutic sessions lasting from 8 to 10 hours each, alternating them with 40-42 hours of rest, each session is formed from a rational, suggestive and relaxation part; at the first session, by the method of rational psychotherapy, the patient develops targeted motivation for behavior, using verbal information, the content of which allows the patient to recognize the psychic causes of excess weight, then the patient is put into a trance and an aversive suggestive psychotherapy with modalities of positive and negative images is performed; at the second session, subjective attitudes are controlled and corrected by the method of rational psychotherapy, in a trance state they form the dominant for weight loss, on the basis of the “systemic structural trace”, they start or re-form the “vegetative memory” of a healthy organism; at the third session, by the method of rational psychotherapy, the positive effect of treatment is fixed, then hypnotic suggestive verbal coding of the desired weight is carried out; and each session is completed by physical relaxation of the patient (patent for the invention of the Russian Federation No. 2218944 C1). The disadvantage of this method, preventing the achievement of the following technical result, is the strong dependence between the effectiveness of therapy and qualifications, as well as the personal characteristics of the therapist. In addition, sleep deprivation is a powerful stress factor and can negatively affect people under stress.

A known method for the correction of obesity, including group and individual psychotherapy and reflexology, in which the correction is carried out in three sessions, the first two of which are carried out at night; in the first session, a rational psychotherapy session is sequentially conducted, at which a psychotherapeutic contract is concluded, in which the doctor and patient share responsibility for the treatment, then rational psychotherapy is carried out, which includes forming an attitude to the problem and discussing the principles of balanced nutrition, then simultaneously with acupuncture conduct non-directive hypnotic psychotherapy aimed at activating internal resources, after which conduct behavioral ihoterapiyu with the formation of aversion to the product, leading to excessive appetite; at the beginning of the second session on rational psychotherapy, the importance of regulating the energy balance is emphasized, then acupuncture and general relaxing relaxation trance are performed, then transpersonal psychotherapy is carried out with the induction of an altered state of consciousness and a stereotype of a slender person is formed, then non-directive hypnotic suggestive therapy is aimed at maximizing satisfaction from minimum amount of food, after which acupuncture is carried out od at the same time with behavioral aversive therapy; the third session begins with rational psychotherapy aimed at fixing the normal body weight, then acupuncture is carried out, after that, when conducting behavioral psychotherapy, the dominant according to Ukhtomsky is formed, the results of psychotherapeutic correction are fixed; the course of treatment is 5 days, after 30-40 days they conduct a session of behavioral psychotherapy, where they monitor and provide moral support (RF patent No. 2198000). The disadvantage of this method, which impedes the achievement of the following technical result, is the complexity and invasiveness of acupuncture, as well as the strong influence of the personality characteristics of a psychotherapist on the effectiveness of treatment.

A known method of psychological correction of excess body weight, including group and individual psychotherapeutic effects and reflexology, in which the correction is carried out in 7 sessions; at the first individual session, the causes of excess body weight are identified and based on this, groups of patients are formed; at the second group session, rational psychotherapy is carried out and an attitude towards the problem of internal conflicts associated with overweight is formed, the preferred nutrition skills for natural weight loss are formed, neuro-linguistic programming techniques are used to create installations to reduce hunger and appetite, and reflexology in the form of acupressure to enhance muscle tone of the stomach; at the third group session, rational psychotherapy is carried out and a distinction is formed between the concepts of “hunger” and “appetite”, thereby shaping the nutritional skills of a slim person, they conduct non-directive hypnotic suggestive aversive therapy with the creation of an indifferent attitude to products that cause excessive appetite, conduct an acupressure session and use respiratory techniques with elements of transpersonal psychotherapy with the induction of an altered state of consciousness; at the fourth group session, through behavioral therapy, motivational aspects of reducing body weight and a slender person’s lifestyle are formed, then breathing techniques with elements of transpersonal psychotherapy are performed, the session is completed with a relaxation-resource trance to consolidate the experience gained in the session; at the fifth group session, they apply methods of behavioral psychotherapy to create a stereotype of nutrition and behavior of a slender person, conduct gestalt therapy and form the maximum satisfaction from less food, as well as cathartic psychotherapy; the sixth individual session is carried out 14 days after the end of the intensive course of psychocorrection, the psychologist uses the method of rational and behavioral psychotherapy to form a further positive attitude to reduce body weight, conduct a trance state technique, and then carry out osteopathic treatment; the seventh group session is carried out 30 days after the end of the intensive course, the methods of personality-oriented psychotherapy are used, after which, using the Erickson therapy methods, they form a positive attitude towards achieving the result, shaping the lifestyle and behavior of a slender person (RF patent No. 2352363, chosen as the closest analogue). The disadvantage of the analogue, which impedes the achievement of the following technical result, is that the total duration of the course is not enough to resolve intrapersonal conflicts with the help of rational and / or cathartic psychotherapy, even with reference to one member of the group. The claimed method differs in that in it rational psychotherapy includes the formation of the so-called "internal picture of the disease" (Luria A.R.) by the method of psychosynthesis (see Assagioli R. "Psychosynthesis" Refl-book, 1997, ISBN: 5- 87983-027-6), which allows the patient not only to recognize the psychic causes of overweight and his mistakes, but also to disidentify his personality with the problem of overweight, increase self-esteem and avoid the appearance of guilt.

Another disadvantage of the analogue, which impedes the achievement of the following technical result, is the irrational order of following its stages. Namely, the formation of motivation begins after several sessions of behavioral psychotherapy. This leads to an increase in the total duration of the course. The claimed method is characterized in that the patient’s motivation is formed before the formation of the basic skills necessary for weight loss. To do this, use the goal-setting technique aimed at enhancing motivation to take actions leading to the desired changes (see, for example, I. Vachkov, “Fundamentals of group training technology” 3rd ed., Moscow, “Axis-89”, 2007 )

Another disadvantage of the analogue, which impedes the achievement of the following technical result, is that several meetings are not enough to effectively affect the tone of the muscles of the stomach through acupressure. The claimed method is characterized in that instead of acupressure, they carry out seminal-sujok therapy, which is used as an indirect psychotherapeutic technique, leveling the influence of the personality of the psychotherapist. Semen-su-jok therapy is combined with a meditative technique aimed at shifting kinesthetic attention to the left epigastric region, which allows you to quickly achieve a feeling of primary satiety.

A common disadvantage of the above methods based on psychophysiological correlation is their low efficiency and instability of the achieved effect, while the disadvantage of methods aimed at changing eating behavior is that the achieved effect is highly dependent on the personality characteristics and qualifications of the therapist.

Another common drawback of the above methods is that they can lead to subdepressive and asthenic disorders in some patients. Eating disorder has a different etiology in different groups of patients. In some people, eating disorders occur amid excessive stress, and overeating is a compensatory adaptation mechanism. For others, excess food intake is a source of positive emotions lost in life. In practice, both causes can be combined with each other in different proportions. Imperative restriction of food intake can cause serious psychosomatic disorders in such individuals and lead to subdepressive disorders.

The claimed method is devoid of this drawback, since it provides for a voluntary change in the stereotypes of eating behavior, without a directive limitation of the amount of food and can be applied to non-hypnotizable patients.

SUMMARY OF THE INVENTION

The objective of the present invention is the correction of the patient’s body weight, the formation of self-control skills to maintain the achieved result over a long period of time and to reduce the influence of personal characteristics of the therapist on the effectiveness of the therapy.

The problem is achieved in that in the invented method of reducing excess weight, they conclude a psychotherapeutic contract obliging the patient to follow a rational diet, and conduct a course of psychotherapy that includes at least four full-time group sessions with a total duration of 4 to 7 days, between which the patient performs independent correspondence work using printed guidelines on the psychology and dietetics of rational eating behavior, as well as a follow-up meeting, at least Leray, after 25 days from the start of the course and in the event of side effects and / or identifying the power mode after intramural disorders prescribe corrective therapy sessions, which includes cognitive-behavioral therapy in conjunction with audiovisual stimulation (ABC); in the said method, rational psychotherapy is carried out at each of the sessions, and at the first session, target strategies of rational eating behavior are presented, at the next sessions, target eating behavior is supported and / or behavior that deviates from the target is corrected, and at the last session, they inspire confidence in the setting independent implementation of targeted strategies, in the course of correspondence independent work in the first interval between sessions update the positive effects of weight loss, then act lyse the positive effects of overeating and overweight and, finally, form a list of alternative sources of pleasure that are not related to food consumption, at the first session, the problem of overweight with the patient’s personality is disidentified by the method of psychosynthesis, the first three sessions carry out indirect psychotherapy, which includes physiotherapy and suggestion the patient that it contributes to weight loss, in the second and third sessions, the suggestion is supported by induction of an altered state of consciousness (ASC) through holotropic respiration, and in the second session, an aversion is additionally formed in relation to the imaginary product that causes the neurotic attraction, and in the third - in relation to the real product that causes the neurotic attraction, provided that it is further used in the diet in the process of weight loss, in each session, at least once in combination with ABC induce ASCs by directional visualization by relaxation and / or meditation, while at least one of these sessions is fixed earlier declared suggestions and / or attitudes.

In a private embodiment, the groups are formed using the DEBQ questionnaire to identify restrictive, emotiogenic, and external types of eating disorders, and the test results are taken into account in rational psychotherapy and nutritional recommendations. Dietary recommendations are distinguished by the absence of prohibitions on the choice of certain products, and weight loss is achieved mainly by limiting the energy value of food.

In one particular embodiment, a psychotherapeutic contract obliging the patient to follow a rational diet can oblige the patient, in particular, to eat at least four times a day, count calories of food eaten, keep a food diary, periodically measure weight, do not drink alcohol in period of weight loss, limit the intensity of subjectively heavy physical exertion for the period of weight loss and take multivitamin nutritional supplements. Preferably, when the therapist justifies the need for each of these conditions.

Rational psychotherapy in the first session includes the presentation of targeted strategies for rational eating behavior and can be aimed at forming an attitude to the problem of overweight.

The psychotherapist can begin the first session with the formation of an “internal picture of the disease” (Luria AR), talking about the physiological and psychological causes of being overweight, about ways to reduce it, about the features of the claimed method, explaining techniques for weight loss and maintaining optimal body weight. This allows the patient to recognize the psychic causes of overweight and their mistakes.

According to the method of psychosynthesis (Assagioli R. “Psychosynthesis” Refl book, 1997, ISBN: 5-87983-027-6), the psychotherapist disidentifies the problem of overweight with the patient’s personality, for which a game approach can be used, according to which the patient’s normal body is disidentified. with adipose tissue and it is proposed to fight with abstracted fat, and not with oneself. This allows you to increase the self-esteem of patients and to avoid the appearance of guilt.

The time interval between rational psychotherapy and other types of therapy in the claimed method is preferably not more than 20 minutes.

At each of the first three sessions, indirect psychotherapy is carried out, which includes physiotherapeutic effects and the suggestion of a verbal installation that it helps to reduce weight, reduce stomach volume, increase metabolism and / or create other physiological prerequisites for weight loss.

The main goal of indirect psychotherapy is the placebo effect. An additional goal of indirect psychotherapy is the formation of associative relationships between the verbal setting and physiotherapeutic effects, which can be used in subsequent stages in combination with other methods to increase the effectiveness of fixing installations.

The preferred physiotherapeutic treatment is acupressure. Acupressure is preferably carried out by exposing the point to XU-CHI or HA-GU. According to one of the possible methods, the grain of buckwheat, rice or another plant is attached to one of the hands on the XU-CHI or HE-GU point on one of the hands and rotated with the index finger of the opposite hand for one or several minutes clockwise.

Preferably, when in the claimed method, acupressure is additionally carried out between the change of psychotherapeutic techniques.

ASCI is induced at least once in each patient session. For the induction of ASC in the claimed method, only non-directive hypnosuggestive methods are used, such as the method of directional imaging (Erickson therapy) and holotropic breathing.

In each of the sessions, at least one ASC is combined with ABC. ABC parameters are always selected taking into account the objectives of the ASC.

Preferably, when the first ASC induced in the first session is a relaxation trance, one of the main goals of which is to relieve stress.

The duration of the relaxation and meditative trances in the claimed method is preferably from 20 to 30 minutes.

It is desirable when, before using a new therapeutic technique, the therapist explains his basic principles and mechanisms of influence on the goal. For example, before the first immersion in ASC, psychotherapists can explain that ASC is a normal, natural state that a person experiences every day, and give examples of a natural trance (riding a bus or watching an interesting film with subsequent disorientation in time). The psychotherapist can pay attention to the fact that any healthy person can enter a trance state and that in a trance state the patient completely controls himself and controls himself.

Previously made installations are preferably fixed by combining ASC with ABC. The effectiveness of fixing increases in the position of the patient’s body while standing, the back is straight, the feet are together, the arms hang freely along the body, the chin is raised, the center of gravity of the body is shifted to the socks, the look is raised up.

The preferred setting for the first session is to reduce the volume of the stomach, for which kinesthetic attention is concentrated in the epigastric region and confirm the previously made setting to reduce the volume of the stomach.

The general requirement for tasks for part-time independent work is that they can be easily completed by any patient.

The goal of correspondence independent work in the first interval between sessions is to build an achievable goal and strengthen motivation, for this the patient updates the positive changes that will occur after weight loss.

In a private embodiment, as a correspondence independent work in the first interval between sessions, the patient writes with his left hand at least seven positive changes that will occur after weight loss.

The duration of each of the sessions in the claimed method is preferably from 4.5 to 5 hours

One of the goals of rational psychotherapy in the second and subsequent sessions is to support targeted eating behavior and correct deviant behavior. Rational psychotherapy may include a discussion of the feelings and emotions that arise in the process of eating and counting calories, explaining the principles of a balanced diet, explaining the need to calculate the energy value of food and observing nutritional rules according to the contract, setting the range of daily calorie content depending on body mass index (BMI), age and nature of work. Rational psychotherapy may include an explanation of the differences between hunger, appetite, and satiety. Examples from the life of patients are allowed. Hunger is a combination of unpleasant sensations, manifested in the form of emptiness and stomach cramps, in the instinctive feeling of the need for food, it occurs when the body’s energy reserves have decreased below the level necessary for balance, and appetite is a general feeling of pleasant emotional sensations that are associated with the desire of a person to take certain foods, it is based on the desire to get the pleasant sensations that accompany the intake of a particular food. In contrast to hunger, appetite occurs with sufficient energy reserves of the body. Satiation is the lack of desire to eat, caused by eating. At its core, it is the opposite of a feeling of appetite and hunger.

The second session preferably includes immersion of the patient in the ASC accompanied by ABC for relaxation and activation of internal resources. Against the background of ASC, the psychotherapist can activate life events saturated with positive emotions, use developmental metaphors, and reinforce suggestions about strengthening metabolic processes.

The second and third sessions use elements of transpersonal psychotherapy, in particular holotropic breathing according to Stanislav Grof. Before the first use of this method, the psychotherapist talks about it, forms the group’s opinion that after this procedure, weight loss will be faster and conducts a session during which patients control their breathing by making rhythmic deep breathing movements. The effectiveness of the method is enhanced in combination with musical accompaniment, the melodic structure, rhythm and musical size of which are close to the natural rhythms of breathing and heartbeat. The preferred duration of holotropic respiration is at least 1 hour.

The psychotherapist should strive to anticipate the appearance of any new sensations and experiences caused by psychotherapeutic techniques new to patients in the course of therapy, and to relate these experiences and sensations to beneficial changes that occur or may occur under the influence of these techniques.

The second session includes aversive behavioral therapy with elements of neuro-linguistic programming. The patient in his imagination imagines foods that cause appetite, and then - objects that cause disgust. The therapist can offer patients to close their eyes and present on the left palm a piece of some product that causes excessive appetite, and after successful visualization, accompanied by a sensation of appetite, the task is to present an object of disgust on the right palm, for example, a crushed rat. Attention is focused not on the feeling of disgust for the rat, but on the feeling of pity for it. Then they give instructions to rub their palms.

Conducting aversive psychotherapy after transpersonal helps to transform behavioral stereotypes and changes the patient's attitude to products that cause a neurotic attraction.

One of the tasks of correspondence independent work in the interval between the second and third sessions is to mitigate the resistance, aggression and dissatisfaction of patients, which can be caused by physiological changes in the patient’s body. For this, as part-time independent work between the second and third sessions, it is proposed to update the positive effects of overeating and overweight.

Rational psychotherapy in the third session is aimed at supporting targeted eating behavior and may include monitoring the eating behavior of each member of the group, supporting successful actions, discussing erroneous actions by the whole group and / or discussing ways to solve problems. Rational psychotherapy may also include a discussion of feelings of shame and guilt that violate eating behavior, and the application of dissociation techniques to them. The therapist discusses the benefits of obesity and overeating and suggests their alternative and harmless equivalents.

Aversive psychotherapy in the second and third sessions is preferably carried out after the aforementioned technique associated with intensive breathing.

Even more preferably, when aversive psychotherapy in the second and third sessions is carried out after the induction of ASC, aimed at activating internal resources in combination with ABC.

Aversive psychotherapy in the third session is carried out using real food products. At the same time, the possibility of further use of these products in the diet is emphasized. Thus, the freedom of patients in choosing a diet is not limited.

As a task for correspondence independent work, patients are offered to find significant pleasures and entertainments that are not related to food.

Rational psychotherapy in the fourth session is aimed at consolidating confidence in the independent continuation of the process of weight loss and may include building an image of a successful person, enriching the sphere of interests and hobbies, analyzing the patient’s relationships with significant people, smoothing out conflicts in the sphere of socially significant relationships, increasing self-esteem, strengthening the motive for weight loss, optimizing the categories of time and money in the patient's value system, helping patients to highlight the most important for them to Categories for weight loss.

For the induction of ASCs by directional imaging in the fourth session, positive results of changes in eating behavior are preferably used. As a setting inspire confidence in the independent achievement of the desired result.

They fix the installation on achieving the desired result in the ISS, accompanied by ABC according to the method of D.N.

A control meeting is carried out at least 25 days after the start of the course, since a long break is required to consolidate the new habitual eating behavior. In case of difficulties, the units are re-fixed using the method described above.

The method may include one or more repetitions of one or more of the above sessions, or may include one or more additional sessions, which can be constructed according to the above schemes according to an independent embodiment of the method and include induction of ASC in combination with ABC.

As described above, one of the distinguishing features of the present invention is the use of ABC. The principle of audiovisual stimulation is based on the simultaneous intensive exposure of several channels and modalities of perception. As a result of an increase in the stimulus intensity, cerebral blood flow and trophic processes in the nervous tissue are enhanced, and the storage of information is facilitated.

The impact is carried out at frequencies close to the natural frequencies of the electrical activity of the brain. At the same time, brain activity is synchronized with the frequencies at which they act by flickering light and sound pulsations, such as binaural beats. Binaural pulsation occurs as a result of delivering to each ear sounds of a pure tone, with a small difference in frequencies and is perceived as a smoothly pulsating rhythm.

Different frequencies of the electrical activity of the brain correspond to certain physiological states, such as sleep, wakefulness, intense attention, relaxation, etc. Thus, the choice of one or more frequencies of stimulation allows you to purposefully change the state of the psyche.

In particular, the frequency of 10 Hz corresponding to the alpha rhythm creates a state of serenity, calm contemplation, peace, well-being, relaxed wakefulness, the use of frequencies of 6 Hz and 4.9 Hz, corresponding to the theta rhythm, causes relaxation, reduces the criticality of thinking, facilitates access to the unconscious, causes free associations, makes it easy to assimilate information, the use of a frequency of 14 Hz, corresponding to low beta waves of the sensorimotor rhythm, helps to increase the plasticity of thinking processes, this often and is associated with a state of rest, the perception of their own body, coordination and active attention states.

As additional modalities, both the color of light flashes and the sequence of color changes can be used. The color effect allows you to purposefully shape the emotional state of the patient. In particular, the scarlet color has an exciting effect, increases activity, sensuality, determination. The turquoise color creates a feeling of purity, coolness. The blue color calms, radiates reliability, reduces stress, it is the color of “calm emotionality”, makes it possible to be outside the boundaries of society, expands the space. Yellow-green color promotes activity in social contacts, knowledge of the new. Yellow color increases concentration, helps to overcome limitations, expand opportunities, and speed up decision-making. The green color helps to dispel negative emotions, brings peace and tranquility, helps to concentrate, and has sleeping pills. Red color has an exciting effect, increases activity, sexuality, enhances the work of the endocrine glands. Cream color has a mild effect, expands the space, facilitates the perception of reality, gives confidence that everything will be in order. Orange color contributes to the increase of strength, energy, psychological flexibility. Pink color causes a feeling of comfort, a feeling of kindness, romance, eliminates obsessive thoughts. Light violet color calms with anxiety, symbolizes intuition, has a soft, non-intense effect. Light green color has a light, harmonizing effect, disperses negative emotions. Light gray color contributes to the achievement of a liberated, elevated state, well calms, pacifies. The blue-green color helps to dispel negative emotions, brings peace and tranquility, creates a feeling of refreshing coolness. Blue color contributes to dreaminess, separation from reality, immersion in thought. Maroon promotes confidence, strong-willed decisiveness, immersion in deep thought. The dark blue color causes self-absorption, promotes dreams, sadness, causes a loss of a sense of reality, the need for physiological rest and satisfaction, this is the color of dreams. Violet color increases sensuality, suggestibility. Black color causes curiosity, a sense of mystery, alertness.

ABC modalities are chosen in such a way as to create an emotional state that is most conducive to the assimilation of new stereotypes of behavior and attitudes.

The use of ABC in the claimed method eliminates the influence of personal characteristics and qualifications of a psychotherapist on the effectiveness of traditional methods of psychotherapy, increases the suggestibility of patients, reduces their resistance to suggestion and enhances the effectiveness of treatment in an over-additive manner.

The claimed method does not cause an aversion to food, forms skills and beliefs that allow you to independently reduce body weight and maintain the achieved result. After completing therapy, the patient can independently control body weight and calorie content within certain limits until the desired result is achieved, eat fractionally, refuse fasting, heavy physical exertion, and food prohibitions.

DETAILED DESCRIPTION OF THE INVENTION

The following examples are given only to illustrate an inventive idea. Nothing in this section of the description should be construed as limiting the scope of the claims. It should be clear that the average person familiar with the ideas of the present invention, can use its main distinguishing features and make equivalent replacements to achieve the task and without deviating from the spirit and scope of the present invention.

EXAMPLE 1

On the first day, a group of patients aged 18 to 65 years is formed, who do not have contraindications for weight loss. At the preliminary session of rational psychotherapy, the psychotherapist at least 1.5 hours talks about the principles of reducing and maintaining normal weight and concludes a psychotherapeutic contract with the group, providing for the calculation and recording of calorie intake, refusal to drink alcohol, fractional nutrition, at least 4 once a day, daily weight control, the absence of any prohibited foods, the restriction of heavy physical exertion, compliance with the water regime, multivitamins.

Then a self-massage is carried out, for which a buckwheat grain (rice, etc.) is attached to the XU-CHI point of one of the hands with a hypoallergenic patch and rotated with the index finger of the opposite hand for one minute clockwise, at the same time concentrating the kinesthetic attention of patients in areas of the epigastrium and in the affirmative form report that this will subsequently help to reduce the stomach and / or enhance metabolic processes.

Then, dissociation is carried out for 1 hour by the method of psychosynthesis. For this, the problem of excess weight and obesity is disidentified with the patient’s personality. The therapist creates a vivid image of the problem and explains the mechanisms of its occurrence and development, and then shows that the treatment is aimed only at combating the problem and does not affect the personality of the patient.

After that, a directed visualization session is conducted for 25 minutes in combination with audiovisual stimulation (2.5 min 10 Hz, 2 min 6 Hz, 4 min 4 g 9 Hz, or 2.5 min 10 Hz, 2 min 6 Hz, 1 min 4 , 9 Hz, dark blue and cream color alternate) to create a state of relaxation and 30 minutes each patient is surveyed about their well-being. Discussion of the effects of ABC builds a trusting relationship between the therapist and the group and helps to reduce resistance to suggestion and create an altered state of consciousness (ASC) that promotes the assimilation of new behavior.

For a minute, they re-stimulate the XU-CHI point, at the same time they tell a psychotherapeutic metaphor.

In a standing pose, the back is straight, the feet together, the arms hang freely along the torso, the chin is raised, the center of gravity of the body is shifted to the socks, the gaze is raised upwards, the directional imaging session accompanied by ABC is performed for 25 min (3.5 min 10 Hz, 2 5 min 6 Hz, 4 min 4.9 Hz, 5 min 14 Hz, alternate dark blue and cream color, or 2.5 min 10 Hz, 2 min 6 Hz, alternate dark blue, blue-green, purple, light green, dark blue and blue-green, or 2 min 10 Hz, 2 min 6 Hz, alternate dark blue and blue-green, or 2 min 10 Hz, 1 min 6 Hz, alternate red and po call color) to consolidate suggestions about a decrease in the volume of the stomach and about quick saturation from a smaller amount of food. As an independent work, the patient is offered to write with the left hand in the diary seven positive changes that will occur after weight loss. Other well-known methods can be used to build the goal of achievement and strengthen the motivation of the client.

The second day begins with a session of rational psychotherapy, where they analyze the results of independent work, support changes in eating behavior, find out the difficulties that arise and help find a way to solve them. The psychotherapist finds out what emotions arise in the process of nutrition and calorie counting, explains how to distinguish hunger from appetite in various situations, explains what emotions are hidden behind appetite, stimulates the emotional work of psychotherapeutic metaphors, for each patient, depending on height, age, weight and nature of the work assigns a range of daily calories.

Spent self-massage as described above. Then for 25 minutes spend a resource session directed visualization in combination with ABC, aimed at creating a state of relaxation (2.5 min 10 Hz, 2 min 6 Hz, 4 min 4.9 Hz, or 2.5 min 10 Hz, 2 min 6 Hz, 1 min 4.9 Hz, dark blue and cream color alternate).

For 15 minutes, the therapist talks about the method of S. Grof and forms the group’s opinion that after this procedure, weight loss will be faster. Then, for 20-25 minutes, the members of the group control their breathing, making rhythmic deeper breathing movements with musical accompaniment. Then for 15 minutes a therapeutic metaphor is told.

Then, over the course of 5 minutes, an aversive NLP technique is performed. Patients close their eyes and present on the left palm a piece of some product that causes excessive appetite, then they are given the task of presenting a crushed rat on the right palm, after which they are instructed to rub their palms.

Spent self-massage, as described above. At the same time they tell a psychotherapeutic metaphor.

As an independent work, the patient is offered (a) to prepare products for the next day that, according to his own ideas, cause an increased desire, (b) find and write in the diary the positive aspects of overeating and overweight, (c) bring along products that from the point of view of group members, they can interfere with weight loss, and the products should be ready for use.

The third day begins with a session of rational psychotherapy and homework associated with the positive aspects of obesity, where they check the eating behavior of each member of the group, support successful actions, discuss erroneous ones and the whole group outlines ways to solve difficult situations. Two feelings that violate eating behavior are discussed: shame and guilt. Apply the technique of dissociation in relation to these feelings. They discuss the positive aspects of obesity and overeating and find alternative and harmless ways to get these positive points.

Spent self-massage, as described above.

Then, for 20-25 minutes, participants control their breathing, making rhythmic deep breathing movements.

Immediately without interruption, to mediate the stress caused by intense breathing, color meditation is carried out in combination with ABC (1.5 min 10 Hz, purple and light green, red and pink, orange and yellow-orange, yellow and light gray alternate , green and blue-green, cyan and turquoise, navy and blue, purple and light purple, scarlet and yellow).

After that, aversive therapy is carried out to change attitudes towards “forbidden” products. Each patient places products brought with him on his left palm. Then, biting and chewing each piece 9 times, spits chewed on the right palm. As a result, all brought products are chewed and are in the right palm. The therapist suggests tossing everyone their chewed foods into a transparent bag. As a result, the bag is filled with a heterogeneous mass. Next, the task is given to spit in the package and stretch its contents. After that, the patients demonstrate the package and they are given the installation: "At the festive table, you can easily refuse an extra piece."

As a task for correspondence independent work, patients are invited to find new pleasures that are not related to food consumption. The therapist suggests writing all those significant pleasures and entertainments that are not related to food that may be in the life of each member of the group.

Rational psychotherapy in the fourth session includes reinforcing confidence in the independent continuation of the process of weight loss. The psychiatrist creates the image of a successful person, works out the categories of time and money, invites each member of the group to write down all his hobbies and entertainments, which can be really put into practice in the near future.

To increase self-esteem and strengthen motivation, the psychiatrist analyzes the system of the patient’s relationship with significant people, helps each member of the group to identify the most important category for themselves for weight loss.

The support of the settings on the independent achievement of the desired result of the patients is introduced into the ASC by the method of directed visualization using the positive results of changes in eating behavior.

Fixing the installation to achieve the desired result is carried out according to Uznadze D.N. in the ASC state accompanied by ABC (3 min 10 Hz, alternate black and maroon, or 2.5 min 10 Hz, 2.5 min 6 Hz, 4 min 4.9 Hz, alternate black and maroon, either 3 min 10 Hz, alternate orange and yellow-green, or 1.5 min 10 Hz, alternate scarlet and yellow) in a standing position, back straight, feet together, arms hanging freely along the body, chin raised, center of gravity of the body shifted to socks, look raised up.

The session ends with a story of a psychotherapeutic metaphor.

At the control meeting, they provide psychological support to patients, identify and correct errors, check the safety of the process of normalizing weight.

Self-massage point of the XU-CHI point is carried out according to the aforementioned method, the suggestion is made: "Stimulation of this point enhances the metabolic processes."

After that, fix the installation to achieve the desired result by D. Uznadze in the ASC state accompanied by ABC (3 min 10 Hz, alternate black and maroon, or 2.5 min 10 Hz, 2.5 min 6 Hz, 4 min 4.9 Hz, alternate black and maroon, either 3 min 10 Hz, alternate orange and yellow-green, or 1.5 min 10 Hz, alternate scarlet and yellow) in a standing position, back straight, feet together, arms hanging freely along the body, chin raised, center of gravity of the body shifted to socks, look raised up.

Each is given a sheet of A4, cut into 2 parts. The patient stands on one half of the sheet, at the same time the therapist indicates all the negative aspects of being overweight, then the sheet breaks. The patient stands on the other half of the sheet, the therapist indicates all the positive aspects of harmony, the desired weight is written on the sheet. Then the psychotherapist gives the task to attach this sheet to the floor scales, on which the group member will be weighed in the process of weight loss.

The control meeting is completed with a story of a psychotherapeutic metaphor.

After the end of full-time sessions of psychotherapy, patients are remotely monitored and, if side effects of the therapy occur or when nutritional disorders are detected, corrective and / or maintenance therapy is prescribed according to examples 2 and / or 3.

EXAMPLE 2

Cognitive-behavioral psychotherapy (corrective)

Cognitive-behavioral psychotherapy is carried out individually in case of ineffective implementation of recommendations for weight loss. Each patient is assigned an individual ABC program, applied daily for at least 10 days, choosing the intensity of stimulation at the frequency of theta waves in direct proportion to the degree of neuroticism of the patient.

Cognitive-behavioral therapy is carried out in group sessions in accordance with the guidance of Fedorov A.P. Cognitive-behavioral psychotherapy - St. Petersburg: Peter, 2002, p. 280 and Fedorov A.P. Methods of behavioral psychotherapy. Textbook for medical students. - Leningrad, 1987, p.24). To do this, after weakening the psychological defense reactions using well-known approaches (“problem analysis”, “setting your own value”), effective coping behavior programs are developed using cognitive-behavioral psychotherapy techniques aimed at modeling effective coping techniques with complex life situations: research of choice (alternatives) of thoughts and actions; paradoxical techniques using humor; "Advantages and disadvantages"; training in self-control methods; methods of positive reinforcement and extinction (Fedorov A.P. Methods of behavioral psychotherapy. A manual for medical students. - Leningrad, 1987. - 24 p.).

During audiovisual stimulation at frequencies of alpha-beta rhythms (alternating screen colors, sound clicks) at a frequency of 10 Hz, then 14 Hz alternate saturated green (R16, G59, B16, steady, stable, healthy, safe, calm, powerful color, saturated color life), yellow-green (R166, G183, B19 stimulates the intellectual abilities of a person), green (R16, G59, B16 calms the nervous system, reduces pain, fatigue, normalizes blood pressure, favors concentration), yellow-green (R194, G196 , B24), green (R15, G85, B15), yellow (R203, G203, B17, life joyful color, helps to solve problems and problems), green (R15, G80, B16), cadmium yellow (R234, G192, B12, gold, it is radiant, stimulating, funny, sunny, energetic, fruity, invigorating), green (R14 , G102, B15), cadmium yellow (R234, G207, B12).

Audiovisual stimulation of the alpha-theta series is carried out at frequencies of 10 Hz, 6 Hz, 4.9 Hz, 14 Hz, alternating blue (R15, G15, B101 and its spectral shades, creates a cool environment, relieves pain with neuralgia and inflammation, under the influence of this the color of a person’s level of anxiety decreases, tension and blood pressure decrease), cold light green (R122, G234, B122, pure, vegetable, calms the nervous system, reduces pain, fatigue, normalizes blood pressure, favors concentration), lilac (R55, G16 , B97, creative, fantastic pure color, helps to immerse oneself in fantasy), fluorescent green (R13, G223, B14, excites associations, but incomprehensible, cold, leads to confusion), blue color (R16, G16, B70), green color (R14, G126, B14) , blue color (R15, G15, B101), blue-green (R13, G186, B130, cold, wet and mysterious color).

EXAMPLE 3

Effect of ABC and Corrective Therapy

To assess the impact of ABC, the method of example 1 was carried out without ABC, without corrective psychotherapy and without additional sessions, was tested on 119 patients. The results are presented in Table 1. The average body mass index before the start of therapy was 35.58, by the end of the first month - 33.92, after a year - 31.12. The average change in body mass index over the year is 4.46.

The method of example 1 using cognitive-behavioral corrective psychotherapy of example 2 was tested on 47 patients for two years, the results are presented in Table 2. The average body mass index before therapy was 35.26, by the end of the second month - 32.90 , in a year - 28.04, in two years - 28.72. The average change in body mass index during the year is 7.22, during two years - 6.54.

Thus, it is shown that the use of ABC can significantly increase the efficiency of the method.

Literature

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3. Tukaev R.D. Hypnosis. Mechanisms and methods of clinical hypnotherapy / Rashit Dzhaudatovich Tukaev. - M .: Medical Information Agency LLC, 2006.

4. Ruzhenkov V.A. The basics of clinical hypnotherapy. Rostov n / a: Phoenix, 2005.

5. Daniel G. Bessen, Robert Kushner. Overweight and obesity. Prevention, diagnosis and treatment - M .: CJSC "Publishing House BINOM", 2004.

6. Dedova I.I., Melnichenko G.A. Obesity: etiology, pathogenesis, clinical aspects. - M.: Medical News Agency, 2004.

7. Puzikov V.G. Training technology. - SPb .: Speech, 2005.

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Claims (17)

1. A way to reduce excess weight, in which they conclude a psychotherapeutic contract obliging the patient to follow a rational diet, and conduct a course of psychotherapy that includes at least four full-time group sessions with a total duration of 4 to 7 days, between which the patient performs in absentia independent work using printed guidelines on the psychology and dietetics of rational eating behavior, as well as a follow-up meeting at least 25 days after the start of the course, and if In the event of side effects and / or in the detection of eating disorders after full-time sessions, corrective psychotherapy is prescribed, including cognitive-behavioral psychotherapy in combination with audiovisual stimulation (ABC), characterized in that rational psychotherapy is carried out in each of the sessions, moreover at the first session, the presentation of target strategies of rational eating behavior is carried out, at subsequent sessions, target eating behavior is supported and / or deviant behavior is adjusted from the target, and at the last session, as an installation, inspire confidence in the independent implementation of target strategies, in the course of correspondence independent work in the first interval between sessions, update the positive effects of weight loss, then update the positive effects of overeating and overweight and, finally, form a list of alternative sources pleasures not related to food consumption in the first session disidentify the problem of overweight with the patient’s personality by the method of psychosynthesis, the first three se Ansa conduct indirect psychotherapy, which includes physiotherapeutic effect and suggestion to the patient that it helps to reduce weight. In the second and third sessions, the suggestion is supported by induction of an altered state of consciousness (ASC) by means of holotropic breathing, and in the second session, an aversion is formed in relation to the imaginary the product causing the neurotic attraction, and on the third - in relation to the real product causing the neurotic attraction, subject to its further use in diet in the process of weight loss, at each of the sessions, at least once in combination with ABC, induce ASCs by the method of directed visualization through relaxation and / or meditation, while at least one of these sessions fix previously presented suggestions and / or installation. 2. The method according to claim 1, characterized in that, according to the psychotherapeutic contract, the patient further agrees to eat at least four times a day, count the calorie content of the food eaten, keep a food diary, periodically measure weight, do not drink alcohol during the period of decline weight, limit the intensity of subjectively heavy physical exertion for a period of weight loss and take multivitamin nutritional supplements. 3. The method according to claim 1, characterized in that the previously presented suggestions and / or installations in the ASC are fixed in the patient’s body position while standing, the back is straight, the feet are together, the arms hang freely along the body, the chin is raised, the center of gravity of the body is shifted by socks, look raised up. 4. The method according to claim 1, characterized in that in it, as an installation, it is suggested that saturation occurs from a smaller amount of food, metabolic processes are intensified, and / or the volume of the stomach is reduced. 5. The method according to claim 1, characterized in that it uses acupressure as a physiotherapeutic effect. 6. The method according to claim 1, characterized in that it additionally carry out acupressure in the interval between the change of psychotherapeutic techniques. 7. The method according to any one of claims 5 or 6, characterized in that in it acupressure is carried out by stimulation of the CE-GU point and / or XU-CHI. 8. The method according to claim 1, characterized in that therein an aversive psychotherapy in relation to an imaginary product that causes a neurotic attraction, is carried out by neuro-linguistic programming, preferably by the method of "mixing anchors". 9. The method according to claim 1, characterized in that in it, as a correspondence independent work in the first interval between sessions, the patient writes with his left hand at least seven positive changes that will occur after weight loss. 10. The method according to claim 1, characterized in that in it, as a correspondence independent work in the second interval between sessions, the patient identifies the positive effects of overeating and overweight, as well as prepares products that cause a neurotic attraction. 11. The method according to claim 10, characterized in that in it an aversion is formed in relation to products prepared by the patient in the second interval between sessions. 12. The method according to claim 1, characterized in that in it rational psychotherapy in the first session is carried out for from 1.5 to 2 hours 13. The method according to claim 1, characterized in that in it rational psychotherapy and other methods of psychotherapy alternate with an interval of not more than 20 minutes 14. The method according to claim 1, characterized in that in it meditation is carried out from 20 to 30 minutes 15. The method according to claim 1, characterized in that in it the duration of holotropic respiration is at least 1 hour 16. The method according to claim 1, characterized in that in it the duration of each of the sessions is from 4.5 to 5 hours 17. The method according to claim 1, characterized in that in it the sessions are carried out in the evening or at night.