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Psycology » Psychiatry and psychotherapy » Psychophysiologically-oriented model of psychosomatic disorders » Integration of psychosomatic concepts

Despite the differences set out views on the mechanisms of psychosomatic disorders, all of the above concept to some extent true. The reason why such a variety of models that each focuses only on individual elements of such a complex and multifaceted process, the interaction of body and psyche.

From the standpoint of somatic-centered approach to psychotherapy and psychology, psychogenic and psychosomatic diseases closer to each other. As with those, and with others in order obligate exist and psycho-emotional and physical disorders, just prioritize their alternate. In psychogenic diseases come first psycho-emotional problems, psychosomatic diseases at - respectively bodily disorders. For explanation of psychosomatic disorders described above heterogeneous presentation now been combined into a multifactorial approach. So, Y. and E. M.Gubachev M.Stabrovsky (1981) distinguish such basic options of psychosomatic diseases as:

1) situational option - a primary psychogenic, a major role in the development of the disease plays an acute or chronic psychological trauma;

2) personal option - a major role played by personal characteristics that impede human adaptation, creating a predisposition to physical projection of psychological problems.

Formation of psychogenic disorders, personality associated with intrapsychic conflict. The role of internal conflict as the basis of neurosis has been discussed in detail in the papers of Karen Horney. As mentioned above, it was divided into 3 main types of personal relationships (attitudes), which normally counterbalance each other. Unilateral predominance of one of them leads to a disharmonious personality structure, internal conflict, and coupled with the underlying anxiety and unmet need for security - to neurosis:

A) Committed to people - the need for attention of others, in their recognition, love and respect. Excessive current severity of attitude leads to the development of personality disorders according to the type or demonstrative.

B) efforts against people - the desire to subjugate others meet their own needs, manage, otherwise - the thirst for power. Strengthening of attitude this entails the formation of aggressive, antisocial personality disorder.

B) The desire of the people - the tendency to isolation and introversion. In case of unilateral dominance - avoidance of social contacts, shut off.

From a clinical point of view, consistent with the basic options intrapsychic conflict, dedicated V. M.Myasischevym: (1) hysterical (2) and neurotic (3) obsessive-psychasthenic. A similar principle underlies the classification of personality disorders according to ICD-10 and DSM-IV, which are allocated according to three groups of disorders - Cluster A (paranoid, schizoid and schizotypal disorder), cluster B (gistrionicheskie, narcissistic, borderline, antisocial disorders) and Cluster C (obsessive-compulsive disorder, as well as the type of disorder and depending avoidance). For neurophysiological approach that considers these conflicts in terms of the dynamics of hemispheric asymmetry, they are associated with three different formation of stable pathological state - hemispheric respectively, mixed and left hemisphere.

As for the problems about which people turned for help to the therapist, then, most of them, as rightly pointed V.Makarov V. (2001), can be reduced to a few basic, deep. Appliances such information private to general problems discussed in detail in the method of crystallization problems B. V.MAKAROV and includes simplifying the problem, separating it from the individual, bringing problems to the absurd or to its logical conclusion, the reduction of problems to intrapersonal and linguistic replacement, aimed at assigning patient responsibility (as in Gestalt therapy). Why there is a need for such formulations editing problems, its crystallization?

On the one hand, the desire to rationalistic simplification reflects generally familiar to the human search for simple solutions to complex problems. The latter is a manifestation of the fundamental psychological principles of information processing - conceptualization. As you know, the person is not a dispassionate mirror, passively reflecting the world. Any information they assimilated, assumes the character of personal knowledge. This man makes a reformulation of the initial information, to translate it into your own, familiar language. The process of creation of information processing its individualized, compact and intuitive internal representation by generalizing, integration with life experience and previously obtained theoretical knowledge and the convolution with the formation of a global image - a conceptual model (Welford AT, 1961). In general terms, it is a violation of the normal course of cognitive processes lead to a breach of adequate mental reflection of reality and the emergence of psychological problems.

On the other hand, the person is aware of both external and internal manifestations often its deep crisis in a distorted form, due to the action of psychological defense mechanisms. Obviously, it is often seen workarounds prevent maladaptive beliefs. Figuratively speaking, the deadlock is always open, but take a step toward him, give yourself permission to use this path to inner freedom person interfering with his own psychological barriers and restrictions associated with irrational prohibitions or imaginary danger (just like a hunted wolf hunters - red flags). The words of S. Covey (1996), the way we see the problem, and there is a problem. That is why that request, which the patient turns to a therapist, you need to reformulate the joint efforts of both sides.

For the same reason the reformulation of the problem itself has psychocorrectional action. Further to the method of crystallization problems can be used to refer to a so-called positive gestalt Rename, and personal growth psychotechniques (procedure Simoron) - temporary assignment (functional, role) name.

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