Methods of correction and treatment of psychosomatic disorders

Abdullaeva Aliya Salavatovna ORCID: 0000-0002-6534-7035 PhD in Psychology Senior lecturer, Department of Economics and health management, Astrakhan State Medical University 414000, Russia, Astrakhan region, Astrakhan, ul. Bakinskaya, 121 alya_kubekova@mail.ru

Introduction. Currently, the number of people with various psychosomatic disorders is increasing due to an increase in stress factors, military conflicts, and the growth of traumatic events, therefore, methods of correction, treatment and prevention of psychosomatic disorders are increasingly in demand. Psychotherapy is one of the most effective methods of both prevention and treatment of all types of psychosomatic disorders (psychosomatoses). Literally translated, "Psychosomatics" is a "treatment of the soul." It is important to note that psychosomatics also includes psychological correction. Psychotherapy of psychosomatic disorders can be performed as a separate tool in the treatment or it can be combined with physiotherapy, phytotherapy and other methods. Studying the state of the problem of psychotherapy of psychosomatic disorders among domestic and foreign sources will allow us to compile the most complete picture of the provision of effective non-drug care to people with various psychosomatic disorders.

The purpose of this review is to summarize and systematize the scientific works of domestic and foreign researchers, which are aimed at identifying the causes of psychosomatic disorders, as well as their diagnosis and psychotherapy.

Materials and methods. The leading method of this study was a comparative analysis of literary sources of the causes of psychosomatic disorders, as well as their diagnosis and psychotherapy. The main materials for the study are articles on psychosomatic disorders (psychosomatoses) by foreign and domestic scientists.

The results of the study.

In psychotherapy of psychosomatic disorders, the patient's confidence of various somatic profiles increases, internal resources appear in the fight against the disease, situational and personal anxiety can be significantly reduced, the patient begins to understand in the process of psychotherapy that he is able to manage his life, which he can control and change. In addition, the psychotherapeutic influence is completely focused on the patient's personality, and not on a specific human organ.

Currently, psychotherapeutic practice has accumulated a large arsenal of effective psychotherapeutic methods and techniques for psychosomatic disorders. However, a long-term and effective result, as well as the complete removal of psychosomatic symptoms, is possible only if the patient understands and wants to change the attitudes and motives that influenced his somatic status ^[3].

The leading role in psychotherapy is given to the emotional contact of the psychotherapist and the patient, namely, the establishment of a therapeutic bridge, since the effectiveness of the psychotherapeutic process as a whole depends on the emotional impact ^[1].

Psychotherapeutic effects can be individual (counseling only one patient) and group, i.e. psychotherapy of a group of patients. Psychotherapy can combine individual and group work. In addition, effective types of psychotherapy include family psychotherapy (counseling family members and the immediate environment).

Among the scientifically based and effective methods of correction and psychotherapy is rational psychotherapy, the author of which is the Swiss neurologist P. Dubois, who used this method in the treatment of psychoneuroses. Rational psychotherapy by P. Dubois is similar in theoretical positions to such areas as: cognitive psychotherapy by A. Beck and rational-emotional psychotherapy by A. Ellis.

When applying rational psychotherapy by P. Dubois, a psychotherapist or psychologist uses the techniques and techniques of rational psychotherapy, as a result of which the patient's attitude towards traumatic or frustrating situations changes, individual psychological characteristics change, value orientations that affect the attitude towards traumatic situations. Such a fundamental approach contributes to the effective treatment of the patient. Psychotherapy is based on a specially constructed conversation with the patient, where the psychotherapist finds and explains a traumatic situation that affects the patient's somatic state, and the psychotherapist also explains the reversibility of this condition and disease. It helps the patient not to fixate on the negative symptoms of the disease.

Autogenic training

Autogenic training is an effective method of psychotherapy, psychohygenics and psychoprophylaxis. The author of this technique was I. Schultz, he actively used autogenic training in psychotherapy of neurotic states (1932). In Russia, autogenic training began to be used in the 1950s. Autogenic training is based on positive suggestions and autosuggestion, which are taught by the patient's psychotherapist, as a result of which the self-regulating mechanisms of the body are restored.

It should be noted that the human body is capable of self-healing, i.e. the human body is able to heal itself independently and recover from various diseases. But long-term stress factors disrupt the self-regulating system of the human body.

The method of autogenic training has proven itself in the treatment of psychosomatic disorders, allows you to optimize your psychoemotional state, reduces psychoemotional stress.

The biofeedback method

The biofeedback method has become widely known as psychotherapeutic techniques for the treatment of psychosomatic disorders of various spectrum and neurotic conditions.

The biofeedback method or adaptive biofeedback method is a modern technique in the treatment and rehabilitation of psychosomatic disorders, which is focused on mobilizing internal resources to restore and strengthen physiological functions.

The biofeedback method in psychotherapy is more often used in two very different ways, namely: 1) as a basic technique for the formation of self-regulation skills, which eliminates psychosomatic reactions and neurotic states; 2) as a second method, the biofeedback method is already used in the treatment of neurotic conditions and psychosomatic disorders in a certain physiological system of the patient.

In addition, clinical studies have found that the biofeedback method is especially effective in those patients who have difficulty relaxing. Using the biofeedback method, patients can redirect psychoemotional tension to a conscious level, and this objective information will help develop relaxation skills in patients.

Cognitive Behavioral therapy

Cognitive behavioral therapy currently prevails in the treatment of psychosomatic disorders compared to other areas of psychotherapy. CBT is actively used to correct patients with neurotic disorders and psychosomatic diseases who are experiencing intrapersonal conflicts and problems.

In infancy, the formation of attitudes begins. During this period, interest in the outside world arises, trust in it appears under the influence of parental education and traditions of family, friends, teachers, idols and other significant people. The child's worldview is actively developing and by the age of a student, beliefs and attitudes characteristic of a particular person appear.

The use of installations helps a person to quickly navigate and act in accordance with the situation, minimizing the cost of intellectual, spiritual, and moral resources.

There are different approaches to the classification of attitudes: for example, common and differentiated attitudes, positive and negative, rational and irrational can be distinguished.

Rational, or objective, attitudes are a source of vital energy, mental health of a person, contribute to his effective adaptation, social integration, form positive thinking and a way of action.

Irrational attitudes have no connection with reality. They are a source of negative thoughts and emotional experiences, lead to a decrease in vitality, self-doubt, distrust of others, low self-esteem, and a feeling of worthlessness. All this adversely affects the personality, becoming the cause of emotional burnout and the development of a depressive state.

It should be emphasized that irrational attitudes are far from the real state of affairs, subjective and do not have sufficient logical justification. This means that the most effective way to solve this problem will be the identification, awareness and restructuring of such attitudes. And this is exactly the method of cognitive behavioral therapy.

Taking into account the factors that influence students and increase psychological stress (change of social environment, increasing responsibility, worry about the chosen field of activity), it is worth noting that irrational attitudes of "Catastrophization" and "self-respect" prevail among students. That is, any negative events are assessed as terrible and of decisive importance for the whole life, therefore they lead to long-term experiences. At the same time, there are excessive demands on oneself, which, not finding satisfaction, generate a feeling of helplessness and self-inferiority, reflected in self-esteem ^[9-10].

Therefore, today cognitive therapy is recognized as one of the main methods of the cognitive behavioral approach in psychotherapy, which in turn is one of the leading areas of psychotherapy in the world. Cognitive psychotherapy makes it possible to successfully cope with the emotional and personal problems of patients, based on the idea that the leading factor in the formation of psychological personality problems are errors of thinking, illogical or inappropriate thoughts and beliefs, as well as dysfunctional perception stereotypes.

Cognitive therapy includes a significant number of approaches, among which it is worth highlighting the cognitive therapy of Aaron Beck and the rational-emotional-behavioral therapy of Albert Ellis as the most influential.

According to A. Ellis, most people have a tendency to think irrationally or thinking combines irrational and rational thinking ^[8]. The way a person thinks, the way he thinks, can have a direct impact on the emotional state of a person. The words most often used by a person eventually become thoughts, respectively, an emotional state. Thus, in order to change maladaptive thoughts, it is necessary to rebuild one's own thinking with the help of psychotherapy. The main parameters in cognitive psychotherapy are, first of all, its speed, focus on a specific problem and goal, accuracy and a high level of effectiveness. The effectiveness of cognitive therapy has been proven by a number of empirical studies that have been conducted in accordance with scientific methodology and accurate methods of processing the data obtained.

Cognitive therapy has a serious integrating potential inherent in its theoretical schemes. For example, A.A. Alexandrov notes that cognitive therapy is of great interest for pathogenetic psychotherapy as a tool for reconstructing the relationship system of patients with neuroses. A.B. Kholmogorova and N.G. Garanyan ^[4] show the possibility of integrating cognitive and psychodynamic approaches using the example of psychotherapy of somatoform disorders. An essential characteristic and advantage of cognitive therapy can be considered teaching the patient a wide range of methods and techniques of self-regulation aimed at coping with life difficulties that he may face in the future.

A. Beck and A. Alice are the founders of cognitive behavioral psychotherapy. According to the authors, the cognitive behavioral approach and all psychological difficulties are based on various false conclusions, generalizations, and thoughts that trigger various emotional states. According to A.B. Kholmogorova, the main difference in the approach is that A. Ellis found cognitive characteristics in almost all psychoemotional disorders, while A. Beck distinguished psychoemotional disorders and states based on cognitive content. Thus, it is A. Beck and his understanding of the cognitive behavioral approach that forms the basis of one of the most popular and scientifically based methods in psychotherapy ^[7].

To date, cognitive behavioral therapy is the most well-known and scientifically proven method that is actively used in the professional community of psychologists and psychotherapists. The main idea of cognitive behavioral psychotherapy is that psychological difficulties arise on the basis of incorrect thinking, cognitive errors, misconceptions that arise, as a rule, as a result of incorrect personal learning at life stages. And the main task of CBT is to recognize incorrect thinking strategies, irrational attitudes, as well as replace them with adaptive attitudes and thinking.

The cognitive approach is designed to change a person's attitude towards himself, the perception of his own problems. If an individual does not think of himself as a helpless victim of circumstances, then he will be able to perceive himself not only as someone who can form irrational attitudes, but also change them. Awareness and correction of thinking errors can improve the level of self-realization and quality of life.

Thus, cognitive barriers that prevent effective self-realization in educational, professional and managerial activities can be overcome using cognitive behavioral techniques in psychological counseling. CBT is a short-term compressed method that includes structured activities and adaptive expectations.

It is important to note that the cognitive behavioral approach uses the method of behavioral intervention. Currently, the following main groups of methods are used in behavioral psychology: stimulation of motivation for behavior change; correction of emotional disorders; methods of self-regulation; methods of cognitive restructuring; methods of "repayment" of undesirable behavior; methods of forming positive behavior.

The psychological model of patient counseling within the framework of a cognitive behavioral approach is focused on the following elements: 1) cognition - thoughts and knowledge of a person about himself in a certain problem situation; 2) emotions – the emotions accompanying this problem situation; 3) behavior – actions that a person commits in this situation ^[1].

It is worth noting that this method is indicated when working with dysfunctional thoughts and irrational attitudes of patients, since patients are most susceptible to negative influences during the disease period. It is important to pay attention to the organization of work with students to correct irrational attitudes, since they reduce the effectiveness of professional activities and the quality of life.

Prevention of psychosomatic diseases

Prevention of psychosomatic diseases (psychosomatoses) is a necessary and important stage for every person, since it is much easier to prevent psychosomatic disorders than to treat it already. In addition, the treatment of psychosomatic diseases requires high costs on the part of both the patient and the medical staff. It is important to note that the occurrence of clinical symptoms and the formation of a psychosomatic disorder may not occur immediately, but over several years. Many clinicians note that most disorders and diseases that form throughout life begin to form in early childhood. Often, many parents may not pay attention to certain complaints in children, however, subsequently, this is formed into diseases and disorders.

Conclusions. Thus, it is necessary to carry out psychoprophylactic measures for psychosomatic disorders at the premorbid stage, both in adults and children, in adolescence, significantly improves their psychological and somatic well-being in terms of health, which is more beneficial for the economy than the treatment of various psychosomatic disorders and neurotic conditions that reduce the quality of life of the population and Accordingly, they reduce the country's economy.