What is psychosomatics and how to treat it?

Are all diseases caused by nerves? Is it possible to get sick due to “bad” emotions? What is a psychosomatic disorder? These and many other questions from the Challenger magazine are answered by Anton Rodionov, Candidate of Medical Sciences, cardiologist of the highest category, Associate Professor of the Department of Faculty Therapy of the Faculty of Medicine of the Federal State Autonomous Educational Institution of Higher Education First Moscow State Medical University named after I.M. Sechenov.

— In the 80-90s of the last century, a very famous psychologist, Professor Yu. M. Orlov, worked at our institute (First Moscow State Medical University named after I.M. Sechenov. - Ed.). He belonged to the theory of “sanogenic thinking”. Its meaning boiled down to the fact that if you think correctly, cultivate good emotions and fight bad ones, you can prevent many diseases. It must be admitted that for the fragile minds of young doctors, his theory looked very convincing...

Can emotions affect health? Definitely yes. To be a reason - no. Negative emotions activate the sympathetic nervous system, which in turn leads to increased blood pressure, increased heart rate and vasospasm. Everyone knows the stories when, against the background of, for example, fear or anger, people suffered heart attacks and strokes. I repeat: emotion in this case is not the cause of the disease, but only a provoking factor, a trigger.

In some cases, a negative emotion, of course, can become a cause of illness. For example, if you hit a wall with your fist out of anger, you can break your arm. Here is a very clear cause-and-effect relationship. By the way, we must not forget about the existence of an inverse relationship. Often the cause of negative emotions is chronic physical suffering. Remember Baba Yaga with a bone leg - perhaps she would have been a very sweet old lady if not for chronic pain in the hip joint...

“All diseases are caused by nerves” – a myth?

It's not even a myth, it's just an old student joke. The full quote is: “ All diseases are from nerves, and only five are from love ” (referring to the five classic venereal diseases). However, chronic stress is indeed a proven risk factor for the development of at least cardiovascular diseases. Several years ago, using positron emission tomography (a high-precision study that allows one to study metabolic processes in various tissues), scientists identified mechanisms that transform stress into chronic inflammation, which, in turn, serves as a key mechanism for the development of atherosclerosis.

“However, I repeat again and again: stress is not the cause of disease, but one of the risk factors that works only in conjunction with other factors, primarily genetic.

Psychosomatic disorders: what are the causes and mechanisms of their occurrence?

Psychosomatic diseases are a group of diseases that are manifested by bodily suffering (that is, symptoms of diseases of the internal organs), but their main cause still lies in problems with the nervous system. These include a whole range of gastrointestinal disorders (functional gastric dyspepsia and irritable bowel syndrome), fibromyalgia (a specific pain syndrome in the projection of the joints), hyperventilation syndrome (a feeling of lack of oxygen and the need for rapid breathing) and much more.

I will explain how mental suffering and somatic symptoms are related to each other using the example of the most common complaint with which patients come to a cardiologist - a feeling of rapid heartbeat. Tachycardia (fast pulse) normally occurs when you need to respond to an external stimulus, for example, to run away from danger. In this situation, the muscles need more blood, therefore, the heart must increase its contraction frequency. But when the danger passes, the pulse returns to normal. A patient with a neurotic disorder is outwardly calm, no one is chasing him, he does not need to catch up with anyone, but the brain gives a signal: “You are in danger, run away!” As a result, the sympathetic nervous system is activated, blood pressure rises and heart rate increases. The patient feels unwell... In this case, treating tachycardia as a separate symptom is at least absurd - it is necessary to treat the neurotic disease itself, and such patients should be treated not by a cardiologist, but by a psychiatrist or psychotherapist.

As for child psychosomatics, I’ll tell you another story. Recently a young woman came to an appointment. She looked very worried and kept trying to ask me about her husband’s health, although, in my opinion, her husband could well have come to the appointment himself. During the conversation, it turned out that the husband (a man who works hard and earns well) constantly yells at his wife and child at home, while still successfully manipulating his high blood pressure, but does not want to be treated. At the end of our meeting, the woman asked if I knew of a good neurologist, a specialist in childhood tics... Should I continue the story? In my opinion, you don’t have to be Dr. House to understand a simple thing: most transient neurological and neurotic symptoms in children are a problem with the parents.

Psychological causes of excess weight

Excess weight does not occur on its own and very often has psychosomatic causes. The main ones are the following:

Building protection from the outside world. The fat layer acts as a kind of protection for the shell, and the more weight, the stronger it is. An additional function also plays a role: a person appears larger in appearance, which is why he can seem to “crush” his enemy. But both functions have the same goal - protection from outside hostility.
Slender girls can gain weight after getting married or having a child. Psychology associates this with the emergence of a new image in the individual: a mother or a housewife. When new tasks arise, the figure is relegated to the background, and an unconscious desire for the image of a plump housewife appears.
Lack of attention. This most often manifests itself in childhood. When a child lacks attention, he unconsciously gains weight, thereby wanting others to notice him.
A woman's weight gain may be related to her man. So, he can say that he loves softness in women, and the lady can begin to gain weight in order to realize this softness through her figure.
Eating stress and anxiety. During childhood, candy becomes the best comfort, and this mechanism may persist as we grow older. By overeating, a person tries to drown out negative emotions, grief, worries, and so on.
There is a stereotype in society that excess weight is associated with respectability. When gaining weight, a person may subconsciously want to emphasize his importance. It may also be due to low self-esteem.
Accumulated grievances can also lead to excess body weight. A person literally accumulates them, resulting in fat deposits.
Violence in childhood. Scientists have found that after psychological or physical violence, the risk of obesity increases. This is especially true for women - by gaining weight, they try to become unattractive, thereby protecting themselves in the future.

In addition, there is a secondary benefit that a person receives from the symptoms of his problem. In the case of excess weight, it can manifest itself in the following:

Reluctance to please men. Let's say a woman does not want attention from other men besides her husband or has a non-traditional sexual orientation. In this case, she needs weight so that representatives of the stronger sex do not show attention to her.
Having fun. People who do not know how to enjoy food compensate for this with delicious food. She becomes their only joy.
The imaginary goal of losing weight. The process of losing weight can be a continuous meaning of life, without giving any results. A person sticks to diets, and then gains weight again, and so on in a circle.
Psychological protection. Obesity can be a kind of mask or an attempt to escape reality.

Louise Hay's look

Louise Hay believes that the main reason for obesity in the country is the need for protection, lack of self-acceptance and unwillingness to feel for others. She also notes the desire to show off and increased sensitivity. First of all, she advises fighting the fear that being overweight protects against.

Excess weight according to Liz Burbo

Liz Burbo connects the problem with emotional blocks, believing that it is a consequence of childhood humiliation. The layer of fat is a kind of protection from those who insulted. Fat is also characteristic of those who subconsciously want to occupy an important place in society, but at the same time consider this unacceptable. Such conflict leads to overeating. Another reason is a mental block. Fat Lyuli cannot always evaluate themselves objectively, and, according to Liz and Burbo, at the end of each day they need to analyze the events that have occurred that can cause shame.

Sinelnikov's opinion

Valery Sinelnikov claims that excess weight is an expression of fear and the need for protection. The fat layer acts as a shell through which a person hides his feelings from others. Also, in his opinion, he talks about the inability to cope with his experiences and dissatisfaction with himself, even to the point of hatred.

What is the “Chicago Seven” and how relevant is such a classification today?

I don’t really need classifications of psychosomatic disorders in my daily work, and I first learned about the “Chicago Seven” thanks to this question. I read it and was horrified. Can anyone really seriously consider them in the 21st century as “diseases of unreacted emotions”! I will list these seven diseases indicating their true causes:

Arterial hypertension is a disease based on a genetic predisposition, which is caused by dozens of additional factors (smoking, excess weight, salt abuse, physical inactivity, increased sugar and cholesterol levels, and so on). Stress is only one of the risk factors, but far from the main one.
Peptic ulcer of the stomach and duodenum is a disease whose cause was well studied at the end of the 20th century. This is a microorganism called Helicobacter Pylori. Yes, acute “stress” ulcers have been described, but that’s a completely different story.
Inflammatory bowel diseases (ulcerative colitis and Crohn's disease) are a group of inflammatory autoimmune diseases with a genetic predisposition.
Neurodermatitis (atopic dermatitis) is a disease that has a genetic predisposition. A stress factor can only in some cases cause an exacerbation.
Bronchial asthma is a chronic inflammatory disease with a clear genetic predisposition. Sometimes stress can contribute to an exacerbation, and sometimes vice versa - stimulation of the sympathetic nervous system leads to dilation of the bronchi.
Thyrotoxicosis (hyperfunction of the thyroid gland) is a classic autoimmune disease, which is based on the production of antibodies to the tissues of the thyroid gland. Here, would-be psychologists generally confuse cause and effect. Thyrotoxicosis greatly changes a person's character - he becomes whiny, hot-tempered, and nervous. After thyrotoxicosis is cured, mental manifestations completely disappear.
Rheumatoid arthritis is a disease of unknown nature (the connection between genetic and infectious factors is being discussed). However, stress definitely has nothing to do with it.

Part 1 What is psychosomatics?

What is psychosomatics and why has it become so popular in recent years? As it is written in medical reference books, psychosomatics ( other - Greek.

ψυχή - “soul” and σῶμα - “body”) is a direction in medicine and psychology that studies the influence of psychological factors on the occurrence and course of somatic (bodily) ailments. This is important to understand, because in this book we will look at the problem of excess weight from precisely this angle, without breaking away from biology, neurophysiology and physiology, logic and common sense.

Discussions about the connection between soul and body have been going on since time immemorial. In ancient Greek medicine it was understood that the physical and mental are indivisible. Socrates argued that any physical illness is associated with mental pain. His student Plato believed that “a big mistake is made where physical and mental illnesses are treated by different doctors, because the body is inseparable from the soul.”

Hippocrates believed that “the human brain contains within itself the cause of many diseases.” Galen argued that in most of his patients the symptoms were of emotional rather than physical origin: “The mind of man is a special art that can replace all other medicines.” Paracelsus wrote: “Diseases are cured less by physical means and more by spiritual means.”

The founder of the term “psychosomatic” is the doctor Johann Christian Heinroth, who first used it in 1818. Since the beginning of the 20th century, this area of medicine has become widespread. Many geniuses of psychology worked in this field, the most famous of whom was the endlessly controversial, but absolutely brilliant Sigmund Freud. “If we drive some problem through the door, then it comes through the window in the form of a symptom of disease,” he said. That is, a person cannot avoid the disease if he does not solve the problem, but simply ignores it.

Freud's student Wilhelm Reich, no less scandalous for his theories and experiments, also did a lot for the development and popularization of psychosomatics. He believed that each patient should be approached as a whole organism, whose emotional problems can only be understood by viewing him as a whole being - through his physicality. In all his activities, Reich was a courageous and persistent innovator, whose ideas were far ahead of their time and are still relevant today.

Further, the wave of popularization of psychosomatics owes to such a name as Louise Hay with her famous book “You Can Heal Your Life.” In it, the author explains how our beliefs and self-image often cause emotional problems and physical ailments, and how, with the help of certain tools, we can change our thinking and our lives for the better, sharing her story of being healed from cancer. Her philosophy resonated in the hearts of millions of people.

The most recent, daring, but also the most medically substantiated discoveries about psychosomatics belong to Rick Hamer, an oncologist who made them while fighting his own cancer. In short, he discovered and very reasonably proved the connection between the disease and the psychological processes that influence its formation.

All innovators and truly creators are always a little crazy, people out of this world. And this is the norm, because it is impossible to be normal and at the same time create something truly new. Many people hate Freud for his psychoanalysis, call him obsessed with penises and devalue his thoughts, citing the very modest number of patients in his practice. Many biographers consider Reich to be a real psychopath. Louise Hay is accused of falsifying tests and they say that, in general, she never had cancer. Ricky Hamer was jailed for "fraud."

Be that as it may, it doesn't matter. You and I are not given the opportunity to find out how and what really happened. We can only make a choice - either to use the works and achievements of those who came before us, or to ignore them. Whatever the details of the theory of this or that popularizer and researcher of psychosomatics, in general it all comes down to one thing:

Psychosomatics is based on the mechanism of psychological defense.

The human body is a single, holistic, complex self-regulating system. You will find this definition in any anatomy textbook. It is clear that man is far from being a self-contained system. We are surrounded by a great many events, and we somehow react to them. Psychosomatic diseases, including excess weight, are illnesses that are based precisely on this – the body’s reaction to stressful situations.

We often don't analyze problems because we are afraid to look them in the eye and confront them directly. It’s much easier to ignore them and try not to think about unpleasant things. Unfortunately, problems illusorily repressed in this way do not disappear, but simply move to another level, from psychological to physical - they find their place in the body.

Chapter 1 The body in which we live

I really love logic and consistency, especially when it comes to a science like psychology. I propose to move gradually and within the framework of logical sense. And since the book is devoted to the problem of excess weight and it can be directly touched in the body, we’ll start with it.

The human body consists of approximately 40% muscles, there are from 640 to... - the number depends on the development of muscle tissue. When a person smiles, 17 muscles work, during a kiss - about 34 facial muscles, when crying - approximately 40, and while walking - around 200. And you and I don’t really strain ourselves, we don’t even notice how much the body is involved in the work, – everything seems to happen automatically.

There are 206 bones in our body, almost half of which are in the wrists and feet, and about 75 km of nerves. There are about 9,000 taste buds on the tongue. Our eye is capable of distinguishing 130–250 pure color tones and 5–10 million mixed shades. There are about 25,000 cells in the inner ear that respond to sound. The range of frequencies perceived by hearing lies between 16 and 20,000 Hz.

During an average life, the heart beats 3,300,000,000 times - just think about this colossal figure! And the brain generates more electrical impulses per day than all the phones in the world combined.

Our intestines are rightly called our second brain. The food tract reflects any emotions that occur in the brain. When you are seething with indignation, finding yourself in a traffic jam, the brain sends signals to the gastrointestinal tract and facial muscles. They also react sharply to incoming signals. When you are indignant at a rude saleswoman, your stomach begins to contract vigorously, which leads to an increase in the production of hydrochloric acid and a slowdown in the process of removing the omelet you ate for breakfast. This causes the intestines to contract and release mucus and digestive juices. Much the same thing happens when you are anxious or upset.

Digestion is largely controlled by the intraintestinal nervous system, an amazing network of 50 million nerve cells that lines the entire gastrointestinal tract, from the esophagus to the rectum. This “second brain” is smaller than the first, that is, the head, whose weight ranges from 1000 to 2000 g, but it copes brilliantly with everything related to digestion.

Our skin has tactile, temperature and pain receptors. When we're cold, we get goose bumps: the cold causes the tiny muscles at the base of each hair to contract, causing them to rise. This involuntary reflex made the hair of our ancestors more fluffy, trapping a small amount of air close to the skin, which created a warming effect. Hair-raising goosebumps are also a response to threats, which made our ancestors appear larger and scarier.

When we are embarrassed, we blush. Interestingly, blushing is only possible in the presence of other people. In other words, this is a social phenomenon, that is, it manifests itself only in society. Tiny vessels under the skin fill with blood - this reaction cannot be faked, it is absolutely sincere.

We know how to automatically shiver to keep warm. Trembling is caused by frequent, rapid contractions of the muscles of the body. Moving your muscles produces heat, which is why you feel hot after exercising. That is why shivering also helps a person warm up.

When we are hot, we sweat. As water evaporates, it carries away heat with it, and we cool down. In areas where it is both warm and humid, water does not evaporate. It flows down in droplets, and in this case, while sweating, a person hardly cools down.

When we run, we begin to breathe more often to provide our muscles with more oxygen. The heart rate accelerates and body temperature rises.

To get rid of overheating, the body directs blood flow to the skin, and a blush appears on the cheeks. The sweating system is activated. Mama mia, how many processes are included! At the same time, this is not particularly difficult for us - all functions work automatically.

Our body is capable of conceiving a child. Can you imagine how much there is to take into account? Throughout pregnancy, the uterus increases in size and increases its muscle mass (before pregnancy, the weight of the uterus is 50 g, before childbirth - more than 1 kg) and size. The location of internal organs during pregnancy completely changes, adapting to new conditions.

We often treat our body as something given by default, without appreciating the full range of abilities that we have with its help. I sing all these praises to the body in order to show how it is an ideal soldier: systematic, efficient and very smart.

And you know what’s coolest about it is that our body doesn’t know how to lie. It is also incapable of making excuses or dodging. You can read many books and theories, get confused in philosophy three times, but you will not be able to deceive the body.

The body reacts to EVERYTHING.

Chapter 2 The body begins with emotions

Any event in our life has a certain emotional coloring. We create the “color” and “intensity” of the paint ourselves. There is a good expression: “ The quality of life is determined by the quality of the emotions that we experience.”

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Biologically, we need emotions in order to inform others about our needs and views. One of the most important characteristics of the manifestation of feelings is that they have not only a psychological, but also a physiological manifestation - an impulse.

An impulse is an internal urge to do something, an intellectual or emotional push, a stimulus. In physiology, this is a wave of excitation propagating along a nerve fiber. That is, it is a kind of physical tension/irritation, an energy charge that prompts the body to action. Accordingly, if the action is not implemented, the charge has nowhere to go, and it settles somewhere in the body. Suppressing emotional charges over and over again, they accumulate and accumulate inside the body. We carry the accumulated “good” with us for years: in the form of symptoms, chronic diseases, classic psychosomatosis (when the tests are all good, but it still hurts) and, of course, His Majesty’s excess weight.

Every second, dozens of “dialogues” between the brain and internal organs and tissues take place inside the body. This communication process is the most important of all those that support health.

The emotions experienced by the brain are reflected in the functioning of the body, from the cardiovascular and respiratory systems to the functioning of bone and muscle tissue. The reason these “conversations” are important is that the quality of the emotional signal that forms the conscious and subconscious determines what chemical elements can be released into the body and how the body will feel as a result.

When a person feels what is commonly called negative emotions, the conscious mind sends a signal to the brain that reflects the feelings. These emotions manifest themselves irregularly and chaotically, the whole body undergoes a restructuring, it begins to work suppressedly, the metabolism changes.

A fat cell has a relatively simple structure: a nucleus, a membrane, cellular organelles and a large amount of fat. If we simplify the structure of fat as much as possible, it becomes clear that the fat cell consists of 98% water. Science fully confirms this.

When you gain excess weight, fat cells do not divide, but increase in size! Question: why do they suddenly begin to accumulate water?

What is water? Water is a source of information at the level of both the cell, the organism and the macrocosm. Water accumulates certain information materials (energy) in itself like an information storage device, that is, in essence, emotions are the energy of the body.

Don't believe that everything is so “simple”?

You can do a simple experiment. It only takes 4-5 days. Take two identical jars - you can use the ones they give out in clinics for tests. Boil the rice, pour the same amount into jars and close the lid. You can designate one jar with this “J” emoticon, and the second, on the contrary, with another “L”.

You broadcast all the good things to the first jar for 7 days, the second - the bad. Pour all the negativity that you encounter during the experiment onto the second jar. Don't skimp on your words, and you will see how, in the end, the contents of one jar will not change, while the second will become moldy.

Does everyone know about how grandmothers used conspiracies in villages to cure utter illness? Any word is a set of sounds, and sound is vibration. Vibration is a wave that has certain properties that are endowed by its source.

Researchers on this topic have even calculated the frequencies of different human states: grief gives vibrations from 0.1 to 2.0 Hz; fear – from 0.2 to 2.2 Hz; resentment – from 0.6 to 3.3 Hz; irritation – from 0.9 to 3.8 Hz; disturbance – from 0.6 to 1.9 Hz; pride – 3.1 Hz; neglect – 1.5 Hz; superiority - 1.9 Hz, pity - 3 Hz.

If a person lives with positive feelings, then he has completely different vibrations: vibrations of gratitude - 45 Hz; unity with other people – 144 Hz, mercy – from 150 Hz; falling in love - 50 Hz; love – 150 Hz.

A person, as a rule, simultaneously experiences several different psycho-emotional states or their shades.

What frequency do you think your life is on? What emotions do you experience most often? ____________________________________

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Do you understand now why it happens that, eating the same food, the same amount of calories, having the same physical activity and the same parents, one person gets fat, another loses weight, and the third remains the same?

Emotions, feelings and experiences have always been the most curious and darkest, most mysterious place of psychological science. I often come across trainings on managing emotions and practices in the spirit of: “And here you are, all covered in soap, with one little baby on one arm, a second one hanging on the other, your husband calls and says that he is wildly hungry and asks you to cook dinner. And you have zero in the refrigerator, everyone around you is screaming, and even the cat treacherously lets out a pitiful “meow.” And then you imagine how a magical treasure sword cuts your heavy shackles, you exhale - comb your hair, go to the store and cook his favorite steak with sauce from...” Yeah! 10 times!

A person either progresses or degenerates. There is no third. If nothing happens to him, he is dead. It's the same with emotions: either you express them or they settle in the body.

As a rule, if you ask a person about what emotions he experiences, he will immediately name at most five: joy, anger, sadness, delight, despondency... And then he will hang. Meanwhile, there are many different human emotions - about 160. I won’t dump this ton on you, don’t be afraid. I suggest starting to deal with the main ones: studying them in yourself and noting them.

I will give you an interesting task that will help you learn to notice, track and analyze your emotions and their impact on your appetite and weight. It's called "Diary of Emotions." Try to track your emotions and their connection with your general state for at least a week, then your eyes will open to a lot.

Sample

My team of psychologists and I regularly conduct an online project called “It’s not about the food” (you can read more about it on my Instagram @nataly.otvet). There, in the form of video lessons, participants undergo therapy to work with excess weight. Meditation on working with the “inner child” is also included in the project. With the permission of the participants, I share with you their feelings and thoughts. I think for many it will be very therapeutic, because nothing helps as much as understanding that you are not alone with your misfortune.

From messages from participants in the course “It’s not about the food”

“I have tracked that the emotions that I begin to eat are rage, anger, injustice, boredom and everything that is not my way! Amazing! I never would have guessed, I never made the connection. I’m starting to work - I’ve already growled with my daughter. Super cool idea."

“I realized that I usually eat boredom, anxiety, resentment, anger, aggression. But I can’t say that I eat emotions very often. Sometimes I just don’t have time to do it, I swallow everything and move on. But sometimes you still want to either get a chocolate bar out of the nightstand, or, more likely, find ten minutes to go to the refrigerator and make a sausage sandwich. While a chocolate bar can last a long time and lasts for a week, it’s not so easy with sausage. I even have a favorite phrase: “No sausage in the refrigerator means no food.” By the way, constantly, when I feel aggression and anger, my hands and lips begin to shake. And sometimes I just run away, slamming the door, and tears involuntarily flow in a stream. The reason could be simply an argument with a colleague, or something more serious. Thank you, Natalie! I’m learning to talk about what I feel - I feel how it REALLY affects my appetite!”

“I seem to be an outwardly emotional person, a choleric person. I am very happy and very sad. But I can’t demonstrate my other emotions to other people. It seems to me that others don’t care about my emotions. Yes, this is education. And I’m afraid of offending my husband with some of my negative emotions. I hate heart-to-heart conversations. I avoid problems in every possible way and always pretend that everything is fine. Hence the psychosomatics, I know. The most common emotion that is consumed is anxiety. Boredom and joyful excitement too, and it seems to me that any emotional excitement in general. Thank you, Natalie! I have already begun, in small steps, to move towards revealing myself, my emotional shell.”

Perhaps before you even finish reading the first chapter, you are already beginning to feel a huge amount of resistance. Remember: everything has its time. And perhaps now is such a period - let it be. Maybe you'll come back to this book later. Or maybe never – it’s a choice. I am a rationalizer myself, and it took me a long time to learn to understand that you don’t have to know some points, you can just feel, feel, and on this simple basis it will be true

How are psychosomatic disorders diagnosed?

Patients with psychosomatic disorders can visit doctors of any specialty. For some, illnesses manifest as unmotivated shortness of breath and palpitations, for others, nausea, vomiting and diarrhea, and for others, pain syndromes.

— The main diagnostic criterion is examination, often repeated, which does not detect any signs of an organic disease. It is this fact that should suggest the need for consultation with a psychiatrist or psychotherapist.

The basis of diagnosis is a conversation with the patient. Just based on how the patient presents his complaints, one can think about the presence of psychosomatic disorders. If the doctor has sufficient time to clarify the circumstances associated with the onset or exacerbation of the disease, if he finds accurate words to clarify psychotraumatic situations, then the picture of the disease will begin to emerge. As I already said, the dissociation between complaints and the absence of organic pathology is an important argument in favor of “psychosomatics”. Of course, a reasonable amount of additional examination is always necessary, but it should not be excessive.

Let me give you an example of one of the classic psychosomatic diseases - irritable bowel syndrome (IBS). In Russia, they believe that in order to establish a diagnosis, it is necessary to do a colonoscopy - a difficult and expensive endoscopic examination of the large intestine. All over the world they think differently. If long-term symptoms of intestinal discomfort (diarrhea or constipation, bloating, etc.) are not accompanied by the presence of so-called “red flags” (weight loss, blood in the stool, inflammatory changes in blood tests, late age of onset of the disease and the presence of cancer in close relatives ), then there is no point in tormenting the patient with such a difficult procedure as a colonoscopy - the diagnosis of IBS is very likely. How many years pass from a patient presenting with a psychosomatic disorder to receiving a correct diagnosis? It's not always the same. It seems to me that if you build communication with the patient correctly, it is not at all difficult. But we are well trained for this. The fact is that our now deceased teacher, former director of the First Medical Faculty Therapy Clinic (now Sechenov University), Professor V.I. Makolkin, paid great attention to the study of psychosomatic pathology, as a result of which a small psychosomatic center was actually created on the basis of the clinic. The clinic staff are quite well versed in this kind of pathology, in addition, we are supported by a team of several psychiatrists. Sometimes it happens that years pass from the onset of the disease to receiving professional help. It's difficult to say what this is connected with. Most likely, because colleagues “do not see” psychosomatics or are embarrassed to send patients to a psychiatrist, fearing that the patients will misunderstand them.

Excess weight in different parts of the body and psychosomatics: table

According to experts, in which parts the weight is deposited can tell in more detail about the psychosomatic reason for this.

Double chin	Understatement, inability to express thoughts, some kind of protective barrier.
Shoulders and arms	Increased care, guardianship, responsibility, unhappy love or dislike for oneself, the constant need to receive approval from the outside.
Fat hump on the back and deposits on the neck	Such deposits are called a wine hump. They say that a person feels sin, considers himself very guilty of something.
Back and shoulders	Rolls and folds in these areas indicate feelings of guilt, lack of protection, and the inability to let go of past events. It may also indicate increased responsibility for others.
Waist and belly	The psychosomatics of excess weight in women on the stomach has to do with non-acceptance of the feminine principle. A fuzzy waist line speaks of a fear of being weak and showing femininity. A big belly can be a way to relieve fear, worry and worry. Here it also makes sense to talk about indecisiveness and problems in communicating with the opposite sex.
Legs and buttocks	If everything unnecessary is concentrated in the lower part, we can talk about overprotection. It could also be anger at parents for being too protective, fears and grievances from childhood, or a reluctance to grow up. This also includes problems in the sexual sphere.
Breeches	It is considered a site of pointless accumulation. The more a person accumulates in himself what he does not need, the larger the area of breeches.
Buttocks	If they are full and loose, this indicates a fear of change and fears, empty promises, stubbornness, and self-centeredness.

How to treat psychosomatics?

It all depends on the situation; The concept of “psychosomatic disorders” is too broad. In mild cases, specific treatment is not required at all; a detailed conversation between the doctor and the patient and an explanation of the essence of what is happening is sufficient. The fact is that sometimes the patient is worried not so much by the symptoms themselves as by the unknown and suspicion of serious organic diseases. If you explain that behind the “feeling of incomplete inspiration” or “tingling in the heart” there are no organic diseases of the heart and lungs, this will be quite satisfactory for many patients.

In some cases, an internist (therapist, cardiologist, gastroenterologist and others) can independently prescribe psychotropic therapy, if, of course, he knows how to do this. For example, a qualified gastroenterologist can and should himself prescribe antidepressants to patients with functional diseases of the gastrointestinal tract, without resorting to the help of psychiatrists. Why do gastroenterology patients need antidepressants? They are needed to break the pathological connection between signals in the brain and symptoms from the gastrointestinal tract. By the way, antidepressants have long ceased to be specific drugs for the treatment of depression. They are also successfully used in the treatment of certain pain syndromes.

If the internist feels that the patient needs serious combination therapy, then it is better to involve a psychiatrist in the treatment, since psychopharmacology is quite complex and the arsenal of drugs is diverse. It is advisable to consult not just with a psychiatrist from the district dispensary, but with a specialist who has experience working specifically with psychosomatic patients.

Psychotherapy (that is, talking therapy) can be very helpful for many patients with psychosomatic disorders. There are only two disadvantages: it is expensive and takes a long time. A contraindication to psychotherapy is symptoms of a “major” mental illness (delusional disorders, hallucinations), however, this already goes beyond the scope of the “psychosomatics” topic.

But what the patient definitely does not need is the appearance of treatment using dummies: vitamins, “restorative”, “metabolic”, “vascular” drugs and so on.

Interpretation by Louise Hay

According to Louise Hay, the main causes of excess weight and obesity lie in the following:

a variety of fears;
strong need for protection;
denial of your feelings and yourself;
suppression of any desires that may hurt self-esteem (that is, almost everything);
suppressed anger.

Every person needs protection, but overweight people do not have it. The invisible shell of confidence in one's own safety is formed in early childhood. This is a barely perceptible and yet quite strong feeling “I am always safe”: my parents will take care of me, I am always able to help myself, I have a roof over my head, arms, legs.

It seems so natural, and yet fat people don't feel it. Anxiety and tension always bleed in their subconscious, they force them to be in a state of endless stress - no one will ever help, no one will protect, no one will come to the rescue.

The feeling of security is instinctive, deep. If it is not there, it is difficult to build a happy life. But you should not look for protection from the outside, you need to look for it within. You must believe in your own strength, that you will always take care of yourself, always create an invisible protective dome for yourself and a pleasant development of the event. Cultivate this in yourself.

What is mental hygiene and how can it help?

Perhaps mental hygiene can be a way to prevent such disorders, although it is not so simple. Here again it is appropriate to recall the theory of “sanogenic thinking” by Yu. M. Orlov. On my own behalf, I will add four positions that I try to follow myself (more about this in my book “Heart and Vascular Health”):

limit negative information flow. Don't let the TV run in the background. It’s better to play recorded music or favorite movies;
separate work from home. Get two phone numbers - for home and for work calls, turn off your work mobile phone at home, on weekends and on vacation;
think about the most difficult event in your life. Maybe everything else isn't worth going crazy?
The best way to get rid of accumulated fatigue and irritation is physical activity.

And one last thing. If you feel that something in life is going completely wrong and you can’t get out on your own, do not hesitate to contact specialists in the field of psychiatry and psychotherapy. Modern psychiatry has come a long way compared to the classic image of it in the movie One Flew Over the Cuckoo's Nest.

If you want to competently use all the possibilities of modern medicine, and also not become a victim of questionable treatment and excessive diagnostics, books from the course of the “Dr. Rodionov Academy” will help you. All the authors of the series are not only practicing doctors and specialists, but also our permanent experts (for which we thank them very much).

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Link to publication: the-challenger.ru