Psychosomatic diseases. Causes and treatment, table of theories, list of diseases, education

What are psychosomatic diseases

Psychosomatic disorders manifest themselves as somatic ones, but develop against the background of psychogenic factors. Psychosomatic can be translated as “belonging to the soul and body.” Psychosomatic diseases refer to mental disorders. But they manifest themselves as physical ailments. Taking medications in this case will not have a lasting effect. Medicines will briefly eliminate the symptoms, but without psychological correction the disease will return again and again.

What diseases are considered psychosomatic?

The following classification of psychosomatic disorders is generally accepted:

1. Conversion disorders. Internal conflict finds a somatic outlet. In this case, functional and structural disturbances in the functioning of organs are observed. The disease helps solve social problems, for example, eye diseases allow you not to see what you are not happy with.
2. Functional syndromes (somatization disorder). The structure of organs and systems does not change, but functional disturbances are observed. Symptoms of diseases are noticeable, but medical diagnostics do not reveal pathology.
3. Psychosomatoses (somatopsychic disorders). These are real diseases (organic and functional disorders) caused by stress.

Psychosomatism includes the so-called Chicago Seven:

• bronchial asthma;
• ulcerative colitis;
• hypertension;
• hyperthyroidism;
• neurodermatitis;
• rheumatoid arthritis;
• ulcer of the stomach and duodenum.

Later, ischemia, diabetes, and obesity were added to these diseases. This list is constantly expanding. Most psychologists claim that all diseases can be classified as psychosomatic.

How do psychosomatic illnesses differ from ordinary illnesses?

Psychosomatic disorders are distinguished by the fact that they arise and intensify after overstrain (intellectual, emotional, physical). But there is also a delayed reaction. For example, childhood psychotrauma can be reflected in psychosomatics in adulthood. Another feature is that symptoms can arise not only against the background of negative experiences, but also against the background of pleasant anticipation or achievement of success.

It is important! Psychosomatic diseases depend on a person’s resistance to stress and his ways of responding to stress.

Who is at risk

The risk group includes secretive people who are used to keeping everything inside themselves. What other character traits make a person vulnerable:

• low self-esteem;
• complexes;
• melancholy;
• mental and emotional imbalance.

All people suffering from psychosomatic illnesses have something in common. They hold pessimistic views of the world, do not love themselves and do not recognize themselves as individuals, and do not know how to withstand stress and overcome difficulties.

It is important! A separate risk group consists of children, adolescents and the elderly, as they have a weak psyche.

What diseases are considered psychosomatic?

Psychosomatic diseases (from ancient Greek ψυχή - soul and σῶμα - body) are diseases whose occurrence is closely related to mental and psychological factors. The essence of these fairly common disorders lies, as the name itself suggests, in the close connection and interaction of soul and body. The term itself was proposed in 1818 by the Leipzig professor of psychology and doctor of mental illness (psychiatrist) Johann Christian August Heinroth (1773-1843). Heinroth is also called in dictionaries and reference books: a romantic, a moralist and a mystic. Heinroth believed that the source of many diseases was the pathology of the spirit and the depravity of the soul, on the basis of which he based his methods and models of treatment.

Only a century later, an independent “psychosomatic” direction in medicine was formed, the emergence of which was largely due to the emerging crisis of a purely materialistic view of all diseases in general, which has dominated over the past centuries in the wake of numerous scientific and technical achievements. Many representatives of various schools and directions, both in medicine and in psychology, philosophy, physiology and sociology, took part in the formation of “Psychosomatic Medicine”. Let's point out some of them: the German psychiatrist Karl Wiegand Maximillian Jacobi (1775-1858), who introduced the concept of “somatopsychic” in 1822; Berlin therapist Gustav Bergmann (1878-1955), who developed the doctrine of functional pathology; German philosopher Friedrich Wilhelm Nietzsche (1844-1900); the world famous French psychiatrist Jean Martin Charcot (1825-1893), who studied with the father of psychoanalysis, Sigmund Freud (1856-1939); the founder of the doctrine of neurasthenia (1869), American neuropathologist George Miller Beard (1839-1883); his compatriot the physician Da Costa (1833-1900), after whom the “soldier’s excitable heart” syndrome (1871) is named; American psychoanalyst Franz Gabriel Alexander (1891-1964), who is considered one of the founders of modern psychosomatic medicine; German doctor Alexander Mitscherlich (1908 -1982), who opened a psychosomatic clinic in Heidelburg in 1949; Austrian physician and psychoanalyst, professor of psychosomatic medicine at the University of Washington Felix Deutsch (1884-1964); the founder of the “stress” theory, Canadian pathologist and endocrinologist, Nobel Prize winner Hans Selye (1907-1982) and many, many others. Psychoanalysts, as a rule, see the cause of psychosomatic diseases in the presence of unconscious conflicts in a person, carefully examine mental traumas forgotten by patients, focus on sexual problems, including children’s unconscious relationships with parents, etc. In the development of a psychosomatic illness, psychosomatic reactions, disorders, conditions, and sometimes affects are distinguished.

Symptoms of psychosomatic disorders

Manifestations of psychosomatics are different. Sometimes it is one symptom, and sometimes several. The most common manifestation is pain of different nature and localization. But a characteristic feature of psychosomatic pain is that medical diagnosis does not reveal its cause.

Manifestations of psychosomatics

In addition to pain, the following somatic manifestations are often encountered:

• change in heart rhythm;
• pressure changes;
• sweating;
• change in body temperature;
• nausea;
• headache;
• dyspnea;
• heaviness in the legs and arms;
• stool disorders;
• weakness;
• decreased performance;
• decreased libido;
• cough;
• runny nose.

With conversion disorders, functional impairments are observed:

• respiratory spasms;
• paralysis;
• loss of tactile sensitivity;
• muteness;
• deafness;
• blindness.

This is interesting! Women are more susceptible to conversion disorder.

Psychosomatics – body protest

Symptoms intensify after stressful situations, increased stress, and emotional stress. In this connection, it can be argued that psychosomatics is a protest of the body. This is how the soul communicates that it does not like the person’s lifestyle, thoughts and actions.

Conversion symptoms

They occur mainly in neuroses of the hysterical type. There is a huge variety of symptoms:

• various disorders of skin sensitivity, up to its complete loss,
• blindness or deafness,
• psychosomatic disorders of motor functions up to paralysis,
• spasms of the eyelids or fingers,
• a wide variety of unpleasant bodily sensations, including the well-known “lump in the throat”
• various tics,
• speech disorders up to the inability to speak,
• sexual disorders such as vaginismus, anorgasmia, etc.

Sometimes symptoms can “imitate” some physical disease. The corresponding organs are absolutely intact; no pathological changes are detected in their tissues.

When suggested under hypnosis, such symptoms disappear, but then reappear when the patient comes to his senses. They are absolutely not subject to the conscious efforts of the patient, but arise through purely psychogenic mechanisms.

At their core, they are a symbolic expression of some powerful desires and feelings that are unacceptable to the conscious personality of the patient, and therefore rejected by him and unconscious. However, these desires and feelings, figuratively speaking, return in the form of symptoms, and the body becomes, as it were, a stage for their symbolic expression.

Each such symptom has its own specific unconscious meaning. Hence the name: “conversion” means “transformation, transformation, change of direction”, etc.

Since the cause of these symptoms is purely psychological, the only truly effective “cure” is psychotherapy, including psychoanalytic therapy. In the process of psychotherapy, the patient must become aware of the unconscious desires he rejects that are behind the symptoms, accept them and consciously process them. Then the symptoms finally disappear.

Psychosomatic pathologies in children and adolescents

Children and adolescents develop preneurotic, vegetative dystonic and somatic disorders. Psychosomatic disorders in children:

• teak;
• enuresis;
• insomnia;
• dyspnea;
• cardiopalmus;
• thirst;
• nausea;
• vomit;
• itching and rashes;
• decreased immunity and frequent colds against this background.

Causes of disturbances in the psychosomatic development of a child:

• conflicts in the family, school, kindergarten, relationships with peers;
• parental suppression;
• violence and cruelty in the family.

The health of children and adolescents largely depends on the psychological climate in the family, the attitude of parents towards each other and towards the child. In children, illness can be both a defensive reaction and an attempt to unite parents.

Which specialists should you contact for the treatment of psychosomatic diseases?

Unlike foreign medicine, where there are official psychosomatic departments, faculties and clinics, in Russia there is no approved status of a psychosomatic doctor, so this problem is most often dealt with by psychiatrists, psychotherapists and partly psychologists. This is the official point of view, theory and practice. But there is also spiritual, spiritual and moral therapy, which has the right to exist and gives remarkable results in the treatment of many diseases (look at this in the series of books by the author of this article: “Therapy of the Soul”, “Healing with Words”, “Vice of the Soul”, “ Treatise on healing in Orthodox explanation", "Miraculous healings").

Causes of psychosomatic disorders

The prerequisite for a psychosomatic disorder is the physiological vulnerability of some organ (each person has his own vulnerabilities). This is an internal factor. External factors include individual psychological characteristics, specific lifestyle and relationships with others, personal experience (positive and negative).

The following causes of psychosomatics can be identified:

• intrapersonal conflict of capabilities and desires, needs and responsibilities;
• psychotrauma, negative personal experience (often childhood memories);
• benefit from illness (illness gives permission to rest or satisfies the need for love, care, etc.);
• suggestion and self-hypnosis;
• character traits: uncertainty, isolation, immaturity, dependence on other people’s opinions;
• identification with an authoritative person (imitation of his illness);
• the need for punishment due to feelings of guilt, shame, inferiority complex, self-hatred;
• alexithymia.

This is interesting! Modern Russian psychotherapist A. B. Smulevich examines the tendency towards psychosomatics from the point of view of accentuations of character and personality types. For example, the risk group includes people with hysterical and asthenic accentuations. You can read more about this in the author’s book “Psychosomatic Disorders.”

Why does stress make us sick?

How are stress and psychosomatic disorders related? Stress is a period of adaptation of the body to new conditions. To cope with danger, the body resorts to animal reactions: it accumulates energy to defend itself (to attack or flee). During stress, norepinephrine, adrenaline and cortisol are produced. They allow you to generate energy that creates tension in the muscles (legs, back, stomach, arms) and is waiting to be released.

At the same time, intellectual activity increases and cognitive abilities improve. But the longer physical and mental relaxation does not occur, the more hormonal balance is disturbed. Gradually, stress hormones take over, and systems that have long been working at the limit wear out. General immunity weakens. All this creates favorable conditions for the development of diseases.

This is interesting! When stressed, those systems that are responsible for survival are activated. And less important systems, for example, the integumentary (hair, skin, nails) and reproductive (there is no need to reproduce - you need to save your life) are turned off. In this regard, problems with hair and skin, as well as diseases of the reproductive sphere arise.

Constitutional type is our biological base

Figuratively speaking, this is a set of “strengths and weaknesses” of our body, which determines predisposition to certain diseases and resistance to others. Naturally, when exposed to various hazards, the “weakest” organ systems will first be disregulated and then damaged.

“Predisposition” is by no means the “direct cause-and-effect relationship” that we deal with, for example, in cases of genetic diseases. In comfortable, optimal conditions, even our least protected organs will function “normally.” However, with chronic emotional stress (whatever its source), the adequate functioning of these organs will be dysregulated in the first place.

However, if emotional stress and associated dysregulation continue long enough, the “safety reserves” of the suffering organs can gradually become depleted. Biological compensatory mechanisms begin to “break down”, morphological changes appear in the tissues that make up the affected organs, and then pathological changes in the organs themselves. Various destructive biological processes are launched, and now a real disease arises.

Groups of psychosomatic diseases

Psychosomatic diseases can be grouped as follows (types of psychosomatic disorders):

• diseases of the respiratory system;
• diseases of the cardiovascular system;
• eating disorders;
• gastrointestinal diseases;
• diseases of the endocrine system;
• skin diseases;
• women's diseases;
• sexual dysfunction;
• men's diseases;
• oncology;
• infections;
• psychovegetative disorders;
• diseases of the musculoskeletal system;
• depression and other mental disorders.

Features of the formation of disorders

The pathogenetic scheme of disease development includes several stages.

The violation is formed against the background of:

• The tendency of the target organ to be affected by a stress agent.
• Accumulation of affective tension.
• Excessive response to stress of the autonomic nervous system.
• The appearance of deviations in the functioning of neuroendocrine reactions.

Due to disease processes:

• Physiological nerve impulses are disrupted.
• The innervation of blood vessels and blood circulation suffers.
• Ischemia and metabolic failures occur in the organs.

In the very initial (functional) stages, if treatment is used, the process is reversible. If timely assistance is not provided, the patient develops somatic pathology.

Diagnostics

Making a diagnosis takes a lot of time and, first of all, this is due to the fact that most patients see a psychotherapist only after years of visiting doctors of various somatic profiles. But this does not mean that you should skip medical diagnostics. It is necessary to undergo a full medical examination, and at the same time visit a psychologist.

What diagnostic tools does a psychotherapist use:

• Conversation. Necessary for collecting anamnesis, identifying stress factors, and characteristics of the client’s life.
• Tests and questionnaires. Necessary for differential diagnosis, determination of personality characteristics, psycho-emotional state.
• Projective tests. They allow you to look into the client's subconscious.

This is interesting! From 30 to 50% of psychosomatic diseases remain undiagnosed. Patients manage their symptoms and maintain a more or less normal standard of living with medication.

Functional psychosomatic syndromes

These syndromes are also extremely broad. The term “syndrome” in its meaning is already the same as the concept of “disease”, and means only a certain natural combination of some symptoms. That is, many such conditions are nonspecific, can occur in various diseases, and their psychosomatic nature still needs to be proven by the doctor - excluding the presence of various diseases that can cause a similar picture.

The word “functional” means that there are still no true pathological changes in the organs that send us alarming signals in the form of symptoms. Only the function of the organ suffers, and this is due to the fact that its work is incorrectly regulated by the corresponding parts of the central nervous system.

The sections of the central nervous system that regulate the functioning of internal organs are called the “autonomic nervous system”, and, in turn, are closely interconnected with the brain structures responsible for emotional responses. Normally, this relationship serves to adapt the body, preparing the body for actions corresponding to the emotion being experienced.

For example, when we are excited, experiencing anger or fear, the heart begins to contract more often, the lumen of blood vessels decreases, adrenaline is released into the blood, etc. However, if something wrong is going on in the “emotional centers” themselves, this leads to indirect dysregulation of the internal organs, which manifests itself as “functional psychosomatic syndromes.”

The most common and nonspecific is the so-called “ vegetative-vascular dystonia.” Migraines, panic attacks, some types of cardiac arrhythmias, gastrointestinal disorders such as increased gastric acidity, “irritable bowel syndrome” or “bear disease”; Sexual disorders such as erectile dysfunction, pre- or difficulty ejaculating, and many other conditions may also fall into this category.

Thus, unlike conversion symptoms, the symptoms of “functional psychosomatic syndromes” do not have a primary unconscious meaning or meaning, and their presence only indicates to us the dysregulation of the autonomic and “emotional” parts of the nervous system.

The cause of this dysregulation is most often various neuroses - psychogenic states that arise in connection with the presence of unresolved internal conflicts. Moreover, in the overwhelming majority of cases, the patient himself is not aware of these conflicts, or is only partially aware. The main treatment here, of course, is psychotherapy.

The patient must become aware of his internal conflicts, consciously process and resolve them. Then the correct, balanced regulation of the internal organs will be restored and the symptoms will disappear. However, here, in contrast to conversion symptoms, the symptomatic prescription of drugs that reduce the unpleasant effects of dysregulation and protect organs from secondary damage caused by their malfunction is also indicated.

Prognosis and prevention

The earlier the disease is diagnosed and treatment of a psychosomatic illness is started, the better the prognosis. In the initial stages, all diseases respond well to treatment. The most favorable prognosis is assigned to functional disorders without organic damage. In case of anatomical and structural changes, long-term drug treatment of psychosomatic disorders may be necessary.

In order to prevent psychosomatic diseases, it is necessary to increase stress resistance, learn to resolve conflicts and express all emotions, including negative ones.

Factors influencing the development of the disease

Factors that provoke the development of diseases include:

• suppressed emotions and needs;
• unspoken opinions and feelings;
• obsessive bad thoughts.

All this creates tension, which accumulates until it reaches a peak and results in somatic manifestations.

Complications

Without drug treatment and psychotherapy, psychosomatic disorders develop in the same way as their somatic counterparts. Structural disorders turn into chronic diseases. Constant use of medications, frequent pain and other symptoms significantly reduce the patient’s quality of life. He becomes dependent on other people, their care and help. Social, labor, and physical activity are noticeably reduced. Some diseases can lead to disability.

At-risk groups

The majority of patients with psychosomatics are people who constantly hide their true emotions from others. Behind the external calm of melancholic people, real emotional storms are hidden. This may be the beginning of the development of some psychosomatic disease.

Typically, a tendency to develop such pathologies can be noticed in childhood or adolescence. At this age, the psyche is extremely unstable, the child is not able to overcome stress on his own, which means that it will leave a mark on his physical condition. Some people can live for a long time and not think about their problems; diagnosis in this case will be more complex and lengthy.

An example would be a person suffering from alcohol addiction. To recover from alcoholism, he needs to believe in himself as a person. This problem often begins in childhood if parents demanded too much from their child and constantly set the bar too high.

A cause-and-effect relationship between other diseases and psychological problems has also been proven:

1. The tendency to catch colds increases when a person is in a low mood and lacks interest in life.
2. Anemia occurs in patients who are afraid of the unknown.
3. ENT diseases develop in people with reduced communication skills who are afraid to express their opinions.
4. Gastritis manifests itself against the background of a feeling of doom.
5. Female infertility occurs in those women who are afraid to make decisions on their own.

Lack of self-confidence and depression inevitably affect the development of psychosomatic pathologies.

Treatment of psychosomatic disorders

Full healing is possible only after eliminating the psychological cause: trauma, external conflict, internal contradiction. Methods of psychotherapy for psychosomatic diseases are selected individually, depending on the individual characteristics of the client.

In general, the treatment program can be presented as follows:

1. Group and individual psychotherapy. Art therapy, Gestalt therapy, body-oriented therapy, hypnosis, NLP, psychoanalysis, and cognitive behavioral therapy have a positive effect. At this stage, you need to remove all problems from the subconscious and restore harmony between soul and body.
2. Taking medications. This is necessary to relieve symptoms and eliminate physiological disorders. For serious mental disorders, the use of antidepressants, tranquilizers, sedatives, etc. is indicated.
3. Rehabilitation. This means changing your usual lifestyle, supporting family and loved ones.

It is important! Treatment must be comprehensive. Moreover, the patient’s independent work, especially after undergoing therapy, is most important. You need to work on yourself all your life, engage in prevention and maintain results.

Which specialists should you contact for the treatment of psychosomatic diseases?

In Russia there is no such official specialty as a psychosmatist. And psychosomatic medicine as an independent field is poorly developed. Therefore, you can contact a clinical psychologist (medical psychologist), psychotherapist, psychologist, psychiatrist with psychosomatics.

Adherents of alternative medicine can read books by famous healing psychologists, for example, Louise Hay and Liz Burbo. Or you can contact practicing specialists, for example, V. Sinelnikov.

Can a properly tuned spiritual life help cope with psychosomatics?

Yes, re-evaluating life will undoubtedly help cope with the disease. There is nothing better for health than self-development and self-improvement of a person. You need to find love within yourself and faith in yourself. But at the same time, it is important to believe in the laws of the Universe. Realize that the Universe will help you if you follow your path, that is, follow your abilities, desires and capabilities.

If you get sick, then consider it as a lesson, a hint about what exactly needs to be changed in life. And tables of diseases and their causes from authoritative psychosomatists will help with this (more on this in the article below).

How to learn to work with your emotions

Every event in life is neutral in itself. Everything depends on our perception. We ourselves attach a positive or negative connotation. To react calmly to everything and be able to turn difficulties into opportunities, you need to learn to work with your emotions.

We invite you to get acquainted with the methods of personal growth coach and psychologist Isaac. The author suggests influencing emotions through three levers:

1. Focusing on joyful events. As soon as you feel pessimistic trends, remember or imagine something pleasant. Specify everything down to the smallest detail. This method will help you manage your mood and get rid of negative thoughts.
2. Take a “happy pose.” The flow of joy corresponds to this body position: shoulders straightened, back straight, wide smile. Now, in the same position, begin to move vigorously. Body and psyche are interconnected. The brain can be instilled into a good mood, and the body can be instilled into lightness.
3. While maintaining a cheerful gait and straight posture, say the following phrases in a cheerful voice: “I am a hero”, “Everything is fine”, “I am a happy person. I’m lucky in everything,” “I’m in a great mood, it’s only getting better.”

Additionally, monitor your emotions. Monitor connections between specific emotions and situations. Track your bodily reactions to a particular emotion. Over time, you will discover your vulnerabilities and stressors, the connection between soul and body. And Isaac’s method will teach you awareness. You will be able to choose your emotional reaction to any event. You yourself will decide what to take from the world.

Features of treatment

For the treatment of psychosomatics to be successful, it is necessary to understand that there are no general methods in this area.
Each specific case requires an individual approach. Treatment begins with identifying the nature of the disease. The doctor must understand which symptoms are due to physical pathologies and which are due to psychological problems. At this stage, an experienced psychotherapist can join the patient’s examination. Work is being carried out in several directions at once, and it is very important to assess the psychological situation in the patient’s family. Often the cause of psychosomatic disorders is intrafamily conflicts or a negative microclimate in the family. Perhaps psychosomatics will be identified in other relatives of the patient who have been in the same environment for a long time.

Psychosomatics requires complex treatment:

• Drug therapy can alleviate the symptoms of the disease and improve the psychological state of the patient. The patient may be offered sedatives or drugs with a hypnotic effect;
• Psychotherapeutic treatment is aimed at resolving internal conflicts. The most effective methods of influence are behavioral therapy, psychoanalysis and Gestalt therapy. During treatment, the patient not only gets rid of existing problems, but also learns to cope with difficult life situations in the future. In particularly severe cases, the psychotherapist can use various hypnotic techniques. But the choice of a specific psychotherapeutic method largely depends on the patient’s condition and the nature of his problems;
• auxiliary methods. Since the main cause of psychosomatics is the presence of emotional experiences and hidden negative emotions, experts can recommend one of the methods of alternative therapy to the patient. This could be art therapy, treatment with music or drawing, various relaxing techniques, massage, relaxation, yoga, meditation. Playing sports and interacting with animals, such as horses or dolphins, have a positive effect on a person’s emotional health.

If treatment was started in a timely manner, then some psychosomatic diseases can be cured in just a few sessions of psychotherapy. But in order to prevent the disease from returning again, you need to learn to resist stress and other negative life circumstances.

Causes of psychosomatic diseases

Metaphysiology, causes and treatment of psychosomatic diseases are structured by psychologists and presented in the form of tables. The most popular tables are those of V. Sinelnikov and Louise Hay.

Complete table according to Sinelnikov

Valery Sinelnikov is a domestic doctor and psychologist, homeopath and author of books on healing the soul and body. We invite you to get acquainted with his table of diseases:

This is not the entire list of diseases presented in Sinelnikov’s table. You can get acquainted with the full table in our article “Psychosomatics of diseases, psychological causes of diseases” and in the author’s book “Love your illness”.

Psychosomatics of Louise Hay's diseases

Louise Hay was one of the first to undertake a detailed study and structuring of psychosomatic illnesses. The psychologist calls negative thinking and a person’s dislike for himself the main cause of any disease. And he suggests fighting illnesses with the help of affirmations. We invite you to get acquainted with the alphabetical table of Louise Hay:

You can find the complete table in our article “Mental Causes of Various Diseases” and in the author’s book “Heal Yourself.”

Psychosomatic disorders: treatment methods with examples from practice

Not every patient is ready to realize and accept the fact that his illness is nothing more than a psychosomatic disorder. The specialist’s task is to help a person understand the source of his health problems. This is quite difficult to do, and sometimes completely impossible. Surely you have heard about a story from the practice of the famous psychotherapist M. Erickson, when he helped a patient give vent to negative emotions, due to which he achieved a significant reduction in psoriasis on her hands.

Not every specialist is able to discern a psychosomatic disorder in external manifestations. However, to see it means to provide effective and truly necessary assistance to the patient. It is for this reason that specialists in the field of psychosomatics of diseases are among the most in demand in the field of providing advisory services.

Here are some examples from practice of successfully identifying the primary source of health problems. The man turned to a specialist with heart complaints. The official diagnosis is extrasystole - a violation of the rhythm of heart contractions. The patient himself suffered from discomfort in the heart area.

At the appointment, it turned out that the patient was striving for career growth, which was not yet possible. However, a person who has reached a certain ceiling in professional development is not ready to wait. In this regard, the man constantly experienced internal tension, which provoked extraordinary contractions of his heart. Thus, the body expressed his desire to move up the career ladder as quickly as possible.

Another striking example of a psychosomatic disorder was identified at an appointment with a woman who was diagnosed with reflux esophagitis. With this disease, the movement of gastric juice is disrupted, which leads to inflammation of the esophagus. When communicating with a specialist, it was possible to find out that such “behavior” of the body is a reaction to feelings of guilt and the patient’s desire to return to the past in order to correct a mistake. And there are a huge number of such examples. Another question is how to help a patient with a psychosomatic disorder.

Let us say right away that a specialist working in almost any area of ​​psychotherapy can help a patient with a psychosomatic illness. Psychosomatic disorders can be eliminated both with the help of psychoanalysis and methods of art therapy, body-oriented therapy, hypnosis and other methods.

Let's look at ways to treat patients of this kind using a practical example. A woman contacted a specialist complaining of frequent and sudden stomatitis. It turned out that before the last exacerbation of the disease, the woman felt guilty before her daughter, who was tired while visiting and wanted to return home as soon as possible.

Unable to contain her emotions, the woman spanked her aching daughter on the bottom, which only increased the feeling of guilt towards the child. As a result, stomatitis appeared the next morning. At the appointment, the patient accepted the fact that unexpectedly manifesting stomatitis is the body’s reaction to anger and guilt, which are associated with her role as a mother.

Negativity on the part of the patient’s mother and her negativity towards her daughter, accompanied by a constant feeling of guilt, provokes the appearance of ulcers on the oral mucosa. It was possible to unravel the tangle of problems with the help of Ericksonian hypnosis. The patient chose a symbol of her anger - the image of a bear, which she was able to see during a trance and even played with it. Already at the next hypnosis session, the patient was able to react and transform the accumulated anger. The result is that stomatitis is a thing of the past.

Clinical diagnosis

Establishing an accurate diagnosis can take a long time. The problem is that patients get to the doctor late. They go to specialized specialists, and often in circles until they get to a psychiatrist. Uncertainty can last for months and even years.

In the client clinic:

• They carefully question and listen to complaints.
• They examine.
• Investigated by physical, laboratory and instrumental methods.
• They are referred to specialists for clarification.

Psychologists are involved in the diagnostic process, prescribing:

• Carrying out tests.
• Application of questionnaires.
• Projective techniques.

Only after a final diagnosis has been established is a treatment plan selected.

How to treat psychosomatics?

In this article I will give a good working algorithm that will help you understand which direction to move. But before that, I want to talk about what not to do.

Most importantly, you do not need to refuse the help of doctors. For some reason, some people come to the following conclusion: since my illness arose from emotional experiences, it means that I only need to deal with them. I’ll deal with my emotions and the disease will go away on its own.

Unfortunately, it's not that simple. If the disease has already formed, then it begins to live according to its own laws, which have no direct connection with emotions. Emotional experiences can influence the course of the disease, aggravate it, and cause exacerbations. But even if you completely deal with emotions and achieve complete spiritual harmony, this is not a guarantee that the disease will disappear.

Therefore, it is very important to approach the treatment of psychosomatics not one-sidedly, but comprehensively: to use the capabilities of both medicine and psychology. That is, if doctors have discovered a sore, it is best to trust their opinion and carry out treatment, while at the same time also working on the psychological side of the issue.

Symptoms of pathologies of psychostasis

Psychosomatic diseases are replete with variety. Patients describe both individual painful manifestations and present multisystem complaints.

The most common:

• Painful sensations.
  Patients complain of chest pain, muscle-joint pain, and headaches. Often they indicate a projection from their point of view: “ache in the heart”, “bursts in the stomach”, “stabs in the liver”, “shoots in the kidneys”, etc. Often, suffering people note a psychogenic factor at the onset of a painful attack. The ongoing diagnostics do not reveal any pathological changes.
• Weakness, fatigue,
  dizziness, feeling of heaviness in the body or individual limbs.
• Cardiopalmus.

• Shortness of breath with hot flashes or vice versa
  , chills, psychosomatic cough.
• Difficulty in nasal breathing.
• Nausea, vomiting, heartburn, constipation.
• Sexual disorders:
  decreased libido, problems with erection, ejaculation.
• “Loss of function” (more often in women).
  We are talking about spasmodic conditions, paralysis, loss of sensitivity, vision, hearing, and difficulty speaking.

These symptoms occur more often in adults.
Children are characterized by disorders that manifest themselves:

• Pre-neurotic complaints of poor sleep, screaming and crying for no reason, enuresis, convulsive twitching, tics.
• Vegetovascular problems: fainting, excessive sweating, dizziness, palpitations.
• Psychosomatics with thirst, nausea, skin rashes, itching, respiratory manifestations.

Features of psychosomatics in children

Recent studies have shown that even infants are susceptible to psychosomatic disorders. A number of doctors talk about the possibility of psychological factors influencing the condition of the fetus during intrauterine development.

It is no secret that unwanted children are more susceptible to various kinds of diseases, they are more often weakened, and less developed physically. They may suffer from illnesses that are difficult to treat with traditional methods. Therefore, in this case, psychosomatic causes are often assumed.

In the perinatal period, as in the first months of a child’s life, the psycho-emotional state of the mother is of great importance for him. The connection that exists between a woman and a baby has not been denied by anyone for a long time. The child feels even minor changes in her mood. Accordingly, the mother’s negative emotions, such as dissatisfaction, jealousy, anxiety, negatively affect not only the woman herself, but also the baby.

Older children may also experience psychosomatic symptoms. Among the reasons for this kind of disease are lack of attention from the mother , adaptation to kindergarten or school, conflict situations at home, divorce, overprotection from parents or other relatives.

For example, in a situation of constant conflicts or divorce, a child’s illness may be caused by the desire to unite loved ones at least temporarily to care for him. During the period of adaptation to kindergarten, children get sick quite often, and therefore adults do not always pay attention to it. However, there is a possibility of psychological causes of frequent colds if, between sick days, the baby goes to the kindergarten with tears and returns sad.

children of overly demanding parents are quite common . The reason is a softer regime and less stress during the period of pathology, that is, the child considers poor health as the only opportunity to rest. In this case, it is necessary to treat psychosomatics, allowing the baby to rest more.

Doctors talk about the existence of several groups of diseases , the cause of which is most often psychosomatics. They are represented by colds, sore throats and bronchitis, allergies, eczema and dermatitis, intestinal disorders, even type 1 diabetes and oncology.

Understanding how to treat psychosomatics, experienced psychologists working with children prone to this kind of disorder can determine the nature of the psychological problem the child is facing based on the existing somatic deviation.

For example, if the baby constantly has a cold , coughs, suffers from nasal congestion, and also suffers from other ailments associated with difficulty breathing, the parents’ task is to find the reasons that are preventing the child from breathing. Among them are excessive guardianship from adults, sharp criticism of any actions of the baby, and excessive (inappropriate for age or temperament) demands placed on him.

With such actions, the child is, as it were, enclosed in a cocoon, deprived of the opportunity to live a full life. He is in constant tension, he cannot let his parents down, he cannot fail to meet their expectations, upset them, or cause new reproaches or accusations.

If a child often suffers from sore throats or loss of voice, then there is a high probability that he wants to say something , but is afraid to do it. He may suffer from feelings of guilt or shame, often far-fetched. This happens when parents convince the child that some of his actions are shameful or bad.

Anemia is also called a psychosomatic disease, indicating that there are too few bright, joyful moments . Another cause of this disorder may be doubts in one’s own abilities. Experts believe that in both cases there is a possibility of persistent iron deficiency in the blood.

Among shy, withdrawn, nervous children, intestinal disorders are most common . When thinking about how to treat psychosomatics of the intestines or stomach, keep in mind that among the causes of constipation and abdominal pain there may be an acute feeling of fear.

Psychological factors often cause skin problems, including allergic rashes, eczema, dermatitis, and urticaria. It can be quite difficult to understand what exactly resulted in such a reaction. Such opposition can arise in response to a variety of difficulties in children . When thinking about how to treat the psychosomatics of allergies, parents need to take a close look at the child to determine the source of his psychological discomfort.

Your psychologist. The work of a psychologist at school.

Step 1. Conclusion of a contract. With clarification: method, responsibility, deadlines, results, payment. See above for more information. Step 2. Find out the client model. The following question allows you to find out the client’s model: “What do you think is happening to you? Choose one of the answers:

1. Is such and such a disease attached to you?
2. Is your body doing something wrong?
3. Are you doing something wrong yourself?”

Step 3. Selecting techniques. This point of work fundamentally depends on what model you were able to determine at the previous stage. In this case, it is not very important how the client answered the questions of step No. 2. Having read smart books, the client can readily say: “Yes, of course, it’s me who makes myself sick!” But before that, drop the phrase: “I’m completely tormented by the damned sore.” What needs to be taken into account is what model the client is inadvertently demonstrating, not what model he or she is trying to believe. And of course, you shouldn’t try to forcefully change the client’s model. Throughout the book, I write that any client model is suitable for therapy. The question is what views the therapist holds. So, the client can adhere to three models. Step 3.1. If the client believes that some kind of illness has become attached to him (he was attacked, he developed, etc.), then his model is called dissociated. He rejects a part of himself, perceiving this part as an external foreign object - a disease. In this case, the therapist should maintain this model and begin to use integrating methods of work: working with the “empty chair”, working with the “symptom maker”, projective techniques, working with the “energy of chemical compounds”, etc. Step 3.2 . The client may occupy an intermediate position. For example, consider that his body is mistaken. I call this model the street model. In this case, no one seems to be responsible for the manifestations of the disease: neither the external object nor the client himself. One way to work with this model is to ask the client to decide. For example, ask the following question: “Do you think your body is you or not you? (Please note that it is not my goal to engage in religious or philosophical Debates and once again I emphasize that I respect any model. I have worked quite successfully with many believers of different faiths, without violating their beliefs in any way. (That is the question!) " It's hard to get out of here. An organism may be “not me”, or “like me”, etc. Then, of course, the client still has a dissociated model. He will just have to sort things out with his body. In this case, step 3.2. very similar to step 3.1. But it may turn out that the client will say: “Yes, of course, I and my body are one and the same.” Or something else like that. Then your client chose the associated model. Automatically go to step 3.3. Step 3.3 . Associated model. A pattern that exists in almost all preschool children. Almost all kids very confidently say: “Of course, I make myself sick.” It was thanks to children that I began to think about the strangeness of medical models. Even when I asked my preschool clients to draw pictures of their illnesses, they rarely drew any monsters. For example, one boy painted himself as melting. Due to their spontaneity, young patients do not yet believe that diseases are attacking them from somewhere. Amazingly, children seem to be seeking greater responsibility for their lives. But let's end the lyrical digression. If the client says: “Yes, I myself create the manifestations of my illness!” - then for the therapist this is both bad and good at the same time. Good, because this client took responsibility for his own health. It’s bad because you’ll have to work in dialogue. Such a client will not tolerate hackwork. To work with it, you will have to be very self-aware. Step 4. Working with awareness. Step 4.1. (4.2) Working with a dissociated model. So our client has a dissociated pattern. This means that his intrapersonal conflict is perceived as a conflict between him and the disease. In this case, telling him about it directly means immediately losing the client. The best solution is to accept this model and work as if the disease were truly an external entity. 1.Work with an empty chair. This technique involves asking the patient to talk to an imaginary interlocutor, for example, a conflict partner, a relative, a part of himself, or in this case, his illness. The technology is designed for integration. EXAMPLE Almost classic. I have already given this example in one of the articles. Working with a patient with bronchial asthma with 20 years of experience. The patient entered the office with a fairly severe asthma attack that had already begun. I invited him to imagine his illness on the empty chair in front of him. He did this with ease and described the disease as a terrible monster that mocks him. The client spoke about the disease with great fear, almost horror. I asked him to sit in the place of this monster and try to play his role. The patient sat on the chair of illness and was reincarnated. His labored breathing disappeared; on the contrary, in the place of his illness he was breathing heavily and angrily. He sent many threats to himself. He was now angry and healthy, but he didn’t notice it at all! If I had intervened, his attack might have returned again. I worked in a physical therapy room where there were several mats on the floor. It occurred to me to ask this guy to imagine that these lying mats were the rest of humanity. Could he try to express the feelings that he experiences towards himself at the site of his illness to these obscenities? Then something unexpected happened. The unfortunate asthmatic disappeared completely. This guy turned into Napoleon. He crossed his arms over his chest and began and began to give orders to imaginary subordinates. He breathed completely easily and freely. The asthma attack resolved within a few minutes. Later I spoke with his wife. She said that in life he is a very quiet and shy person. Only now he works as a prosecutor. Is it better to be sick and modest, or sassy and healthy?

The sadness of this example is that an instant miraculous relief from an attack does not solve anything. It gives the patient hope, shows possible ways of recovery, but most often it requires work. Conscious work on using those forces and potentials that still manifest themselves as bronchial asthma. I have a student with diabetes. Our first meeting made a great impression on him. After several minutes of work, he experienced a hypo-state (a hypo-state is a decrease in blood sugar levels. In healthy people, it happens during fasting, after strenuous physical or mental work. In diabetic patients, it is a sign of too much insulin.) That is, fifteen minutes of work acted like a dose of insulin. However, further therapy was quite long and required the acquisition of new skills. Usually, working with an empty chair ends either with spontaneous integration, when the patient says: “But there’s no one there, in this empty place, it’s all mine!”, or I have to ask the patient to try on the words and experiences expressed from the role of the disease. The main issue with this technique is still to clarify the need. What is the asthma need of the patient in the recent example? In aggressiveness. But aggressiveness is neither bad nor good. Winning at the Olympics is aggressive, and so is yelling at your neighbor in the hallway. Only the first method is welcomed by society, the second is rejected. Chronic patients have to re-realize their needs and look for socially acceptable forms for them. I call this process re-socialization.

1. Working with the energy of chemical compounds.

For God's sake, don't be alarmed, reader, there's not enough magic in this book anyway. The equipment is reliable, tested in many different cities. How does it work? It is well known that any drug causes some effect only because it is an external, introduced analogue of those compounds that the body is capable of producing itself. But the compounds are produced under fairly strict control of the nervous system. For example, if a person forbids himself to be angry, he will try to restrain himself. How to block your psychological and, therefore, chemical reactions? As a result, adrenaline and similar substances have to be administered externally. This happens, for example, in asthmatics. Narcotic compounds also either stimulate the production of their own mediators, or are direct analogues of internal substances in a good mood. Do you know the story about the rat and the pedal? If electrodes are inserted into the pleasure center of rats and a special pedal is created that closes the contacts, then the rat presses on this pedal until it dies, forgetting about food and other rat concerns. A very sad story. Does this remind you of anything? It's strange how people didn't think of such an operation. Millions of drug addicts would sit at home and press on the pedals. Or, going further, why not implement electrodes everywhere? I pressed a button - insulin was produced, pressed another - the pressure increased. I'm sure someone will like my idea. Although it looks like something from a horror movie to me. Why not immediately introduce a processor instead of a brain? But people still manage without buttons. Why complexity? I took one pill and my blood pressure went up; I took another and it went down. Why not a .robot? I don't know, maybe I'm being too harsh again? EXAMPLE 1: A client with diabetes. I asked him somewhere in the room to imagine the energy of insulin. And then get up, leave your seat and enter into a state of energy. Feel its features. Live as this energy would live in its pure form. Realize some of its basic content. And again I saw an amazing metamorphosis! A quiet, reserved and gentle man began to behave very strangely. He ran quickly and abruptly around the room, tried to break furniture, and did some other antisocial actions. When he returned to his usual state, he was very delighted with what had happened. He said that external insulin made him feel more energized. But I have never experienced such strong mobilization in my life. 2. Working with the energy of alcohol. Young woman. I asked her to imagine the energy of alcohol. Then enter this state. A second later, a blissful smile appeared on her face. The body completely relaxed. Her whole being expressed serenity. When she came back to herself, she said that she had not experienced such a state since she was five years old. When asked “why”, she answered that in her family it is not customary to be so relaxed. That her relatives are constantly tense and worried about something. And in general they perceive life as a very difficult, exhausting process. Sad. And then I pressed the chemical button and relaxed.

3. Working with a weight loss product. As soon as the client entered the state of this substance, she immediately rushed to take things out of the room. She incredibly wanted to throw everything right out the door. Later she said that it seems that a lot of unnecessary things have really accumulated in her life: things, events, relationships. It's time to tidy up.

I'll stop. An entire book could be filled with examples like this. It will read like a detective story. But these examples are not very suitable for sharing experiences. People are different. Chemical compounds can bring something different to each of us. How this technique works is probably already clear from the book. Chemical compounds allow deception to achieve what could happen easily and naturally if we were whole. The technique itself is reminiscent of hypnosis or NLP techniques, only the meaning of these techniques is different. The point is not change, but awareness. To remain forever in some lost part, even a very pleasant one, simply means replacing one symptom with another.

1. State of integrity.

The last technique in this section. If you get the general idea, reader, then you can create many similar techniques yourself. But let's return to integrity. I saw the idea of ​​the technique from the Moscow therapist Lena Romanchenko, and then I developed the technique itself to its present form. The good thing about this technique is that it can be done alone without any therapist as an exercise.

EXERCISE FOR THE WHOLE BOOK

Sit comfortably. Close your eyes, or stay open. Imagine that you have all the space and all the time in this world at your disposal. And that by using your imagination, you can go wherever you want. In any era and any corner of the universe. Your task is to come across a certain image in these imaginary wanderings, preferably one that is more metaphorical, but not at all necessary. It is important that when you find this image, there is a feeling of recognition, so that in this image you can recognize yourself. It is important that you know that this is an image of yourself as a whole! Everything, everything, everything! And not just any individual piece. If you are in doubt, or the image doesn’t really suit you, you can continue wandering until you feel: “Yes, this is exactly me!” If you are sure that this is your image, but you somehow feel bad or uncomfortable next to it, allow the image to transform, transform, but do not use any violence. Just let things happen by listening to your heart. You may feel sad, or happy, or something else. But in the end, the heart is filled with amazing warmth. And then you can say the phrase “It’s me!” And I love myself! " Now you can finish the exercise. Try to remember the feeling in your heart. This is a very simple exercise. It is dedicated to bringing back a childhood state of happiness and serenity. Or for some people purchasing it for the first time. You can do it whenever and as much as you like. It is especially fun to do this exercise at a time of quarrel and conflict. Conflicts arise when someone begins to very strongly display some lost part of you. As soon as you become yourself, the conflict bursts like a soap bubble, or disappears like smoke. Step 4.3 (4.2) Working with the associated model . If a client chooses an associated model, this does not mean that the techniques described above are not suitable for him. How they fit. But if the client quite consciously and responsibly says: “I somehow make myself sick,” then a whole sea of ​​possibilities opens up for the therapist. But! On one condition only. If this person is able to be aware of events in his body, his feelings and sensations. If you have a "Professor Dowell head" who sees his body as a stand and is only aware of thoughts and ideas, then you will have to teach this person to listen to his body. One example of how to do this is in this book in the “Needs” chapter. Quite a lot has been written about this in Gestalt books. If the client is able to be aware of the events of his body and accept responsibility for his health, then it is not clear how he managed to get sick in the first place. But anyway. Most often these are clients already engaged in some kind of practice, or people undergoing psychotherapy. So, the possibilities that arise for the therapist. 1. Work in full responsibility mode. A very interesting opportunity. Conventionally, I highlight three options for distributing responsibility. Sorry for repeating myself. Dissociated - the disease does this to me, homeless - this happened to me, the full version of responsibility - I do this myself. For example, a person with asthma might say, “Asthma keeps me from breathing.” Responsibility is shifted to some unknown beast - asthma. Another way to say it is: “I’m suffocating.” That is, everything happens by accident. The cup broke. Nobody is responsible for this. And finally, there is the most radical option that can be offered to the client: “Try to say: I don’t allow myself to breathe.” Or: “I take myself by the throat,” “I squeeze my heart,” “I tear my skin,” etc. This phrase is the moment of transition to “full responsibility mode.” Typically the patient will say this phrase and then, after some confusion, say, “Wait, but it looks like it’s true!!!” And this requires all your existential support, all your empathy. Because often after this sad discovery people begin to attack themselves. They are already attacking, but now there is an extra reason. I usually giggle at this point because it's actually tragicomic to hurt yourself for hurting yourself. We also need all your attentiveness and delicacy. Because, having made the discovery that he himself is the source of his illness, a person already begins to be treated. Some energy of protest awakens in him. It is important not to lose it; it is important to ask the client about his experiences. It's important to share yours. Dialogue is important. The next question usually comes to the client’s mind on his own. It naturally suggests itself: “If I don’t allow myself to breathe, then why am I doing this?” The answers can be very different. Some out of habit. Someone accomplishes a feat in the name of something. Or maybe this is a form of revenge or protest. I recently spoke with an eleven-year-old asthmatic. Sometimes asthmatics recover at this age. They become more independent, more obstinate, preferring to express anger openly instead of quietly being offended. But then it will become more difficult for others around him. Remember, I said that diseases belong to the system, not to the individual. So, it seems that this boy understood the mechanisms of his illness and almost consciously decided not to recover. He said that more than anything in the world he did not want to offend or offend anyone. If you have any desire for your client to recover, then this place of work requires true therapeutic humility. Sometimes clients, having learned about the mechanisms of their illness, prefer to continue to get sick. Especially if the illness is associated with feelings of guilt. For example, I had to work with former Afghan soldiers. Many of them, realizing the processes taking place inside them, said: “So that’s what I need.” And this is an existential position. A person with such a position has lived until these days. No wonder he has a chronic illness. It is unlikely that he will give up this position thanks to the dashing attack of the therapist. Most often, people only strengthen their positions when they try to change them by force. Remember, change is possible when a person moves towards himself, not away from himself. It is important to simply return to the needs. Is there a need to punish yourself? No, of course, the need is for something else. And this is a conflict of needs. For example, for an asthmatic child I recently remembered, it is important to protect his boundaries and it is important to show his love to the world. You have to protect yourself from everyone, even from those you love. There is a myth that those you love cannot harm. How can they! Accidentally, unknowingly, in anger, etc. Making yourself sick is not the best way to express love, but how do you show it? But most often it is discovered that people block their energy precisely out of their own safety. They were once attacked, now they are afraid of being attacked again. No matter what mechanism is used, the mode of full responsibility allows the client to clarify his own existential menu. Here are possible examples. , “I don’t let myself breathe, I stop my anger because I don’t want to cause anyone grief.” “I squeeze my heart because I want to stop my sadness so I can look strong because I believe that no one loves the weak.” “I tear my skin because I don’t want to show my irritation. Because I'm afraid that I will be rejected." In full responsibility mode, the client tells his entire life scenario and describes his character structure. But what to do with this next? I usually say to the client: “Would you like to communicate with this world in a different way, not so traumatic for yourself?” If the client agrees, I begin to teach him dialogue skills. 2. Working with early destruction of integrity. Some of the important skills for being healthy are the skills of protecting your boundaries and the skills of showing aggressiveness. In childhood, some of the needs and aspects of the personality associated with them are blocked. People either cannot express these needs at all, or they can express them asocially and therefore do not express them. Have you seen a mother screaming at her baby? A person with blocked needs either yells at himself or finds a partner: a spouse, a boss who yells at him in a similar way. Even if the partner is not very suitable for this role at first, over time he will be trained to the fullest extent, since he is not seen as a partner, but behind him is the image of a mother or father from childhood. People unintentionally take advantage of each other and make themselves sick. But it seems to them that the external enemy is to blame. As long as this myth underlies the scenario, the person will continue to get sick. Remember, I gave you an example of a client with atrial fibrillation, who, in response to the phrase “Old fool, where are you going!” a heart attack began. Why exactly? Why does it seem natural to have a heart attack in a community like this? Why can’t this woman say to herself and this young man: “No, I know that I’m normal” and calmly go about her business. She cannot do this because her boundaries are destroyed, at this moment she is a little girl, very dependent on other people's recognition. If for some reason she cannot cry and experience sadness, then perhaps her offender will develop empathy and apologize. If empathy does not arise, it means that his feelings are also very blocked. Indeed, a sad story. But she shouldn’t be sad either. What remains? A very narrow corridor in which it is impossible to avoid a bad heart. Sometimes people strive to become strong and practice martial arts in order to learn how to fight back against all their offenders. But the biggest offender is inside, not outside. This is why people cry when they defeat all their enemies. They discover that external opponents have been defeated, but internal integrity has not yet arrived.

How to work with this? 1. Ask the client to remember some, preferably the earliest, moment of a child’s loss, for example, when the child was yelled at and he was unable to respond.

1. Ask to again be in the image of your little self, to realize your experiences and needs at this moment. What, for example, did you want from an adult, what kind of attitude towards yourself?
2. The most difficult moment. Ask to be in the place of an adult, to realize the feelings and experiences that the adult experienced. What did you want from a small child, what were his needs expressed? If this can actually be done, the client discovers that the adult has also been destroyed. That he was filled with fear or grief. That the adult was afraid of the child or for the child. Sometimes in such work it is discovered that the anger was not associated with the baby, that the child simply fell into place. That this aggression was intended for a spouse, one’s own parents, or life in general. It is important to understand the adult's needs. The client is surprised to discover that at the bottom of anger and fear there is the same need for love and recognition that he also experienced.
3. Next, I have a choice. Most often, I ask the client to look at this conflict from the outside, from a third position. Sometimes I myself sit down in the place of both the child and the parent, and talk through everything I heard from the client. If everything happened as expected, then the job is practically done. The client, perhaps for the first time in his life, came out of his self-centered position and tried to understand the feelings of both parties. “To understand means to forgive,” says Robert Resnik.
4. But you can ask the client to again be in the place of his little self and say something to his offender, but so that he understands and hears. Sometimes clients sadly say: “At that moment he would not have heard me anyway, he was blind and deaf, he had no time for me.” Sometimes the words are found, for example: “I understand that you feel bad now. I understand that you are afraid. something will happen to me. But when you scream like that, I feel bad too. And this makes me sick. Please treat me more gently. I really, really miss your love.” If the client says this with an open heart, then the imaginary other side (and the real other side in life) hears him. If the client feels like he is not being heard, then I ask him if he just wanted to express himself? Even without any hope of a response. At least somehow protecting yourself is better than not at all.

6. This work can be completed at any place where you feel it is appropriate to complete it. But usually I invite the client to visit the other side again. And hear the words spoken by your little self. In place of the other side is something in response. Most likely, also with an open heart. For example: “I’m surprised that you understood me. I am very touched by your words. I’m sorry that I’m hurting you, but I’m really scared for you.” 7. I ask the client to return to his seat. And hear this imaginary answer. In this work, it does not matter whether his real parent could utter such words or not. In fact, the client works with his shadow, learns dialogue and peace in his soul. But often such work not only treats psychosomatics, but also leads to a strong improvement in relationships with former offenders. So I wrote this matrix as best I could. Of course, there can be countless variations in a job like this. You can't provide for everything. The only thing I would like to note is that if the client does not want reconciliation and does not want to understand the other side, this is his right. 3. Strengthening technique. One of the good tools designed to understand the needs associated with the symptom. In the Gestalt approach, this technique is usually called the amplification technique. But this is not entirely true. I have already written that a symptom is a combination of two impulses. Conflict of two or more needs. Remember the example with the plane on the aircraft carrier? If the pilot presses the gas and tightens the brake, then both the pilot and the plane will not last long. The therapist’s task is to facilitate the development of one of the impulses, but in such a way that it is not interfered with by the second. There are several ways to do this. 1. Ask the client to determine the natural movement of his energy himself. EXAMPLE Work with almost any pain. For example, with pain in the heart. I say to the client: “Could you not concentrate this feeling in your heart?” Try to let it spread, let this feeling come to your face. If you allow your energy and feelings to flow freely, what will happen to you?

1. I think I'm going to cry.
2. Yes, but for some reason you don’t cry!
3. I'm ashamed of what people will think.
4. Is it better to die from a heart attack than to experience someone's disappointment? This is a pain in the heart, what is it about? What experience does she resemble?
5. I think this is sad...

And so on. The main thing in this work has already happened: the pain in the heart has ceased to be just pain, it has become sadness. Although in fact the work is just beginning.

ANOTHER EXAMPLE, UNFORTUNATELY, ALSO ALMOST CLASSICAL I was traveling on a train and at five o’clock in the morning it was announced over the intercom that a doctor was needed in such and such a carriage. When I arrived, I found a woman with a severe heart attack and a complete lack of medicine in the train first aid kit. From the conversation it turned out that six years ago the woman suffered a heart attack. Now the situation was repeating itself. Then the following conversation took place:

1. Tell me, have you had any troubles lately?
2. Yes, my daughter-in-law offended me very much.
3. Can you handle the sadness about this?

After these words of mine, an amazing struggle began. The woman gave vent to her sadness, her face became alive and soft, her heart let go, but she seemed to come to her senses and again turned into a living stone. “No,” she said, “I’ll come home and cry.” I can't do it here.

1. But you are in pain, and when you are sad, it becomes easier.
2. I don't want to forgive my daughter-in-law.

And these are amazing words. Sadness does bring a feeling of forgiveness. If she bursts into tears, her heart will soften and she won't. hold a grudge against your daughter-in-law. It sounds like this woman, in full responsibility mode, might say, “I kill myself to hurt others.” But somewhere at the bottom of her sick heart lies the same need for love and recognition. But how to get to it? I did not succeed. The train stopped at some station, and a local paramedic came running with a first aid kit. I took the injections. An ambulance picked her up in the city of Donetsk.

Yes, my methods and knowledge are good, but often useless. If there is no willingness on the part of the client, the therapist will not be able to do anything. He can only hurt himself and his client. But let's get back to technology. The therapist can suggest some development of the impulse and ask for its implementation. You can invite the client to express the completion of the impulse with body movements, or sounds, or metaphor. It is important that the client can understand what his movements, or sounds, or metaphor are about. 2. Sometimes, in order not to collide two impulses in a client, it is useful to sort them out. For example, ask to express one of the impulses to the outside world. If something is pressing, ask to also suppress some object, or translate this pressure into words. Usually all patients are identified with that part of themselves that is considered a victim. People usually do not suspect that their dictatorial hypostasis is inside, and not outside. When the client begins to behave like his illness, he begins to recognize and appropriate the needs of his “evil” side. This work is similar to working with an empty chair, only it is done more associatedly. I usually warn my students: “If you meet a very weak and downtrodden person, wait for the blacksmith.” That is, sooner or later you will meet his evil and strong polarity, which such people are not even aware of. They seem soft and fluffy. On the other hand, in any strong and fierce guy, somewhere deep down in the soul hides a small downtrodden boy. Because people know how to turn their ferocity not only on others, but with no less force on themselves. The world is quite fairly arranged. 3. And finally, there is a way for the laziest. Everything can be done for the client. If you are working with a group, you can ask one of the group members to play both impulses. Or you can do everything yourself, for the client. I don’t know if he will take credit for anything, but such training is certainly useful for a psychotherapist.

Step 5. Assimilation of experience. Making decisions. At this stage the model is not so important. Most likely, by this point the client has already realized that his illness is a conflict of his own needs. It's time to appropriate this experience. How to do it? I usually ask the client to try on and speak both sides of the coin at the same time. Usually people do this in turns. The phrase goes something like this: “I want to simultaneously express myself and protect my interests, and I want to protect myself from the possible discontent of others.” “I want to take risks and be careful at the same time.” As one of my teachers said: “I want to climb the tree and not get pricked.” The client wants to be in both yin and yang states at the same time. BUT THIS IS IMPOSSIBLE. Tea cannot be cold and hot at the same time. It can change its temperature, change it very quickly, but it cannot be ice and steam. The client realizes that he has, in fact, demanded the impossible of himself all his life, and therefore it is normal that he failed and became ill. Now there is an opportunity to treat yourself more gently. Tood Berly once said: “People don’t understand that exactly half the things in the world happen not when a person is tense, but when he relaxes. When you go to the toilet in a small way, it is better to relax, when in a big way, it is better to tense up. If you mix it up, nothing will work.” People spend their entire lives trying to develop the right character. Some try to be more decisive, others suffer because they stick their neck out all the time. Some are stubborn, others lack perseverance. In any language in the world, the same states of the human psyche have negative and positive names. Simply changing your character allows you to replace some problems with others and some diseases with others. What is better to die from: a heart attack or arrhythmia? As they say, it's a matter of taste. I will repeat Mindel's phrase. already heard in this book: “Either you become fluid, or nature will find a way to wipe you off the face of the earth.” Socialization shapes character and thereby shapes disease. Many are born already sick. But many were not loved even before birth. Diseases belong to systems, not individuals. But a system is not a cell. By becoming healthier, we make the whole world around us healthier. Each of us has the opportunity to regain lost abilities. Or develop something that has never been used. At this stage of therapy, work about the client’s illness smoothly flows into work about his life. But few of those who seek treatment for a disease of the body are disappointed by the obvious connection between the state of the body and the spirit. However, there are also clients who expected magical healing. True, it’s rare; usually they leave at the stage of forming the contract. This is their choice. Magical healing does happen, but most often for those who have somehow taken care of themselves. Who is ready for his energy to flow along another channel? By the fifth step, people are already fully in touch with the feeling of their authentic, whole self. They discover that their health is truly up to them. Sometimes the discoveries gained in therapy are enough to make a complete recovery. Sometimes additional work is required on your own or with a therapist in order to become more comfortable with the fullness of your inner world. Some people from therapy come to some spiritual practices and continue their path there. All methods are good and respected.

Each of us has opportunities to be healthy, but people choose not to use them .

Doctor. Psychotherapist. Organizational consultant. Trainer at the Moscow Institute of Gestalt and Psychodrama. Author of the “Development of Psychosomatic Medicine” program and the “International Development Institute” project. Developer and presenter of a number of educational programs in psychotherapy and organizational consulting. An inhabitant of this planet.

Source: VYACHESLAV GUSEV “Cure for Diseases” Simferopol - “Terra Tavrika” - 2004

As a result of training you will receive:

– theoretical and practical skills and knowledge about the psychosomatics of diseases;

– methods of working with psychosomatics. Learn to see conflicts that lead to the emergence of psychosomatic diseases and provide assistance in resolving them for yourself, your loved ones and clients;

– theoretical and practical knowledge of how to increase the body’s vital resources and mental stability;

– understanding of the rational use of medicines (depending on the stage of the disease; taking into account the individual characteristics of each person and each case);

– the ability to distinguish between the need for a psychologist and a doctor at different stages of the disease;

– skills to work with both adults and children.

What is psychosomatics?

Psychosomatics (“psycho” - soul, “soma” - body) is a term that in a broad sense refers to various interactions between the physical state and the psyche. In other words, our physical condition affects our psyche: a person who has suffered from high blood pressure for many years may feel depressed and have significant physical limitations that affect the quality of life.

At the same time, our mental state affects our physiology: everyone at least once wanted to stay at home and not go to school or work that their throat or head began to hurt a little, or they began to feel sick, or their temperature rose. These are normal manifestations of the interaction between the body and the psyche.

Milekhina Alla Vladimirovna, psychotherapist, psychiatrist, candidate of medical sciences

A fairly common story: a young man, anxious, with an analytical mind, not inclined to track his emotional experiences, first consults a therapist about hypertension. It does not go away despite any antihypertensive drugs. Then he is prescribed antidepressants - and hypertension disappears.