Method for treating food addiction accompanied with obesity

FIELD: medicine, psychiatry, psychotherapy.

SUBSTANCE: the present innovation deals with carrying out dietotherapy and psychotherapeutic impact in the course of group seances. Moreover, the main psychotherapeutic impact should be performed during two seances per 8 h each, each due to marathon technique under asthenization conditions, biorythmical misfunctioning and behavioral stereotypes. Motivation should be elaborated for patient's healthy nutrition along with self-confidence and belief into success. Program for losing body weight should be developed to visualize and concretize therapy. Diary for nutritive behavior should be written, psychological protection should be performed in case of affected dietary situation. After the main seances one should carry out psychotherapeutic impact during one seance of 3 h duration in 1 or 3 mo. During seances the results obtained should be fixed by discussing and excluding situations provoking obesity relapse. The method enables to prolong duration and stability of remission.

EFFECT: higher efficiency of therapy.

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The invention relates to the field of medicine, particularly psychiatry, and can be used to treat food addiction, accompanied by obesity.

Known methods of treatment for bulimia nervosa and binge eating, which leads to excess body weight (BMI), which are used in complex combination, where the first plan mainly act as diet therapy and exercise therapy in combination with medication (Eaall, Uporov, 1990). Offered a variety of treatment regimens based on different theoretical concepts. So, Eaarch et al. (1986) gave significant attention to diet and change primarily disturbed eating behavior and offers the following principles for the treatment of obesity: mandatory psychotherapeutic restructuring eating behavior; regulation of exposure energy substances; increase energy expenditure of the body (physical therapy, physical methods of influence); the use of pharmacological drugs; drug therapy and therapeutic fasting only in the event of failure of dietary treatment; surgical treatment of alimentary constitutional obesity in case of failure of conservative therapy; relapse prevention.

This position is shared by many Russian and foreign authors (Rahmadinova with SOA is so 1986, 1987; Eaall with Soave. 1987; Sofroniew, Taskova, 1988; Vahreneva, Uporov, 1992). Age and others (1996) proposes the use of reflexology.

A number of other authors (Amman et al. 1979; Ehimare et al., 1981; Evenesence, 1993; MSG, Gselzwecka, 1996; and others) believe the main method of treatment of exogenous constitutional obesity drug therapy.

Diet therapy. According to many authors, this type of therapy is the leading (Eaarch et al., 1986; Eaall et al., 1986). Serves the purpose of the reduced diet with sufficient protein and limit animal fats and digestible carbohydrates. The diet should contain enough vitamins and minerals. In the Institute of nutrition, Academy of medical Sciences have developed the basic principles of diet for fat. These include: 1) the Appointment of a diet reduced in energy value (reduced), balanced in all essential nutritional factors and containing a sufficient amount of protein; 2) Adherence 5-6 meals per day without increasing total energy value of food; 3) Systematic monitoring of the amount of food eaten; 4) Complete abstinence from alcoholic beverages, in addition to a substantial increase in the energy value of the diet, dramatically weaken self-control for p is the abuse of food; 5) Limited introduction of carbohydrates, especially mono - and oligosaccharides, which are the main suppliers of energy and easily turning into body fat; 6) Limit animal fats and increased consumption of vegetable oils (up to 50% of total fat); 7) Reduction of salt intake to 5-6 g / day; 8) Monitoring of fluid intake (not more than 1.5 liters).

Separately, you can select fasting. Fashion direction, an active supporter of which was the American scientist Psig (1997), the author of the book “the Miracle of fasting”, and found support in the scientific community at this point in time almost lost his appeal on a number of objective reasons. When the full body is forced starvation, in addition to fat, to spend the structural proteins of cells and tissues, primarily muscle. Especially large amounts of protein during prolonged fasting (>15 days) according to Eaall et al. (1986). The authors believe that fasting is becoming a serious stress, leading to the deepening of already disturbed metabolism in patients. During starvation very quickly run out of glycogen reserves in the liver and as a result he suffers from a depositing function. Fasting puts the body at a disadvantage when there are increased requirements for immunity. Any banal infection can take the protracted course. When complete starvation there is a certain risk of cardiovascular disorders (De Carvalho S. 1988).

According to Eriksson L.S. et al. (1988), J.G. Kral, Heymsfield S. (1988), in patients with obesity in the treatment of starvation does not occur recovery or radical improvement.

Dev et al. (1994) suggest a method of short-term (10-14 days) nutritional deprivation for preoperative preparation of patients suffering from obesity, in the prevention of surgical complications. Agree with this position and Agoserena et al. (1990), and Evenesence et al. (1994). Therapeutic exercise. There is an opinion that physiotherapy has a wide indications for use for obesity (Eaarch et al., 1986). Physical exercises include work in all parts of the nervous system from the brain cells to peripheral receptors, as well as humoral and endocrine mechanisms; accelerate the oxidative processes by enhancing gas exchange; improve the secretory function of various organs and contribute to the energetic separation of the products of metabolism, increasing energy consumption (Eaall et al., 1986, PCI, Wielinga, 1998; and others).

Plagiaries et al. (1989) argues that the role of physical activity in the pathogenesis of obesity greatly exaggerated, especially for the prevention and treatment of obesity. Evenesence (1993) believes that the increase in the physical loads must be included in the complex treatment of obesity, but keep in mind that inadequate increase physical activity in the obese patient creates a stressful situation, i.e. the voltage in the system, the hypothalamic - pituitary - adrenal cortex and the overproduction of adrenocorticotropic hormone, cortisol.

Pharmacotherapy. Currently, a lot of medical methods of treatment of obesity, but there is no specific common methods and schemes. Drugs used for the treatment of exogenous constitutional obesity can be divided into means of reducing the need for food use, and dosage forms that are conducive to the normalization of the functional state of the body, accelerating the process of weight reduction, evacuation of adipose tissue from adipocytes, etc.

Tools that reduce the feeling of hunger can be divided into:

1 pharmaceutical preparations, acting in its mass;

2 tools that have a direct influence on the excitability of the food center.

It is known that a certain degree of filling of the stomach food causes reflex inhibition of food center. Based on this principle the use of drugs of the 1st group, acting in its mass. These include various kinds of ballast substances, the most pronounced effect of which has methylcellulose.

More than 40 years known such farmacologicas is their preparations, reducing the feeling of hunger, as amfepramone, farnon, dezaemon etc. But due to the obligatory side effects of existing drugs (agitation, insomnia, palpitations, increased blood pressure, the development of drug dependence) continue the search for new anorectics.

Evenesence (1993) believes that anorectic drugs, no matter what group they did not belong, do not have a significant impact on the treatment of obesity, because they are only symptomatic treatment.

From the point of view of this author pathogenetic are therapeutic measures that increase thermogenesis.

Because eating disorders are often accompanied psychopathological disorders (depression, anxiety), in the treatment of these conditions may apply antidepressants. For this purpose, are selective inhibitors of serotonin reuptake (fluoxetine - prozac sertraline - zoloft), which reduce appetite (Smulevich A.B., 1997). Eaarch et al. (1986) argues that medical treatment of obesity is a mandatory tool etiotropic and pathogenetic effects on the body. Simultaneously, these same authors noticed a number of serious side effects of pharmacotherapy.

For patients with a BMI uses a method of acupuncture on the.Glovelike et al. (1985), based on the impact on biologically active points located on the ears and other body parts. To suppress feelings of hunger, thirst and normalize appetite applies a braking action on the auricular points of the hunger - 18, thirst - 17, stomach - 87, mouth - 84, hypothalamus - 26, pancreas - 96. To stimulate the excretion of water and recovery of water-salt metabolism uses a tonic effect on the point of the ear 95, 26 and corporeal 9 IM, 67 V, 7R, 6R, 25-27 V.

Eaall et al (1986) believe that drug therapy plays a minor role. The authors propose to differentiate patients with obesity and are: 1) persons with “normal” power expenditure can reduce the energy value of food without the help of drugs; 2) those with “normal” power expenditure, not able to reduce food intake without the help anorectics drugs; 3) persons with “normal” power expenditure that can not refrain from excessive eating even with medication; 4) persons with reduced power expenditure, requiring them to increase.

Thus, the number of Russian and foreign authors consider drug therapy symptomatic, not affecting the fixation and maintenance of achieved as a result of treatment of normal body weight (Eaall et al., 1986, 1990; Iagariskes, 1998; J.E.Mitchell et all, 1993). One is temporarily difficult to make a choice when determining the course of treatment between the effectiveness of any drug and its side effects.

Psychotherapy. Hyperalimentation. piled on the constitutional predisposition to the development of obesity, can lead to metabolic dysfunction, which in turn leads to secondary somatic disorders (diseases of musculoskeletal system, cardiovascular system etc). Relying on this provision, etiotropic treatment of exogenous constitutional obesity should be aimed at eliminating the causes of the eating disordered. These reasons can be intrapersonal and social conflicts. Stressful factors related to the social sphere, in the opinion of many authors, is quite subjective. Therefore the main emphasis in the treatment of patients with excessive weight should be placed on the normalization of intrapersonal well-being and ability to adequately and to respond adequately to exogenous emotional tension.

Psychotherapeutic treatment aimed at changing eating behavior with exogenous constitutional obesity, is applied, as a rule, in addition to the other above-mentioned therapies of this disease (Megabolsa, Vahreneva, 1968; Eshkenazi, Viglino, 1984; Evenesence, 1993; Eaarch et al; 1986 and others).

Eaall (1986) attaches great importance suggestive crazy therapy, considering hypnosis not only symptomatic measure, but pathogenetically oriented way of treatment, as with hypnosis, you can achieve a restructuring of the psyche fat sick and eliminate unhealthy eating habits, which essentially involves the main cause of the disease.

Kreslavsky Y.S. and Loyko V.I. (1984) proposed a scheme for the rehabilitation program of patients with obesity (partnership, the versatility of effort, unity of psychosocial and biological methods of influence), much of which is accompanied by psychotherapeutic methods, such as hypnosuggestive, rational psychotherapy. Later Kreslavsky Y.S.(1985) reported the need for a combination of psychotherapeutic methods with medical treatment aimed at correcting emotional disorders such as anxiety, low mood, irritability.

According to J. Donelly, Duncan David F., Procaccino Anthony T.(1993) in patients receiving group treatment for overweight, there is a decrease in reactive and personal anxiety when filling the questionnaire of personal and reactive anxiety of Spilberger.

There is evidence of the application of the behavioral approach to reducing overweight in patients with obesity, accompanied by ischemic heart disease (Romelashvili CENTURIES, 1990). Significant role p is idesa group method of psychotherapeutic influence (Budkowski, 1985).

In General, research on psychotherapeutic treatment, fragmented and contradictory. Data on the dynamics of the psychosocial status of patients, reducing weight, and its correlation with the achieved effect in the treatment developed sufficiently for practical use. Finally determined the role of psychotherapeutic intervention and strategic techniques in individual patients. In recent years more and more authors are inclined to the dispensary carrying out correction of overweight, as more profitable catamnestic. Outpatient treatment is often associated with development of proper diet habits not only the patient but also his family, which plays a significant role in achieving stable results of treatment (Kadyrov, A.D. et al., 1986; Eaarch et al. 1986; zamotaev I.P. et al., 1988).

The increasing urgency of the problem requires an active search for the most effective ways and methods to reduce body weight in obese persons and fixation was achieved.

The task of the invention is to increase the effectiveness of treatment of food addiction, accompanied by obesity, and increase firmness and duration of remission.

The problem is solved by applying psychotherapeutic influences and dietet is rapee, moreover, the main psychotherapeutic effect carried out intensively for two sessions of 8 hours each, then a supportive psychotherapeutic effects in a single session lasting 3 hours after one and three months after the main psychotherapeutic influence.

The method is as follows:

The main techniques of psychotherapy used in the treatment of obesity are:

1) Rational psychotherapy

2) Gipnosuggestevna methods (Directive hypnosis, Ericksonian hypnosis)

3) self-Regulation and self-hypnosis

4) Emotional stress therapy

5) neuro-linguistic programming

6) Positive psychotherapy

7) music Therapy

8) Behavioral therapy

Mandatory provisions and modifies the psychology of eating behavior in the process of psychotherapeutic influence are the following:

1) the Development of motivation to eat healthy.

2) a Clear statement and the formation of a weight loss program - how much time and how many pounds you want to lose weight.

3) Visualization and concretization of goals, mandatory plan.

4) keeping a food diary.

5) Rapid or gradual changes in eating habits.

6) Attitude to faith in the success and development of self-confidence.

7) the Response is Skye protection in the event of a situation of possible violations of the diet (situation of temptation or emotional stress).

The treatment stages

The technique of psychotherapy patients are overweight involves certain stages. Each stage involves their tasks, and psychotherapeutic effect differs in form, orientation and content.

The first phase (preparation) is characterized by the indirect (mediated) suggestion. It is advertising and information activities, the Advisory work of psychotherapists, other patients who have undergone treatment (live advertising), doctors medical profile, issuing referrals for treatment, familiarize patients with the treatment results, presented in the album with photos and videos. Before treatment is psychological and psychophysiological examination of patients.

The second stage (therapeutic) includes collectively-group classes for 4-h meetings. Two meetings for 8 hours in a row method marathon (preferably, but not necessarily, when one of the two meetings held at night) and two control-support session for three hours in a month and three months after the main exposure. Method marathon has the following specific mechanisms and benefits:

1) the intensity and concentration of psychotherapeutic influence exceeds the intensity is similar to the sum of the impact of the “classical” (90 minute) sessions due to time savings for “warming up” and structuring group;

2) progressive asthenia and failure of biological rhythms and behavior patterns of patients reduces the resistance, facilitates the occurrence of altered States of consciousness, the development of a new experience;

3) the continuity of the group experience contributes to the inclusion of a variety of exercises and experiences into a single group process.

The number of group members usually no more than 12-15 people. The increase in their numbers is not advisable as this makes it difficult to contact the doctor with patients, monitoring them, deprive him of the opportunity to introduce elements of individual suggestion, keep for all classes of patients in the field of view, to support the activity of their attention. Individual treatment would be less effective as a joint activity of the patients in the group actively involves patients in the treatment process, develops communication skills, facilitates the sharing of experiences from treatment and individual experience, helps to overcome the destructive fixation on unbelief in the achievement of this goal.

After forming the group, exploring its members among themselves and with therapists is rational psychotherapy. During the conversation, therapist repeatedly emphasizes that the most effective way to lose weight and retain optimal weight is to change your eating habits, reducing often the s and the number of meals in accordance with the needs of the individual program weight, the restructuring of the psychological motivations of the person in relation to food and their own physical activity. At this stage we discuss the performance of normal body weight for each group member. To be calculated by using formulas or tables.

Advanced formula Brock:

M=P-100-10% of the obtained difference,

where M is a normal body mass, kg, R is the growth in see

Index of Breitman:

M=P*0,7-50

In English literature, is widely used by body mass index - Body Mass Index (BMI)

VM=M/R2(m)

Body weight in kilograms divided by height in meters squared. Index not more than 25 indicates a normal body weight, BMI in the range of 25-27 corresponds overweight, more than 27 indicates obesity.

Dysregulation of food intake is one of the major reasons for the development of excess fat. For most people with normal body weight usually does not require any special participation of consciousness in determining the amount and quality of food. A significant part of the achievement of energy balance income and spending power requires constant conscious control.

For a proper understanding of the food behavior of the person you want to do with such concepts as “hunger”, “appetite”, “saturation”.

Hunger is sookun is there are unpleasant sensations in the form of voids and spasms of the stomach, instinctive sense of having a meal. It occurs when the nutrient reserves of the organism decreased below the level required for the energy balance.

Appetite (from lat. - a desire - a General feeling of pleasant emotional feelings that are associated with the human desire to receive certain foods. It is based on the desire to receive the pleasant sensations that accompany the acceptance of any food. In contrast to the hunger appetite occurs when sufficient nutrient reserves of the organism.

Saturation - the lack of desire is caused by food intake. It is the opposite of hunger, being the reverse side of the same coin.

During the conversation, therapist emphasizes the need to listen to the changes in the sensations that usually occur during and after treatment (for example, increasing the saturability, loss of appetite, change in taste, indifference or aversion to his beloved earlier high-calorie, sweet or fatty foods and so on) and gives the task is not to take food without feeling hungry that often make many fat people. But, if you still want, you have to eat correctly, rejecting the “empty calories”, competently making your diet using the recommended dietary guidelines.

1) Reduce caloric intake by limiting carbohydrate is, especially easily digestible (sugar, chocolate, sweets, pastries, pasta, white bread, pastries, cakes etc). From carbohydrates, you can leave cereals, which are cooked in water (rice, buckwheat, oatmeal, barley), not more than 100 g bread coarse (trubnogo, black, rye), which contains fiber, more protein and b vitamins and is lower in calories. Excluding honey, jam and sugar from your diet, tea and coffee, you can add a sweetener (“Milford”, “Zucly” and others).

2) to Exclude from the diet of animal fats (lard, butter, fatty meat, cream, fat cheese). In a small amount (1-2 tablespoons) to keep on the diet of vegetable oil for vegetable salads.

3) to Observe the correct methods of cooking food (boiling, stewing in water, steaming etc).

4) Mandatory inclusion in the diet of proteins. A mistake many people wanting to lose weight, is the neglect of protein. But proteins, fissioning to amino acids are the “building blocks” of the body cells, they are low in calories and provide a feeling of satiety field of food. So be sure to include in your diet animals (lean meat, poultry, lean fish, boiled eggs - no more than 1-2 per day) and vegetable (peas, beans, beans, mushrooms, soy products proteins.

5) Dairy products (abusir the TES milk, cheese, yogurt, kefir, yogurt, sour cream 2-3 tablespoons for salads) can be used as a source of protein and calcium.

6) Fruits and berries can all, except bananas. They are a source of vitamins, minerals, fibre, but there they only need to “main” meal or in a separate admission. In winter-spring time to include in the diet of dried fruits (dried apricots, raisins, prunes), which are a source of potassium and stimulate the bowels.

7) Vegetables (raw, cooked, braised) without restrictions, except potatoes, which are high in calories due to the high starch content, but pre-wetting peeled potatoes in cold water for 10-12 hours, calories can be reduced.

8) Avoid beer and other alcoholic drinks.

9) to Limit consumption of salty foods (salted and smoked fish, corned beef, savoury sauces and condiments), because salt retains fluid in the body, promotes the formation of edema, thereby slowing the digestion of adipose tissue.

10) Right to organize the water, eating without restrictions only filtered or mineral water. Listening to their own feelings, to drink only if you want, without overloading the body of excess fluid.

11) to Exclude from the diet spices and seasonings, which can stimulate the appetite

To lose weight, you should use the following rules and recommendations.

1) Create a diary of weight loss, in which each day to note the amount of eaten food in calories.

2) using a diary to regulate the body's energy balance. Any type of obesity, ultimately, provides a revenue surplus of energy from food over consumption. In a person with normal body weight intake of dietary calories is roughly the amount spent in the process of life. The body regulates this balance automatically. Full the man from whom the regulation of energy metabolism is impaired, in order to lose weight, you must very strictly regulate the flow and energy consumption. So, counting in the diary using the proposed tables of calories and tables of energy expenditure for various activities of your balance, you can achieve the desired shortage of supply. In order for effective slimming process began, the energy deficit should be about 500-1500 calories a day.

3) a day to get food no more than 600 calories.

4) Yourself to be the best diet. Using the above dietary recommendations, individual characteristics of its own body, tastes and habits, each patie whom t may establish the most effective and optimal diet.

5) Regularly monitor your weight on the same scales at the same time, as well as to monitor the change in the amounts of various areas of the body. Most often, the weight is reduced smoothly and stupenchataya, so you should be prepared for the fact that the process of losing weight will be accompanied by periods of “stop” weight loss. The main thing is not speed weight loss, and change the usual harmful eating habits, change in the quantity and quality of food.

6) eat slowly, chew. Usually the feeling of satiety comes in 15-20 minutes after the start of the meal, so this is the minimum time that should be spend on food. If there quickly, before the onset of saturation person eats more than is needed to satisfy his hunger.

7) Apply fasting days 1 time per week. For example:

A. Milk-kefir diet: 1 liter of milk or yogurt

B. Fruit and vegetable diet: 1 kg of apples or tomatoes or cabbage-carrot salad.

Century Complete abstinence from food: use only 1.5 liters of mineral water or herbal tea.

8) There is only a small spoons of small plates that subjectively increases the uptake.

9) When the desire to eat, to distinguish hunger from appetite, try to distract on for 10-15 minutes, if the desire is saved, you can go to the kitchen. But to start the PR process is the notion of food is always necessary with liquid (water glass, tea or juice in small SIPS) or low-calorie food (fruits, vegetable salads), carefully listening to the sensations in the body.

10) Stop eating by the clock, under the TV, eat at home.

11) To increase the motivation to lose weight, you can buy an expensive dress or suit size to which the patient seeks and hanging it in a prominent place, to present their “slim” in this outfit.

12) to Use a steam room or sauna for cleansing, removal of toxic products from the body, getting rid of excess fluids, accelerate the breakdown of adipose tissue.

13) the Use of methods of self-regulation and auto-suggestion in the home.

During treatment, patients are taught the basics of autogenic training and instructions to at home by yourself to influence your own feelings, reducing appetite, increasing the uptake, strengthening willpower, etc. the Activity of auditory training counteracts some of the negative sides of hypnotherapy in its classical model - passive relation of the patient to the treatment process, depending on the doctor. The main elements of the methodology are training muscle relaxation, self-hypnosis and self-discipline. Therapeutic effect of auditory training, along with the development in the relaxation trophotropic reaction, characterized by growing the receiving of the parasympathetic tone of the autonomic nervous system and contribute to neutralize stress, based on the attenuation of the activity of limbic and hypothalamic areas, which is accompanied by a decrease in overall anxiety and the development of anti-stress trends. In recent years, in physiology, more and more works, which indicated that the signal of saturation starts a complex reaction pituitary-hypothalamic and limbic systems, some of which are associated with positive emotions. When emotional stress on the background of growing anxiety a feeling of fullness and emotional responses associated therewith, may act as a compensatory mechanism. According to psychiatrists, emotionally immature individuals observed giperbolicheskaya reaction to stress, which is against non-adaptable, but not socially condemned form of protection for any emotional and psychological discomfort (Isaretleme, 1994). A number of authors noted that bulimia may be a symptom of a hidden depression. The presence of indicators such as anxiety and depression are typical for patients suffering from obesity as a symptom of mental distress (Whichelow, 1994). Therefore, it is advisable to teach patients suffering from obesity, the elements of auto-training: 1) lower level - training of relaxation with exercise, designed to invoke the feeling of heaviness, warmth, the mastery of the heart rhythm activities and respiration; 2) the upper level creating trance States at various levels. The lower level is six standard exercises that are performed with patients in one of three positions (sitting in the coachman's posture, lying down or reclining). Exercises are performed by mentally repeat 5-6 times formulas of autosuggestion, which podskazyvayut psychotherapist and aims to evoke the feeling of heaviness in the arms and legs, feeling of warmth in the hands and feet, regulation of heart rate, normalization and regulation of respiratory rhythm, causing feelings of warmth in the abdomen, sensation of coolness in the forehead with the aim of preventing and mitigating headaches of vascular origin. Indicator mastering regular exercise is a generalization of sensations. The second stage uses exercises narrative imagination and self-esteem, developed by Russian authors (Panov A.G., Belyaev G.S., Lobzin B.C., Kopylova I.A., 1980), which are based on the techniques of intentional regulation of emotions. The aim of the exercises is self-conscious modeling of a given emotional state, but the essence lies in the reproduction of emotionally charged ideas, images and dynamic situations. Exercise of self-assertion are mental rehearsal exhilarating significant situation is with the geta, how wants to see the patient. These exercises are best done in the morning, still asleep completely, i.e. being in a natural autologous dive. Autosuggestion or autosuggestion is the process of suggestion, self-addressed. Allows the patient to arouse certain feelings, perceptions, to manage the processes of attention, emotional, and somatic reactions. The essence of the suggestion by I.P. Pavlov is concentrated irritation specific area of the cerebral cortex, which is accompanied by inhibition of other departments of the cortex representing the interests of the whole organism, its integrity and existence. Self-hypnosis does not need any special training. Just two times a day after waking up and before going to sleep for 3-4 times myself to repeat the formula of auto-suggestion. It is made arbitrarily, consists of a few short phrases. As an example, here is one option:

1) I Have a good mood and feeling.

2) I like the process of losing weight.

3) every day, the more I try to lose weight, the less my appetite.

4) the longer I keep a diary, the slimmer and lighter becomes my body.

5) I am indifferent to sweet, fatty and starchy foods food.

6) The faster the uptake, the faster split adipose tissue.

7) the picture is giving weight and volume enhances health and improves health.

The main focus of psychotherapy overweight paid trance methods of psychotherapeutic techniques using modified (split) States of consciousness for therapeutic or prophylactic purposes. In our work we use techniques not only classical hypnosis and Ericksonian that, having absorbed all the positive experience of classical hypnosis, differs from it by the following criteria:

1) Used sanogenic patient resources

2) All patients are considered not so suggestible

3) Therapeutic formulations of diffuse (generalized), high-resolution connectivity subjective reality of the patient.

Examples of psychotherapeutic texts below (Overrecovered, 1996).

Text # 1.

Before You enter into a trance, I will ask You to get comfortable. And You can see that once You have relaxed, inside You have this condition, a state of trance. And You can say that You hear my voice, hear the music, feel like You are sitting in a chair, and You can feel Your hands touch Your feet relaxing. And You can feel the temperature of Your hands, the weight of Your hands and continuing to listen to my voice and music can continue to relax, sinking further and deeper into this state. And USTOA, as Your feet touch the floor, and the back touches the chair, you can feel safe and secure, and, continuing to relax, deeper and deeper into this state, you can afford to learn more about this condition even more. Hearing my voice will help everyone to improve their health, get rid of bad habits, solve many psychological problems. And Your mind may be far away in some nice places, where you can relax and unwind, and these memories or representations activate in a certain direction Your subconscious mind, which in turn makes the body exactly the changes that You need. You don't have to believe them or not believe. Just listening to my voice and my words, You immediately or gradually begin to find in their body or those of other useful changes. It is not necessary to understand the meaning of all sentences, improving Your health will occur without it. Maybe sometimes, listening to these phrases, you'll catch myself thinking, what do you think about something else or even not thinking about anything and not delve into their meaning. And it's good... And if you want, you can listen on and hearing my voice will relieve fatigue, improve your mood, increase alertness, activity, roboto osobnosti. As each of us in varying degrees feels tired: someone constantly, the other end of each working day, the third - only sometimes, after all the hard work. Similarly volatile and our mood. Sometimes You after the trouble can be a long time to be depressed, but sometimes You can experience increased vitality and better mood, do not know why. It all depends on Your subconscious.

And each of you is now able to recall one or more events from his life (maybe from childhood or adolescence or from the recent past), even when seemingly after a hard work, you were still active, fit and healthy and could “move mountains”... And I don't know at what point You can return to that feeling of vivacity and good mood from Your past. Each this requires the time (some minutes, some hours). But I know that Your subconscious mind is capable of so much better than You do, view your past and find those resources, the energy that You need.

It's interesting how You learn about these useful changes. Maybe you will feel the lightness and elasticity of the muscles or physically feel that can walk, climb stairs or to work without fatigue significantly longer than ever before, and who may, You will hear from others that look good, or will see in the mirror of his happy smiling face.

And the more you smile, the more you will be surprised that You have really improved mood, and increased efficiency.

Text # 2.

This treatment will help everyone to be free from excess weight, regardless of how much You have extra pounds: sixty or two. But if someone thinks that all those extra pounds of weight will disappear by the end of the session, he is wrong. Weight reduction will occur gradually. Someone will need to do this few weeks, some a few months depending on Your initial weight. And Your mind can doubt it, while Your subconscious mind is already beginning to explore Your inner mysterious world and begins to identify ways and methods to normalize weight. And maybe some of You listening to my words, make it more deep breath, and others will begin to dive into some state or even enter into a trance, while others, on the contrary, will feel the most energetic and stronger activate your consciousness.

In General, the TRANS is not a special phenomenon is frequent, widely distributed by the state. Every person many times in my life been in this state. And You also is a number of times during the day enter into this state and go from there. Because trance is and standing in line and listening to the lecture, and drive, and all other conditions, when You are immersed in themselves, their thoughts, their feelings. And, listening to me, some of You may already be immersed in a trance to the depth that You need here and now. And it's interesting that everyone seems to intuitively know what the depth and duration of the trance is best for him in this or in another time, in another state.

And You can change quickly or slowly. Similarly, immediately or gradually, You will begin to receive the necessary treatment effects. Someone today, tomorrow or in the next few days will notice that decreases or completely disappears appetite. The other will significantly accelerate the uptake adopted after a meal: for complete saturation and overflow stomach will miss two or three spoons of food, or even any piece of food will cause expansion and swelling in the abdomen. The first third will change flavors previously favorite food will become less tasty or even indifferent. Someone all these sensations will appear at the same time, another will appear one after another sequentially or alternately. And the more now resists Your mind, the faster You will lose weight. And I don't know how You listen to me carefully or casual, serious or funny, what about I know over time, everyone who needs it will find that its weight has decreased, although maybe he didn't notice, decreased appetite, accelerated saturation and perverted tastes and smells of food. This is because You find it difficult to notice that increased metabolism of your body and accelerated the dissolution of fat tissue, and it happens to everybody who inhales and exhales, sitting in this room. And before You agree with what is to be said further, I would like to recommend You today is always before eating to pay attention to your feelings and do not eat if You do not want. And if You really want to lose weight, then, sitting down at the table and starting the meal, You will remember this trance and was surprised to feel that you have eaten or notice that food today is not as tasty and even reminds mouth, mixing with the saliva, something unpleasant.

Text # 3.

I know that some of you already feel shy to go to the beach and swimming in the reeds or no swimming; others do not like the mirror bathrooms; others dream to wear the clothes they want (shorts, short skirts etc), and not one that forces you to wear the piece; others are tired of diseases, which usually accompany excessive weight, headaches, shortness of breath, pain in the joints and spine,hypertension, stones in the gall bladder and kidneys, and many others. But I know that someone who really wants to, can become slim, healthy and beautiful, and so happy.

And the closer You will listen to my words, the next will continue to follow the process of Your recovery. And before You will feel a noticeable weight reduction, You two or three or even four times a day will remember our treatment. And, smiling, You may recall that the process of reducing weight, You precede the reduction and loss of appetite, fast saturation, increase metabolism and other personally Your individual feelings.

Our existence is a chain of continuous change. The universe itself is constantly changing. The seasons change, alternate ebb and flow, the leaves on the trees fall and bloom again. Even in our body there is a constant process of dying cells and new. Even the mighty cliff collapse and decrease over time. So naturally the expected change in ourselves. And the more You concentrate on this thought and realize that achieving these changes within Your capabilities, the more success You will achieve in life. From the outset adjust yourself that You will realize a difference with these lyrics...

And You can imagine t is ply winter day. Can you remember yourself as a child in the winter... or their children or grandchildren... or just children playing in the streets. And You can imagine, easy or hard as You or they build snowmen out of wet snow. Take a small lump of snow and rolled out of the lying snow. And a small lump begins to accumulate soft, friable, white snow. And the lump increases, it becomes more and more. And now ready for the first ball. Then roll out the second and third. Installed one on another, you can attach hands and stick a carrot for a nose, and the snowman is ready. And all winter, this large, white, heavy snowman is invariably. But spring is coming, prigrevaet the sun, and he suddenly begins to melt, reduced eyes. Every day is becoming smaller and smaller, thinner and thinner, it gets easier and easier. And there is only one carrot. And I don't know when in Your life come spring. It can occur even in winter, and, of course, in the spring, and may already be to fly all your loose white snow has already melted, and maybe You will put into your diet healthy carrot or invent for themselves something more effective. But every day: winter, spring, summer or autumn, remembering our treatment, You will be surprised to find in his body, all new and new useful that will help You to get rid of complexes, to strengthen its what health and to deal with excessive weight.

At the end of treatment, at the final stage, the program is discussed and the time control and support meetings that are required to consolidate the effect of treatment, as well as to answer questions that may arise in patients in the process of further independent of weight loss. The doctor strongly emphasizes the need to be especially careful when successful completion of treatment. Many patients after treatment are very satisfied with their appearance and well-being, forgetting about the possibility of recurrence of the disease failure to follow the diet and mode of exercise. Therefore discusses situations that may provoke a relapse of obesity: nervous tension, stress, situation of temptation, which helps to avoid errors.

To identify the effectiveness of treatment used 4 groups of patients:

1. Diet therapy (without psychotherapy) - 15

2. Psychotherapy individual sessions within two weeks (without diet) -12 people

3. Psychotherapy separate sessions over two weeks in combination with nutrition with the control meetings after one and three months - 18

4. Psychotherapeutic marathon in combination with nutrition and subsequent support sessions one and three months - 80 people (the proposed method).

In all groups of patients was measured following pokazateli: body weight before treatment, body weight after 1 and 3 months after treatment and the results of the test SAN (subjective evaluation of health, activity and mood on a ten-point system), respectively. Patients in all groups were tested by the method of multidimensional study of personality: significant differences between groups on all scales, this method is not revealed. Patients of all groups - women (mean age 34 years).

The results presented in the table. Analysis of these data shows that the best result was obtained using psychotherapeutic marathon in conjunction with nutrition (4 patients): for the first month on average they lost 9,68±0,2 kg (11.4% of the initial weight), and 3 months after treatment, the average weight loss was 17.4±0.2 kg, which accounted for 20.2% of the initial weight. On the second place on the effectiveness of the weight loss was group # 3, when I used the classic version of psychotherapy - individual sessions of 1-1 .5 hours a day for 2 weeks in combination with diet therapy: decrease of body weight after 1 and 3 months after treatment was 7.4±0.35 kg and 11.0±0.3 kg (8.6 per cent and 12.8% of the original), respectively. Even less has reduced their body weight in the patients of group 2 (when used the classic version of psychotherapy within 2 weeks without diametera the AI), who lost weight for 1 and 3 months 5.8±0.4 kg and 7.6±0.4 kg of 7.0% and 9.2%respectively. The worst result was obtained in patients of the 1st group, which received only diet therapy: a month after treatment, their body weight decreased only 3.9±0.3 kg (4.8% of initial) and after 3 months of almost remained at the same level of 4.3±0,4 (5,3%). The differences in the rate of weight loss between all groups statistically significant (P<0,05). Moreover, patients of the 4th group this rate 3 months after treatment is maintained, while the patients of the 3rd and 2nd groups is significantly reduced, and the 1st - almost stops.

Analysis of performance test SAN revealed a steady increase in the level of health, activity and mood from the start of treatment and 3 months after treatment, only the 4-th group of patients who underwent psychotherapy marathon in combination with diet therapy. Subjectively they noted a decrease in appetite, accelerating the process of saturation and painless (without much effort) reduction of body weight. While the patients of the other groups only in the first month has been an improvement in the health, activity and mood (but to a much lesser extent than in patients of the 4th group), and 3 months after treatment began the decline of these indicators. In patients of the 1st group ask the Shih-only diet therapy without psychotherapy immediately after treatment has begun a significant reduction in the mood, they explained deterrence quantity and caloric intake through willpower, while the appetite on the contrary increased.

From the above we can conclude that the proposed method for the treatment of food addiction can improve the effectiveness of treatment and to stabilize the results obtained through the integrated use of psychotherapeutic techniques in the form of psychotherapy marathon, helping to change nutritional strategies and psychological motivation of the patient in conjunction with diet therapy, to optimize the power mode.

Thus, the proposed method for the treatment of patients with food addiction, accompanied by obesity, allows you to:

1. To increase the efficiency of treatment of patients with food addiction, accompanied by obesity through integrated use of psychotherapeutic techniques in the form of psychotherapy marathon that change their relationship to food (decrease appetite, accelerating the process of saturation and so on) and improvements in subjective psychological background of health, activity, mood.

2. To stabilize the results and to increase the duration of remission through the use of methods of self-regulation and self-suggestion in combination with diet therapy.

3. To optimize the psychotherapeutic process is with - to work in a short time (2 eight-hour psychotherapy marathon), without drug exposure.

Table
Dynamics of body mass and level of SAN in patients with food addiction, accompanied by obesity
 Before the treatment1 month after the treatment3 months after treatment
 Body weight, kgWith

point.
And

point.
N

point.
The decrease in body weightWith

point.
And

point.
N

point.
The decrease in body weightWith

point.
And

point.
N

point.
     abschRel.%   abschRel.%   
Dietetics80,74,8a 3.96,3a 3.94,85,3 4,05,24,35,35,24,2a 4.9
 ±2,9±0,25±0,25±0,3±0,3±0,4±0,23±0,25±0,2±0,4±0,5±0,22±0,23±0,2
Psychotherapy82,44,6the 3.85,95,87,05,5of 5.46,57,69,25,5the 5.76,2
 ±3,1±0,3±0,3±0,35±0,4±0,4±0,28±0,24±0,3±0,4±0,42±0,3±0,25±0,3
Psychotherapy and              
 86,35,04,25,97,48,6of 5.4 5,56,711,012,85,6of 5.46,2
dietetics±2,3±0,25±0,25±0,25±0,35±0,35±0,3±0,25±0,23±0,3±0,3±0,26±0,25±0,25
Psychotherapist.              
 84,765,14,0the 5.79,6811,46,56,87,417,1620,27,17,58,2
Marathon±1,75±0,1±0,1±0,15±0,2±0,2±0,1±0,15±0,2±0,21±0,23±0,15±0,2±0,23

A method of treating food addiction, accompanied by obesity, including diet therapy and psikhoterapevticheskaja when conducting collective group sessions characterized in that the main therapeutic effect is carried out in two sessions of eight hours each method marathon in conditions asthenia, failure biorhythms and behavioral stereotypes, thus provide motivation for healthy eating, self-confidence and faith in success, form a weight loss program, visualize and concretize treatment, keep a diary of eating behavior, exercise psychological protection in the event of violations of the diet, after the main sessions performed psychotherapeutic effects in a single session lasting three hours after one and three months, aimed to consolidate the obtained results, discussion and exception situations that provoke a relapse of obesity.



 

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FIELD: medicine, psychiatry, psychotherapy.

SUBSTANCE: the present innovation deals with carrying out dietotherapy and psychotherapeutic impact in the course of group seances. Moreover, the main psychotherapeutic impact should be performed during two seances per 8 h each, each due to marathon technique under asthenization conditions, biorythmical misfunctioning and behavioral stereotypes. Motivation should be elaborated for patient's healthy nutrition along with self-confidence and belief into success. Program for losing body weight should be developed to visualize and concretize therapy. Diary for nutritive behavior should be written, psychological protection should be performed in case of affected dietary situation. After the main seances one should carry out psychotherapeutic impact during one seance of 3 h duration in 1 or 3 mo. During seances the results obtained should be fixed by discussing and excluding situations provoking obesity relapse. The method enables to prolong duration and stability of remission.

EFFECT: higher efficiency of therapy.

1 tbl

FIELD: medicine.

SUBSTANCE: the present innovation deals with the ways to treat alcoholism, narcomania, tobacco smoking, obesity, sexual disorders, gambling-mania and others. Videopicture contains either one or two additional exposures, the 25th and 26th, correspondingly, each of them contains verbal information of either prohibiting or encouraging character and depictive information that corresponds to the character of verbal information. Moreover, at first, it is necessary to show the 25th exposure only, then - the 25th and the 26th exposures together, then again - the 25th exposure only. Duration of seance for videopicture watching should last for about 20-40 min. The method enables to perform less severe impact upon a patient.

EFFECT: higher efficiency of therapy.

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FIELD: medicine, in particular, narcology.

SUBSTANCE: method involves using computer as apparatus for displaying on monitor screen of brain colored images reflecting at least two states of brain: before coding by separating portions colored with yellow, green and blue colors and tints thereof reflecting increasing extent of brain affection, and after coding by separating big portion of bright-red color on the background of portions colored with yellow, green and blue colors and tints thereof, respectively; explaining to patient that portion of bright-red color is his dominant code resulted from treatment; before coding procedure, applying and fixing on patient's forehead electrodes simulating elimination of brain potentials; in the course of coding, exposing patient to light flashes with switched-off common illumination and to continuous acoustic signals generated by means of acoustic synthesizer; during coding procedure, exposing patient to light flashes issued from, for example, stroboscope, said light flashes being emitted at frequency of 1-3 Hz; providing immediate suggestion by means of microphone and telephone headsets electrically connected to microphone and secured on patient's head. Method allows preliminary treatment procedure to be avoided.

EFFECT: increased therapeutic effect.

4 cl, 3 dwg, 1 tbl

FIELD: medicine.

SUBSTANCE: method involves carrying out physiological examination with electroencephalogram recorded. Cognitive evoked potential method is additionally applied as neuropsychological examination for detecting hard and latent organic brain lesions causing central nervous system pathological disorders. An additional psychophysiological examination is carried out with vision analyzer test, visuomotor response test being applied for obtaining estimations of selection, discrimination, noise immunity and muscle endurance index, movement coordination, response to moving object and integral estimation of attention and ability for perceiving significant information, motor analyzer rapid response production estimation, estimation of nature of cardiovascular system response to given psychoemotional loading estimation. The examination is sequentially carried out as primary control when hiring personnel, as intermediate control in following a training course and emergency training. Psychological testing is of multi-purpose nature. To achieve it, a set reliable tests and methods of prognostic and substantial validity are applied, including intellect and project-building tests and standardized self-reports. When making decisions concerning professional validity based on test and examination results, risk group is selected from operation personnel.

EFFECT: enhanced effectiveness of occupational skill assessment.

FIELD: medicine, human weight correction.

SUBSTANCE: while elaborating self-realization formula a dietologist should develop weight correction mode for a patient during certain period of time without health deterioration. A psychotherapist should detect several targets for weight correction followed by psychotherapeutic seance by applying neurolinguistic programming. For this purpose, a patient should provide picturesque and detailed description of desirable function. Moreover, a psychotherapist detects positive, emotional and autonomic manifestations to form conditionally reflector relationship due to tactile contact. Under supervision of a psychotherapist due to suggestion technique a patient should imagine "a part of personality" responsible for weight correction. Then his psychotherapist has communication with mentioned "part of personality", arouses patient's attention to desirable result and fixes elaborated conditioned reflex. Then a psychotherapist illustrates communication with physical feelings that correspond to either negative or positive answer and their appearance in "a part of personality". At establishing tactile contact a psychotherapist suggests to choose new ways of behavior directed onto weight correction, obtains agreement from "a part of personality" to take care of this very function, which a psychotherapist should monitor by physiological manifestations and fix with conditioned tactile contact. A patient suggests new ways of alimentary behavior, analyze them and choose not less than 3 really achievable ones and "a part of personality" is responsible for automatic implementation of these new ways of alimentary behavior in patient's next life and at achieving positive answer from "a part of personality" sйance of psychotherapy should be finished by returning a patients into awakening state. Moreover, one should prescribe a diet at decreased caloricity of 800-900 kcal during the 1st mo, then - 1200 kcal for another month with subsequent achieving its value to correspond to normal body requirements. Psychotherapy lasts for 3-4 seances in 3-5 d at repeated maintenance therapy in a month, 1 seance. The method enables to achieve stable weight decrease during preset period of time for prolonged terms.

EFFECT: higher efficiency of weight correction.

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FIELD: medicine, anesthesiology, intensive therapy, surgery.

SUBSTANCE: the present innovation is suggested to correct anesthetic therapy in postoperational period. One should apply a modified visual-analog scale of pain on which patient should mark independently his (her) pain feelings by fixing them on vertical sections of the above-mentioned scale of pain every 2 h during the day, then doctor should plot an algogram of daily fluctuations of patient's pain feelings to analyze them for estimating the strength of pain feelings and adequacy of analgetic therapy conducted; and by taking into account the data obtained to conduct correction anesthetic program next day. The present innovation enables to adequately evaluate patient's pain feelings in postoperational period for subsequent performing adequate preventive analgetic therapy of pain syndrome, that, in its turn, enables to prevent pathological postoperational syndromocomplex.

EFFECT: higher efficiency of correction.

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FIELD: medicine, cardiology.

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EFFECT: higher efficiency of therapy.

1 cl, 1 tbl

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EFFECT: higher efficiency.

1 cl, 4 ex

FIELD: medicine, thoracic surgery, anesthesiology.

SUBSTANCE: as non-narcotic medicinal preparation one should apply heparin to be introduced intratracheally at the dosage of 300-500 IU/kg, moreover, heparin should be introduced during the first 30 min after the operation is over. The present innovation enables to create prolonged anesthetizing effect in combination with prophylaxis of postoperational thrombohemorrhagic complications due to heparin capacity to be kept in the body due to its accumulation by mast cells at blockade of their fermentative activity followed by its gradual release into the blood.

EFFECT: higher efficiency.

1 cl, 1 ex, 3 tbl

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SUBSTANCE: method involves doing complex of physical training exercises on the background of medical rehabilitation treatment. First, dominant hemisphere is determined. Next, exercises are done expanding in turn over higher and higher levels of the nervous system beginning from homolateral movements of extremities. Then, heterolateral movements are done with extremities: first, without crossing median line of the body and then with shoulder girdle rotation to one side and pelvic girdle to the opposite side ending in movements crossing the median line. Then, the heterolateral movements are combined with eye movements and functional loads upon the hemispheres. Infinity sign drawing is carried out in the air with the right hand, left hand and with both hands, following the imaginary drawings with eyes and transferring center of gravity from one leg to the other one. Then, symmetrical figures are drawn simultaneously using both hands. Then, autotraining exercises are done consisting in creating and fixing in memory image of both working hemispheres.

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