RU2494767C2 - Method for psychological overweight correction - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, psychophysiology and psychotherapy, particularly to methods of body weight correction using the psychological and psychotherapeutic effect. The correction comprises eight sessions: the first session - individual - aims at establishing the causes of overweight; the patient is encouraged to follow eating behaviour and to keep fractional nutrition and appeasement; the patients are thereby grouped. At the second session - group - rational psychotherapy and relaxation techniques are applied, and the patients are taught to count calories and to keep a "diet diary". At the third session - group - a diet therapy is carried out taking into account fractional nutrition, and a "free breathing" technique is implemented. At the fourth session - group - a non-directive aversive technique is conducted to develop a balanced attitude to the products, but also the "free breathing" technique is developed. The fifth session - group - provides extensional psychology techniques aiming establishing the causes of overeating. The sixth session - individual - uses the rational and behaviour therapies to form a further positive attitude to weight loss, as well as a tanatotherapy to activate the body's internal resources. At the seventh session - group - techniques of personally oriented psychology, rational psychological correction and Erickson therapy are used. At the eighth session - individual - tanatotherapy aims at psychological adaptation to patient's body and mind changes taken place in the process of weight reduction.

EFFECT: method provides more effective human body weigh correction ensured by prolonging the remission and reducing the risk of side effects in the form of various body dysfunctions and exacerbation of chronic diseases.

2 cl, 1 ex

Description

The invention relates to the field of medicine, psychophysiology and psychotherapy, and in particular to methods of correcting a person’s body weight with the help of psychological and psychotherapeutic effects.

Known methods for the correction of excess weight, including psychotherapy, based on an energy approach to the problem of overweight (diet therapy) (See patent RU No.2019996, class A61M 21/00 "Method for correcting a person’s weight", priority dated 12/14/93, Smelov SS, see patent RU No. 2094064 for class A61M 21/00 "Method for the treatment of obesity", Mirkin V.I., see patent RU No. 2033199 for class A61M 21/00 "Method for weight correction", Belyaev I.N., Belyaeva N.V.).

There are also known methods in which to increase the therapeutic effect and achieve relaxation, they often use an additional effect on the patient’s sensory organs: light, color, audio stimuli and other ways of changing the emotional state (see patent RU No. 2122441 according to class A61M 21/00 " A method for the treatment of obesity ", Katkov B.A., patent RU No. 2122442 according to class A61M 21/00" Method for the directed correction of the psychoemotional state of a person ", Ryabikov V.V. et al.). Also known are methods of correcting overweight using various types of reflexology (see patent RU No. 2317809 for class A61H 39/00, E. Kalitin, "Method for correcting overweight", patent RU No. 2198000 for class A61M 21/00 "Method correction of psychosomatic disorders ”, etc.)

The disadvantages of the known methods include the low effectiveness of treatment with a high percentage of relapses, and in some cases the risk of infection of various diseases when using, for example, acupuncture, or blood sampling to determine the content of certain substances in the blood serum.

The closest in technical essence and the achieved result is the "Method of psychological correction of overweight" (patent RU No. 2352363), based on a combination of group and individual psychotherapeutic sessions using reflexology, osteopathy, respiratory techniques with elements of transpersonal therapy (elements of holotropic breathing) . One of the disadvantages of this method is the use of acupressure reflexology to enhance the tone of the muscles of the stomach, which often leads to digestive system problems (constipation, or diarrhea), and can also cause headaches and nausea. A significant part of patients who come to weight loss centers are people suffering from diseases of the cardiovascular system, as well as glaucoma, pancreatitis, urolithiasis and cholelithiasis, hypertension, etc. therefore, the technique of holotropic breathing, which is performed in the supine position for one and a half to three hours, is contraindicated for health reasons. Osteopathy effectively solves only somatic health problems, and in their absence, is only prevention. In addition, osteopaths are rare and expensive specialists.

The objective of the invention is to expand the arsenal of psychological methods for correcting excess body weight by creating a new method for psychocorrection of excess weight.

The technical result achieved by the implementation of the proposed method consists in the formation of conscious eating behavior in patients by acquiring the skills of nutritional fragmentation and self-control by maintaining a nutrition diary and using this knowledge to “not return” to the previous weight.

The task is achieved by the fact that in the claimed psychological method of correction of excess body weight, the correction is carried out in eight sessions: at the first session - individual - identify the causes of excess body weight, give the task of observing their eating behavior, taking into account the fragmentation of nutrition and satisfying hunger, and on the basis of this, groups of clients are formed, in the second session - group - they conduct rational psychotherapy, relaxation techniques, they teach calorie counting and maintaining a "food diary", in the third session - group - they carry out diet therapy taking into account the fragmentation of nutrition, and also conduct free breathing techniques, in the fourth session - group - conduct non-directive aversive techniques for a calm attitude to products, and also conduct the "free breathing" technique, in the fifth session - group - conduct techniques of existential psychology with by identifying the causes leading to overeating, at the sixth session - individual - with the help of rational and behavioral psychotherapy, a further positive attitude is formed to reduce body weight by thanatotherapy to activate the internal resources of the body, at the seventh session - group - conduct techniques of personality-oriented psychology, rational psychocorrection and Erickson therapy, at the eighth session - individual - conduct therapy for psychological adaptation to changes that have occurred in the patient’s body and mind during weight loss moreover, the first individual session is carried out two or more days before the group session.

Thus, for the first time, a course of psychological correction of overweight in eight sessions was applied, due to an increase in the number of individual sessions and in general the duration of observation of the patient for a period of weight loss and fixation, in addition to consolidating the "non-return" to the previous weight, the following were used: diet therapy taking into account the fragmentation of nutrition and maintaining a "nutrition diary", which allows patients to get satiety of the stomach due to less food due to rational nutrition; “free breathing” technique as an alternative to breathing techniques with elements of transpersonal psychotherapy (for example, “holotropic breathing”); trance state technique in the form of thanatotherapy as an alternative to osteopathy.

It was the use of all the above techniques in one course of treatment that allowed us to create a new way of psycho-correction of weight, to create conscious eating behavior in patients by acquiring skills of nutritional fragmentation and self-control by keeping a nutrition diary, and also to use this knowledge to “not return” to the previous weight.

The method is as follows.

The first session (individual - initial consultation).

The first session is carried out two or more days before the group session, the causes of excess body weight are identified, the task is given to observe your eating behavior, taking into account the fragmentation of nutrition and satisfying hunger, and based on this, groups of clients are formed. The formation of groups in this way allows you to apply specialized techniques aimed at eliminating the causes of gaining excess body weight, which in turn increases the efficiency of not only reducing body weight, but also maintaining the results achieved in the future.

Second Session - Group

In the second session, rational psychotherapy is performed. Differences of needs are revealed: what is important for the body (vital needs.), For the soul (personal, psychological), social needs. In the first place are the needs of the body, given a "nutrition diary." Calorie count training is being provided. There is a relaxation session. The “Food Diary” helps to visually show errors that may not be perceived as mistakes by the client: long breaks between meals, unprofitable food to satisfy hunger, irrational distribution of foods, dishes throughout the day, etc. An exemplary view of the recording of one day from the "food diary" is shown in Figure 1.

Third session - group

At the third session, the difficulties in counting calories are sorted out. Rational recommendations for fractional nutrition (dietetics) are given. Nutritional detail involves nutrition 4-6 times a day, and at least twice a day, the presence in the diet for better saturation of complex, warm dishes, the absence of a ban on any foods, the formula for eating: breakfast (30-40%, lunch 50 -30%, dinner 20-30% of the total daily diet. This allows you to restore the natural biorhythms of the stomach, which leads to the maintenance of metabolic processes. At the same session they give recommendations on the gradual decrease in Ccl to 1200 in women and 1400 Ccl in men. The technique of “Free Breathing.” Unlike respiratory t a technician with elements of transpersonal psychotherapy, slow, connected deep breathing makes it possible to change the state of consciousness in a milder form, to feel your body and emotions better, there are no unpleasant sensations, there are no contraindications for health reasons, a person enters into breathing comfortably, socially, there is no constraint in front of other participants. during the session, work is done on the motivation (goals) of the client to reduce weight. It is proposed to answer the questions: "what I see, hear, feel, what I can do when these excesses go away kg? ". It is possible to use various targeting techniques. Those techniques are selected that most enhance the desire of a particular patient to lose weight and make the process of weight loss interesting and without much difficulty.

Fourth Session - Group

At the fourth (group) session, an “analysis of the day” is carried out, where errors in the fragmentation and rationality of nutrition are finally revealed. Conduct non-directive aversive technique for a calm attitude to products, as well as the technique of "free breathing". Directive methods are direct suggestion, hypnosis or coding. In this case (non-directive methods), the digestion process is considered in such a way that the patient concludes that "food is for a person, not a person for food."

Fifth Session - Group

At the fifth (group) session, they conduct techniques of existential psychology (existential - existence), analyze the causes of overeating, both physiological (accumulation of hunger) and psychological (seizing of difficult feelings). This approach in psychology is closer to the philosophical understanding of being: “Who am I?”, “Why do I live?” “What is the meaning of life? ”, Etc., which allows us to understand and accept life according to the“ here and now ”algorithm. These techniques make it possible to realize, live and eliminate the causes that led to a set of excess body weight, as a result of which, after losing weight, body weight remains stable. The main reason for the stereotype of the behavior of a complete person is the installation that food is the solution to all problems.

Sixth session - individual

At the sixth session, which is carried out 14 days after the end of an intensive course of psychocorrection of excess weight, the correctness of maintaining a "nutrition diary" (time, products or selection of dishes beneficial for satisfying hunger) is examined. Using a rational and behavioral psychotherapy, the psychologist forms a further positive attitude to reduce body weight and conducts tanatotherapy to enter the patient into a trance, which allows you to feel the boundaries of your body and activate internal resources.

Seventh session - group

The seventh (group) session is carried out 21 days (or 3 weeks) after the end of the intensive course for four hours. During the session, the techniques of personality-oriented psychology, rational psychocorrection (analysis of difficulties for this period) are used, allowing to assess the change in lifestyle due to weight loss and transfer positive experience to the ability to maintain the results achieved throughout life, then using the Erickson technique Therapies form a positive attitude towards achieving a result and shaping the lifestyle and behavior of a slender person.

Eighth session - individual

The eighth session is held 2 weeks after the last group meeting. Understand the difficulties in the process of independent work. A session of thanatotherapy is conducted, aimed at psychological adaptation to changes that have occurred in the body and in the patient’s mind in the process of losing weight.

Thus, the formation in patients of a rational approach to the selection of food products (food fragmentation) through an understanding of what exactly gives a full and long-term satiety, is not all that is calorically satisfying, that feelings of “hunger and satiety” are the needs of the body, which were originally laid down by nature to maintain metabolic processes of the body, creates confidence in their abilities and the "non-return" to the previous weight. The use of the “free breathing” technique in this method allows activating the processes of weight loss for all patients, regardless of their history, unlike breathing techniques with elements of transpersonal psychotherapy (for example, “holotropic breathing”). Using the technique of "thanatotherapy" as a body-oriented work makes it easier and more comfortable to go through the adaptation stage in a new weight, which significantly reduces the risk of breakdowns and relapses in the process of weight loss, i.e. "No return" to the previous weight. A third individual session by a psychologist who conducts an intensive course of psychological correction of excess body weight is necessary for discussing with the patient the first experience of independent weight loss, resolving the patient's questions, activating internal resources and creating an active motivational attitude for further weight loss. Often, at the beginning of a decrease in body weight, those problems that previously “stuck” pop up.

The method is illustrated by the following examples of specific performance.

Patient P., 45 years old.

The planned change in body weight from 139 kg to 80 kg. For 4 months he lost 22.9 kg. Subsequently, for 1 month, body weight did not change, although all recommendations were followed. After the start of thanatotherapy with a regularity of twice a week, during the month the body weight decreased by another 12 kg per month. For 8 months of being in the program, he lost 52 kg (Figure 2).

Anamnesis.

Born and raised in a prosperous family. Parents of working professions. Mother is a soft calm woman, prone to fullness. Father imperious, closed inclined to alcoholism. At 16, he began to live independently and earn money at the factory. After the army he entered the police school, after graduation and before retiring, he worked as a district police officer. Married 18 years old, has a son 17 years old. 10 years ago, he had an accident, injured the knee and ankle joint of his left leg, 1.5 years was inactive due to numerous operations. It was during this period that he began to gain weight.

Somatic status.

The physique is hypersthenic. Height 182 cm, body weight 139 kg. The skin is clean. Humidity of the skin is normal, skin turgor and elasticity correspond to the age norm. Visible mucous membranes are pale pink, clean. The subcutaneous fat layer is overdeveloped, evenly distributed. The predominance of fat deposits of the type "apple": stomach, lower back. During auscultation: vesicular breathing over the lungs, without wheezing, heart sounds are slightly muffled, rhythmic. HELL 135/95 mm Hg, heart rate 72 beats per minute. Palpation: the abdomen is soft, painless.

Neurological status.

The gait is flat, stable in the Romberg position. The palatine test performs correctly. The face is symmetrical. The palpebral fissures are equal. Pupils D = S. The reaction to the light is lively. Tongue in the midline. Tendon reflexes live D = S. There are no disorders of sensitivity.

Mental status

In place, time and self oriented correctly. Contact is easily accessible. Outwardly neat. The behavior is adequate to the situation.

Attention is steady. No memory impairment was detected. Intelligence corresponds to age, education and lifestyle. Thinking at a regular pace, consistent. Emotionally adequate.

Psychological research.

Type of personality accentuated by psychasthenic traits of character.

Therapist's opinion.

Chronic gastritis in the stage of persistent remission.

The conclusion of the endocrinologist.

No diseases of the endocrine system have been identified. Overweight is due to nutritional origin. During psychological testing to determine the reasons for gaining excess body weight, the following were identified as they decrease: eating habits, psychological, social physiological. Psychocorrectional work was carried out with the patient in the conditions and structure of group sessions. Priorities were set for understanding the reasons for gaining excess body weight. Along with changing the stereotype of the food approach, the formation of the eating behavior of a slender person, a model of independent life behavior was developed with the adoption of responsibility for their actions and deeds. Against the background of work in thanatotherapy, attention was focused on adopting the image of a slender body and lifestyle in a slender body. Observation over 1.5 years showed a stable result. Change of attitude towards oneself and others: confident, active, active, opened his own business.

Patient T., 36 years old.

The planned change in body weight from 132 kg to 70 kg. For 4 months she lost 27.2 kg. Subsequently, for 1 month, body weight did not change, although all recommendations were followed. After the initiation of thanatotherapy with regularity twice a week, body weight decreased by another 7 kg in two months. For 7 months of operation, she lost 34 kg (Figure 3).

Anamnesis.

Born and raised (youngest daughter) in a prosperous family. Father is soft, driven, with a tendency to alcoholization. Mother imperious, strong-willed, owner of a private business. Has a slight overweight. Grew up healthy, from the side of parents there was a parental hyper-custody. In all her actions and deeds, she was completely subordinate to her mother; by the end of school, she “had no independent thinking” (according to the patient), remaining infantile. At the insistence and with the patronage of her mother, she entered the Faculty of Law. She married at the age of 25. A husband of the same age as a patient is calm and soft in character. The young family lived in the same apartment as the patient's parents. At the age of 27, she gave birth to a daughter. 2 years before applying for psychological help, the mother died at the client. The emotional reaction was deep and remained so until the beginning of work with a psychologist. The patient experienced such emotional experiences as anxiety, guilt, fear of the future. Against this background, appetite began to increase, and the client added another 14 kg to the existing excess body weight.

Psychological research.

Personality type accentuated by psychasthenic traits of character, infantile. A pessimistic attitude with an alarming component is determined.

The conclusion of the endocrinologist.

No diseases of the endocrine system have been identified. Overweight is due to nutritional origin. A set of overweight is associated with feelings about losing a mother. Since then, appetite has increased. Become less emotional. According to the patient, "the joy of life has gone." At the same time, he believes that overweight is due to age-related changes in metabolic processes. He doesn’t notice that he uses food for non-food purposes - food by appetite: “seizes” guilt, anxiety, loneliness. Psychocorrectional work was carried out with the patient in the conditions and structure of group sessions. Priorities were set for understanding the reasons for gaining excess body weight. Along with changing the stereotype of the food approach, the formation of the eating behavior of a slender person, a model of independent life behavior was developed with the adoption of responsibility for their actions and deeds. During the first week, the client's mood improved, optimism and confidence in achieving the desired result appeared. Observation during the year showed a stable result. Change of attitude towards oneself and others: self-confident, active, active.

Thus, a new method of psychological correction of excess body weight is proposed, which allows to increase the method of psychocorrection of weight, to form conscious eating behavior in patients by acquiring skills of nutritional fragmentation and self-control by maintaining a "nutrition diary", and also to use this knowledge to "not return" to the previous weight.

Claims (2)

1. A method of psychological correction of excess body weight, including group and individual psychotherapeutic effects, characterized in that the correction is carried out in eight sessions: at the first session - individual - identify the causes of excess body weight, give a task to observe their eating behavior, taking into account the fragmentation of nutrition and to satisfy hunger, and on the basis of this form customer groups, in the second session - group - conduct rational psychotherapy, relaxation techniques, teach calorie counting and maintaining the “days nutrition ”, in the third session - group - they conduct diet therapy taking into account the fragmentation of nutrition, and also conduct the“ free breathing ”technique, in the fourth session - group - conduct non-directive aversive techniques for a calm attitude to products, and also conduct the“ free breathing ”technique , at the fifth session - group - they conduct techniques of existential psychology with the identification of the causes leading to overeating, at the sixth session - individual - with the help of rational and behavioral psychotherapy, they form further positivities they are in a good mood to reduce body weight, they perform tanatotherapy to activate the internal resources of the body, at the seventh session - group - conduct techniques of personality-oriented psychology, rational psychocorrection and Erickson therapy, at the eighth session - individual - carry out tanatotherapy for psychological adaptation to changes that occurred in the body and mind of the patient during weight loss. 2. The method of psychological correction of excess body weight according to claim 1, characterized in that the first individual session is carried out two or more days before a group session.

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