The treatment of neurosis is the doctor’s business, however, understanding of some of the basics of treatment is necessary for patients.
Since neurosises arise primarily under the influence of psychological influences, then psychotherapy occupies their first place in treatment, that is, treatment by directly affecting the patient’s psyche.
In the presence of appropriate indications, methods such as psychotherapy of persuasion, suggestion in a wakeful state, hypnosis, autogenic training, etc. are used. Various drugs, physiotherapy procedures, labor therapy, medical gymnastics are also used. The question of treatment methods in each case of the disease is decided depending on a number of factors – the nature of the disease, personality characteristics of the patient, life situation, his conviction. Treatment must be accompanied by recreational activities in the patient’s life, at work and the elimination or at least mitigation of the traumatic situation.
In the treatment of neurosis, it is very important to establish the real cause of the disease in a timely manner, which is not always easy to do. If a person falls ill after some kind of conflict situation, this does not always mean that it is she who is the only and main cause of the disease. It can be only the last straw that overflowed the “cup of patience.” In some cases, this situation is unclear or the patient is embarrassed to talk about his experiences, especially about the intimate aspects of his life.
To establish the cause of the disease, it is often necessary to have a long leisurely conversation between the doctor and the patient, during which the doctor gets acquainted with the patient’s life history, the patient’s medical history, his personality formation, and established relationships with people around him at work and in the family.
During such a conversation, “… along with the patient, or, in addition to him, or even with his resistance in the chaos of life relations, those conditions or circumstances that were slowly acting and circumstances that could cause the origin of the painful deviation …” are found.
An important condition for the effectiveness of treatment is the patient’s confidence in his doctor. Of course, it may not be necessary in all cases to have a detailed conversation, and not every conversation should be lengthy. The main thing is that the patient should know that in case of need a detailed conversation can take place. Medical experience shows that a patient’s frank presentation of all complaints and experiences can itself improve his condition, as this relieves internal tension, psycho-traumatic experiences respond . On the other hand, obtaining detailed information enables the doctor to delve deeper into the essence of the disease, to reveal the real causes of the disease. A patient with the help of a doctor should get a clear idea of the causes and mechanisms of his neurotic disorder. Awareness of the cause helps a person cope with the disease, make the necessary amendments to relationships with people around him and, most importantly, correctly assess the nature of his disease.
All this is absolutely necessary when conducting psychotherapy in any way: Hypnosis, autogenic training and other methods.
Reducing the patient’s emotional stress, his various obsessive fears and perceptions, anxiety, increased irritability is carried out by prescribing various Psychotropic drugs:
• some of them stop the state of arousal ,
• others eliminate depression (depression), a state of anxiety and anxiety;
• there are drugs that increase the tone of the nervous system .
• Take them should be under the supervision of a doctor.
Usually, neuroses after a certain, not very long time, end in recovery. However, there are also forms with a protracted course, especially in cases in which various obsessive states are noted. Such a contingent of patients have to repeatedly repeat courses of treatment with psychotropic drugs and psychotherapy, since not always the first of them give a pronounced effect. However, such patients with a patient, persistent and multi-stage treatment recover.
It is advisable that the treatment of patients with prolonged neurosis take place without interruption from their usual work activities, since labor not only creates the opportunity to distract from all kinds of neurotic experiences, but also strengthens the person’s faith in his own strength.
If nevertheless there is a need for inpatient treatment, then it can only be advisable in specialized neuropsychiatric institutions intended for the treatment of neurosis. The result of treatment depends not only on a particular method of treatment, but also on the patient’s attitude to the doctor, on his illness and treatment, on the personality characteristics and patient’s living conditions.
One of the active methods of psychotherapy is autogenic training (self-hypnosis technique). This method was proposed by the German psychotherapist I. Schulz in 1937 and has since been widely used in many countries of the world, including in our country.
Autogenic training ( auto – self, gene – producing) is a workout performed by oneself. It was noted that consciously achieving muscle relaxation (in this case, a feeling of heaviness, warmth in the body), you can thereby cause a special condition that resembles the first degree of hypnosis. A thoroughly performed muscle relaxation relieves nervous tension and by itself, even without a special therapeutic auto-suggestion, as will be discussed below, has a beneficial effect on human health.
With the help of autogenic training, a person can learn to significantly develop and strengthen willpower, control his feelings, mood, control the activity of internal organs (change the rhythm of heart activity, depth and frequency of breathing, etc.). With an insistent desire, with the help of an autogenic training, you can get rid of many functional disorders of the central nervous system – from various obsessive fears, ideas, thoughts, stuttering, sleep disorders. Autogenic training is used in the treatment of alcoholism, various forms of neurasthenia, in the initial stages of hypertension, angina pectoris, with some skin diseases and other diseases.
Currently, there are a significant number of different types of autogenic training. The main thing in them is to perform a series of exercises, the purpose of which is to evoke a feeling of heaviness and warmth in the muscles of the body through their maximum relaxation (relaxation).
We use our version, which in one lesson contains 6 standard exercises of the first degree of an autogenic training .
In subsequent sessions, the exercises are stereotyped and thus the necessary reactions are fixed. Patients with neurosis are engaged in autogenous training under the guidance of a neuropsychiatrist, and later on independently. Before starting the exercises, they are explained in an accessible form to the physiological basis of the method and the effect expected from the performance of one or another exercise. The first sessions are preferably carried out in a quiet room, in a dim light. In the future, the patient will already be able to ignore the noise in the room and, with sufficient mastery of the training technique, will be able to conduct sessions, even while sitting on the train or bus.
Exercises are conducted depending on the conditions in one of the following provisions.
1 Sitting position – “coachman” pose.
2 You need to sit on a stool (chair), head slightly lowered forward, hands and forearms lie freely on the front surface of the hips and knees, legs are comfortably apart, eyes are closed.
3 Half-sitting position.
4 Sit in the chair to be free, comfortable leaning on the back. The whole body is relaxed, both arms are slightly bent at the elbow joints and lie with palms and forearms on the front surface of the thighs or on the armrests of the chair, legs are freely apart, eyes are closed.
5 Lying position.
6 Lie comfortably in a horizontal position on your back. The arms are slightly bent at the elbow joints and lie freely along the trunk, palms down. Eyes are closed.
7 Each lesson begins with the implementation of preparatory exercises. Their goal is to learn “abdominal breathing” and then the maximum relaxation of the muscles of the face (“mask of relaxation”). This is done as follows. Having accepted one of the above provisions (which one you like), you should calmly inhale and exhale 5-10 times. Inhalation should be made deep, and exhalation should be calm and long (exhalation should be approximately 2 times longer than the inhalation). Then gradually you need to breathe less deeply, keeping the exhalation calm and long. Gradually, you will feel how the muscles are more and more relaxed, you will no longer want to breathe deeply.
8 After this, without opening your eyes, you should mentally say to yourself: “My attention is on my face” and then you need to imagine your face very calm, unemotional. Having imagined this, mentally say the phrase 5-10 times: “My face is calm.” A relaxed face is characterized by relaxed muscles, smooth wrinkles, slightly open lips. You need to remember the face of a sleeping person – this will help you imagine what your calm face should be like. Then it should be 5-10 times mentally pronounce the phrase: “My whole face is relaxed, calm, warm.”
9 After the preparatory exercises, they proceed to evoke sensations of heaviness, warmth in the arms, legs, and peace throughout the body.
10 To do this, mentally pronounce the following commands:
11 “My right hand (the left-handed one’s left) is completely relaxed and very heavy” (Repeat 5-6 times).
12 “My both hands are completely relaxed and very heavy” (Repeat 5-b times).
13 “Now I evoke a feeling of pleasant warmth in my arms and legs”
14 “My arms, legs are becoming warmer” (Repeat 5-6 times).
15 “My arms and legs are very heavy and warm” (Repeat 5-6 times).
16 “I am completely calm” (Repeat 2-3 times).
17 Calming should be persistently slowly imagined and stay in this state for 1-2 minutes, focusing on the sensations of heaviness, warmth, peace.
18 Then follows the exit from autogenic training (auto-training ).
19 To do this, take a deep breath and exhale 2 times and mentally repeat: “My muscles are strong, free”, then “lose” weight: bend and unbend arms 2-3 times, open my eyes wide. The session is over.
Teams need to be repeated verbatim. In this case, one must imagine the appearance of heaviness, warmth, and calm. Words should be pronounced, thinking precisely of this, diligently, with great desire.
Not everyone succeeds at once, and therefore, you can use the following technique at the beginning of classes: in a sitting and lying position, tightly compress your fingers into a fist, maximize muscle tension, mentally say: “The muscles of the hands relax, are relaxed,” then freely relax your hands. The feeling of muscle relaxation should be tried to “understand”, “feel”, fix in your mind.
To learn how to maximize muscle relaxation, you need a daily workout. It is recommended to perform exercises for 5-10 minutes 3 times a day according to the following scheme:
• in the morning immediately after waking up;
• in the evening before falling asleep (in this case, exit from auto-training is not necessary); thoughts focused only on commands for relaxation lead a person to natural falling asleep, deep sleep and cheerfulness, a pleasant awakening;
• in the afternoon, during a lunch break (or at another convenient time) in a sitting position or reclining.
A distinct feeling of relaxation, heaviness and warmth will come gradually – from the appearance of a feeling of heaviness and warmth in individual muscles at the beginning of a workout to a clear and pleasant feeling of warmth throughout the body.
Autogenic training prepares a favorable soil (state of increased suggestibility) for self-hypnosis treatment.
In a state of maximum muscle relaxation, self-hypnosis begins to act like a suggestion during sessions of therapeutic hypnosis, the patient as if hypnotizes himself. When the exercises are well mastered, it is possible to replace in the future long sentences of self-hypnosis with shorter ones: “Calm”, “face relaxed”, “deep breathing”, “heaviness”, “warm” and it is not necessary to repeat them many times. After that, they proceed to the therapeutic methods of auto-suggestion that the doctor offers.
The doctor makes up the formulation of therapeutic auto-suggestions depending on the nature of the patient’s disease.
• When functional cardiovascular disorders with an obsessive fear of her heart she is: “I am quite calm. I control myself in any situation. Cold-bloodedness accompanies me. My chest is warm, my heart beats calmly and strongly. Pleasant warmth flows from the left hand into the left half of the chest. ” After repeating these words several times, they proceed to exit auto-training, as indicated above.
• If emotional anxiety, fear, anxiety has engulfed a person somewhere along the way, on the street, in city transport, it is recommended to tightly squeeze your hands, then relax them, feel a feeling of heaviness. Then slowly pronounce the following words “calm”, “completely calm”, while trying to divert attention to something else.
• In bronchial asthma, neurogenic respiratory disorders, the wording of auto-suggestion is as follows:
• “I am completely calm. The breath is even, free and deep. Nothing bothers me. I’m resting. Even breathing without my participation. ” Then comes the exit from auto-training.
• In the treatment of chronic alcoholism , the following auto-suggestion can be recommended:
• “Calm, always calm. Alcohol doesn’t matter. I don’t drink, do not pull, and no one persuades me to drink. Beer, vodka, wine – are indifferent. Indifferent to all pirte drinks. ” After that – exit from auto-training.
• To eliminate emotional tension, anxiety, and anxiety, it is recommended that during self-training sessions, inspire yourself with the following: “Calm, completely calm.” Immediately before exciting events (public speaking, exams, competitions, surgery, etc.), relaxation of the muscles of the shoulder girdle should be encouraged. You can also squeeze and relax your fingers (without taking a special pose) and mentally say: “Calm, completely calm.”
For therapeutic purposes, as already noted, autogenic training should be prescribed only by a doctor and carried out under his supervision. It is used as a valuable adjuvant in the overall treatment complex. Improving the patient’s condition often occurs within two to three weeks of classes. Nevertheless, it is advisable to continue training for at least 6 months in order to perfectly master it and use it when necessary.
Autogenic training can also have psychoprophylactic significance, and therefore mastering it is very advisable not only for patients, but also for healthy individuals. Healthy people are advised to consult a neuropsychiatrist first.