Release date: 2005-0 1-22 Author: Morita Shoma Source: Network Psychological Counseling-Psychological Testing-Mental Health-Psychology -QQ Counseling-Five Elements Learning This page has been accessed 1373 times.
Field therapy
Psychotherapy was founded by Professor Morita Shoma of Japanese Cihui Medical University on 1920, which is a natural and proper psychotherapy method. For decades, with the continuous development and improvement of Morita's successors, it has become an effective and practical psychotherapy with obvious oriental color and international recognition. People with neurotic tendencies have a strong desire for survival, strong introspection and pay attention to their own life safety. When they focus too much on some internal discomfort, these discomfort will become more and more serious, forming a vicious circle. Morita therapy is to break this spiritual interaction, coordinate the antagonistic relationship between desire and depression, and advocate conforming to nature and doing whatever you want.
Morita therapy is mainly used to treat psychosomatic diseases such as neurosis and autonomic nervous disorder. Morita has a unique view on the pathogenesis of neurosis. He believes that the basis of neurosis is neuroticism, which is characterized by introversion, internal strength and labor saving, hypochondriac tendency, abnormal sensitivity to psychosomatic activities, excessive concern and worry about one's psychosomatic health. Strong desire for survival and perfection. They often regard people's normal physiological reaction or slight discomfort as pathological, mental stress and anxiety, which will lead to illness and a vicious circle of body and mind over time. Make the condition worse. Morita Shoma believes that "neuroticism" is purely a subjective problem, not an objective product. It is the hypochondriac nature of patients caused by mental interaction in the process of mental activity. In other words, hypochondria is the basis of neurosis such as neurasthenia, obsessive-compulsive disorder, anxiety attack and various phobias. People with hypochondriac characteristics have a strong desire from the bottom up, hoping for health, happiness and hard work, but they also have a strong energy savings, and often worry about their health and life safety. They often mistake the feelings that ordinary people may have on certain occasions, such as dizziness when they use their brains too much and palpitations when they are nervous, for fear and nervousness caused by illness. The more you focus on these "symptoms", the sharper you feel and the more serious the "symptoms", forming a vicious circle, which Morita calls spiritual interaction. Under its influence, patients fall into a state of inner conflict, resulting in neurasthenia and neurosis. Morita himself was sickly since childhood and had obvious neurosis symptoms. /kloc-I still peed when I was 0/2 years old. /kloc-After 0/6 years old, I often have headaches, rapid heartbeat, fatigue and other neurasthenia symptoms. When he was in middle school, he thought about typhoid fever. Although many people seek medical treatment and insist on treatment, they have little effect and have been worried about their health. It was not until the first year of college that he was tortured by symptoms and it was difficult to persist in his studies. The exam is coming, and he feels unbearable. Depressed and angry, he had the idea of suicide, so he gave up all treatment and studied hard all night. The result was unexpected: the test score was very good, and the symptoms that had been entangled for many years were cured without treatment. From this, he realized that the previous diseases were all imaginary and there was no disease at all. Therefore, Morita Shoma believes that neurosis caused by nervousness can cut off the vicious circle between body and mind by "letting nature take its course", and guide patients to change their anxiety attitude of paying too much attention to diseases into indifference attitude of "letting nature take its course", so that their emotions can be relaxed naturally and all kinds of bad emotions can be eliminated by themselves until they recover.
Morita also believes that people's psychological activities also have antagonistic effects similar to the mutual adjustment of flexors and extensors. For example, an idea, emotion and intention produced in a certain situation will also produce the opposite idea, emotion and intention to regulate people's behavior. Morita called it spiritual confrontation. For example, don't be afraid when fear often appears; Feeling guilty when praised; When you have disrespectful thoughts about a person, you will think that this idea is wrong and deny it. It will bring misfortune if you say it. Don't think about it. The existence of this opposition can ensure people's spiritual stability and constant sense of security. Therefore, any normal person will have ideas that are inconsistent with his own rationality, but he will pass without leaving a trace. And those hypochondriacs have a strong antagonistic effect. Once they appear, they will stubbornly repeat these concepts and control them repeatedly at the same time, forming antagonistic opposition.
Through spiritual interaction, obsessive-compulsive disorder is produced. In addition, Morita believes that people with hypochondriac characteristics are "perfectionists". They often form "ideological contradictions" between desire and reality, between "it should be so" and "it has always been so", and try to solve some contradictions that cannot be solved in reality, and take a subjective attitude towards objective reality, making the symptoms more and more serious.
(1) General nervousness: neurasthenia, including insomnia, headache, heavy head, unconsciousness, paresthesia, excitability, fatigue, mental retardation, fatigue, gastrointestinal neurosis, inferiority complex, unnecessary anxiety, sexual dysfunction, dizziness, writing spasm, tinnitus, tremor, hypomnesia, inattention, etc. (2) Obsessive-compulsive disorder (including phobia): including social phobia (blushing phobia, staring phobia, self-expression phobia, etc. ), impurity phobia, disease phobia, disability phobia, school phobia, acute phobia, height phobia, distraction phobia, etc. (3) Episodic neuroticism: palpitation attack, anxiety attack, dyspnea, etc.
Morita therapy expert Gao Liangwujiu believes that Morita therapy cannot cure all neurosis, and only nervousness is the real indication of Morita therapy. Thus, the formation mechanism of Morita therapy on neurosis symptoms can be summarized as follows: due to the existence of hypochondriacs, under the influence of accidental events, neurosis symptoms are formed through mental interaction. The root of neurosis symptoms lies in the strengthening of spiritual opposition caused by the desire to control objective facts with subjective desire.
According to the above theory, Morita put forward the principles and methods of targeted treatment. The focus of treatment is to cultivate the quality of hypochondriasis, break spiritual interaction and eliminate ideological contradictions. The treatment principle can be summarized as two points:
1. The therapeutic principle of "conforming to nature". Morita believes that to achieve the purpose of treatment, reasoning is futile. Just like you know intellectually that there are no ghosts, but you will still feel scared when you walk through the cemetery at night. It is impossible to understand only intellectually, and only emotional experience can change it. However, people's emotional changes have their own laws. The more they pay attention to, the stronger their emotions will be. Leave it alone, but gradually fade away; Accustomed to the same feeling, the emotion becomes dull; If you don't comfort the patient's depression and worry and let it develop to its peak, you will no longer feel depressed and worried. Therefore, patients are required to admit the reality of symptoms first, not to change them forcibly, and let nature take its course.
What does it mean to let nature take its course? Morita regards it as an "epiphany" state of Buddhism. The so-called "epiphany" is to let patients know and experience their place in nature and experience common things that they can't control, but they are very resistant to it, and as a result, they fall into a whirlpool of nervousness. This is consistent with the fourth and fifth rules mentioned above, that is, by focusing on the emotions that disgust him and constantly suppressing this emotion, he will be strengthened. After repeated times, he will cultivate his own experience of extreme fear of people, and this process violates the first and second rules mentioned above. Therefore, in order to change this situation, it is necessary for patients to understand the law of emotional activities, accept their own fears of emotions, not suppress and reject them, and let them die, and cultivate a positive and healthy emotional experience through their own continuous efforts.
(2) We should recognize the laws of spiritual activities and accept all kinds of ideas that may appear. Neurotic patients often subjectively think that they can only have one idea but not another, which is abnormal or immoral, that is, the extreme desire for perfection has caused a strong sense of inferiority. To change this, we have to accept the fact that people are not sages, that each of us may have evil thoughts, jealousy and narrow-mindedness, and realize that this is an inevitable thing in people's spiritual activities, which cannot be changed and decided by reason and will; But whether or not to do irrational things is entirely up to one person to decide. Therefore, you don't need to struggle with your own thoughts, but pay attention to your own actions. At the same time, we should also recognize the antagonistic role of the spirit, psychologically give up the resistance to opposing ideas, realize that people have two opposing psychological phenomena, namely, the desire for life and the fear of death, and accept this psychological phenomenon without having to be afraid of the horror of death or get rid of these frightening thoughts, thus plunging themselves into fierce mental conflicts.
(3) To understand the law of the formation and development of symptoms and accept symptoms. The neurosis patient didn't have any physical and mental abnormalities originally, just because he had hypochondriac characteristics, regarded a normal feeling as abnormal, and wanted to reject and control this feeling, thus fixing his attention on this feeling, which led to the mutual reinforcement of attention and feeling, that is, the formation of spiritual interaction. This is a vicious circle, which is the main reason for the formation and continuation of symptoms. Recognizing this and adopting an attitude towards your symptoms will not strengthen your subjective feelings about the symptoms. On the other hand, because I no longer reject this feeling, I gradually let my attention no longer be fixed on the symptoms. Breaking mental interaction in this way can alleviate symptoms until they are eliminated. For example, when people are afraid of blushing, the more they pay attention to their expressions, the more nervous they are, the more they will continue to feel blushing. On the contrary, accepting the symptoms of blushing and interacting with people with a "blushing" attitude will make them stop paying attention to this feeling, thus gradually diluting the blushing reaction.
(4) Understand the relationship between subjective and objective, and accept the objective laws of things. The reason why people suffer from neuroticism is that hypochondriasis is the basis of symptom formation, and spiritual interaction is the cause of symptom formation, and its root lies in people's ideological contradictions. The characteristic of this ideological contradiction is that subjective imagination replaces objective facts to "reasonably" limit one's thoughts, feelings and behaviors. Morita pointed out: "How can people get rid of ideological contradictions? In a word, we should give up the futile artificial strategy and obey nature. Trying to control your emotions at will by artificial means is like trying to make chicken feathers fly to the sky and the river cut off. Not only can't you get what you want, but it will only increase your troubles. This is beyond our power, and it is of course painful to do. However, what is nature? Hot summer and cold winter are natural laws. It is a clumsy strategy to make summer not hot and winter not cold, and do the opposite. According to the laws of nature, obedience and patience are natural. " In view of the ideological contradiction, Morita put forward the view that "fact is truth", that is, "fact is truth", and took it as his motto. He said: "We should not mistake emotions or imagination for facts to deceive ourselves. Because whether you agree or not, the facts are unshakable. Facts are facts, so people must admit facts. Recognizing one's spiritual essence is self-awareness; It is the truth to confirm it to the outside world truthfully. " Only by making people's subjective thoughts conform to the laws of objective things can we jump out of the strange circle of ideological contradictions.
2. The treatment principle of "follow one's inclinations". Morita therapy divides things related to people into two categories: controllable things and uncontrollable things. The so-called controllable things refer to things that individuals can adjust and change through their own subjective will; And uncontrollable things refer to things that are not determined by people's subjective will.
Morita therapy requires neurotic patients to learn to adapt to nature and not to control uncontrollable things, such as people's emotions. But we should still pay attention to what we do, that is, control those things that can be controlled, such as human actions. That is, "follow one's inclinations" refers to actions guided by the attitude of conforming to nature, which is the enrichment of conforming to the principle of natural therapy.
Endure the pain and do what you want. Morita therapy believes that to change the symptoms of patients, on the one hand, we should adopt a natural attitude towards symptoms, on the other hand, we should do what we should do with our original desire for life. Usually, symptoms do not disappear immediately. When the symptoms still exist, accept the pain, and put your attention and energy into what you should do in life that is meaningful and can see the results. Focusing on action, regardless of the ups and downs of symptoms, will help to break the psychological interaction and gradually build confidence to get rid of symptoms. For example, people who are afraid of people are afraid of meeting people, and they feel extremely scared when they meet people. Morita therapy requires him to live with symptoms, and it doesn't matter if he is afraid of meeting people, but the people he should meet should still meet, communicate with people with fear and pay attention to what he wants to do. In this way, patients themselves will find that there is no need to try their best to eliminate symptoms and wait until the symptoms no longer exist before contacting people. Before, he was worried that he couldn't do it, because his mind was always thinking. And "doing what you want to do" requires patients to do what they should do immediately, even if they have to persist in pain, breaking the past pattern of mental bondage.
Face reality and cultivate character. Morita therapy expert Gao Wu pointed out long ago: "People's behavior generally affects their personality. There is no denying that a certain personality will lead them to do something, but only this aspect is one-sided understanding. We can't forget the objective fact that' our actions will make our character'. It is this that is the fundamental reason why neuroticism can be cultivated. "
The mental conflict of neurosis patients often stays in the patient's subjective world. They think and think about things that cause their fear and anxiety, and fight and fight, but in real life, they take an evasive and perfunctory attitude towards things that cause their pain. In fact, it is impossible to get rid of the anxiety of neurosis symptoms only by the efforts of personal subjective will. Only through practical actions can their thinking become more practical and profound. Practical action is the most direct catalyst to improve the adaptability to real life. In this regard, Gao Wu said for a long time that he wanted to learn to swim, and he would never learn to swim unless he jumped into the water. Even if you can't swim at all, you can completely jump into the water and gradually learn the necessary skills. Similarly, neurotic patients will do it under the guidance of others no matter how painful they are, so that they can gain a confident experience unconsciously. If you want to meet people without fear, you can only keep in touch with people and adopt a natural attitude in actual contact, so as to reduce your fear and gradually gain self-confidence. As mentioned earlier, "follow one's inclinations" can help to improve symptoms. One of the most important things is to pay attention to what you do when you lead mental energy to the outside world in real life, which reduces the mental energy that points to your body and mind. The actual contact with the outside world helps patients understand the subjective fiction of their symptoms. This process is actually a process of making some changes in introverted personality.
"Do whatever you want" under the guidance of the attitude of conforming to nature is helpful to cultivate neurotic character. This cultivation is not a complete change, but a sublation of different parts of his personality. That is, carry forward the advantages of neurotic personality; Seriously and diligently. Have a sense of responsibility, etc. And abandon the pathogenic factors in neurotic personality: neurotic extreme introspection and desire for perfection.
It can be seen that conforming to nature is neither passive tolerance and inaction for symptoms, nor laissez-faire for symptoms, but acting according to the original law of things, existing with symptoms, not resisting rejection, and living actively with symptoms. The key point of the principle of conforming to nature and acting according to one's ability is to break spiritual interaction, eliminate ideological contradictions and cultivate character. The principle of this dynamic therapy also reflects Morita's view on the relationship between will, sexiness, action and emotion, that is, will can not change people's emotions, but will can change people's behavior; Change one's mood and cultivate one's character by changing one's behavior.
Morita therapy can be divided into inpatient treatment and outpatient treatment. Whether it is hospitalization or outpatient treatment, we should pay attention to those patients who are not only neurotic, but also have some symptoms of self-reflection and are working hard and have a strong desire to get rid of them. Morita therapy is not suitable if there are only some symptoms and there is no strong motivation to seek medical treatment.
1. Hospitalization. After determining the indications and indications, it is necessary to explain the nature of the disease to patients, introduce them to the theory of neuroticism and pathology, tell them that there is no serious disease, and eliminate their unnecessary worries. The hospitalization process is divided into four stages:
(1) Absolute bed rest period. Usually 4-7 days. Patients live in a room alone, and are not allowed to get out of bed except for eating and going to the toilet. No visiting, talking, smoking, reading or writing. During this period, patients will naturally have all kinds of thoughts, especially all kinds of troubles and depression about the disease, which may temporarily aggravate, make the pain unbearable and doubt the treatment. A few patients even asked to stop treatment and leave the hospital. When the patient thinks about all his troubles, there is nothing to think about and he will feel bored. So the first issue is also called boring period. After that, the patient naturally asked to get out of bed and do something, and then entered the second stage.
(2) light working period. 4-7 days. Reading and communication are still prohibited. Stay in bed for 7-8 hours every day, and you can go outdoors during the day. For example, simple and monotonous work such as sweeping the yard and cleaning the glass can be done outdoors, and activities such as calligraphy, painting and sticking paper bags can be done indoors. Generally speaking, starting from the third day, the workload of patients can be gradually relaxed, and patients are required to start writing diaries, instead of writing questions about diseases, only writing what they have done and learned in one day. The healer checks diaries and comments every day to guide patients to avoid paying attention to their illness and care about outside activities.
(3) emphasize the working period. Usually 4-7 days. It is forbidden to receive visitors and entertain, and to participate in heavy manual labor, such as weeding, helping the kitchen, cleaning the environment, doing housework, carpentry and manual labor. At this stage, patients can read books, mainly books about neurosis written by Morita, as well as history, biographies and popular science books. And ask patients to write a treatment diary every night. The patient works with other patients in the hospital and doesn't talk about his illness. The purpose of this stage is to let patients experience the joy after completing their work and cultivate their endurance through hard work. In this process, learn to ignore symptoms and further transfer the energy of mental activities to the outside world.
(4) The tempering period of life is also called the preparation period for returning to society. General 1-2 weeks.
During this period, it is necessary to prepare patients for discharge, guide them to return to their original social environment and restore their original social roles. During this period, according to the specific situation of patients, they are allowed to return to their original units during the day, or participate in some complicated social activities such as hospital management. No matter what kind of activities you participate in, you are required to go back to the ward to write a diary every night. Its purpose is to make patients further experience the principle of conforming to nature in work, interpersonal communication and social practice, and prepare for returning to society.
The above periods are descriptions of general treatment. For each specific patient, the treatment process should be decided according to his situation. Therefore, the treatment period varies from about three weeks to 60-70 days, with an average period of 40-50 days.
The purpose of hospitalization is to let patients have a practical experience of the natural flow and evolution of the spirit, to eliminate previous assumptions and misunderstandings about the disease, and to achieve a psychological state of "natural flow, nowhere to live". Therefore, it is very important not to explain the psychological state that may be revealed during bed rest to patients in advance. Because if patients know in advance that they will feel bored and pessimistic during this period, they will adopt the expected attitude and the natural flow of psychology will be distorted. Of course, before hospitalization, the therapist should let the patient have a general understanding of Morita's hospitalization process before the patient can make a decision on whether to be hospitalized. The stronger the patient's desire for treatment, the better the treatment.
2. Outpatient treatment. Outpatient treatment must still follow the basic principles of Morita therapy. However, because outpatient treatment does not have a specific environment for hospitalization, it cannot be treated by lying in bed, so it has different characteristics from hospitalization.
Outpatient treatment is mainly carried out through one-on-one conversation between doctors and patients, usually once or twice a week. Therapists should pay attention to patients' emotions and establish a good therapeutic relationship. On the basis of mastering the patient's life history, the therapist should try to understand the patient's actual situation as much as possible, do not take symptoms as the main content of discussion, encourage patients to face real life, give up their neurotic attitude of resisting symptoms, realize that things are not transferred by their own subjective wishes, accept the true colors of symptoms without trying to control them, and symptoms will change. Finally, encourage patients to take responsibility for their own lives. In the treatment, the therapist should stimulate the patient's understanding of the problem by asking questions, rather than using persuasion too much. The key to treatment is to help patients understand the principle of adapting to nature.
The key points of outpatient treatment are:
(1) Carry out detailed physical examination to eliminate the possibility of serious physical illness and eliminate the worries of patients;
(2) instruct patients to accept symptoms, and don't try to reject them;
(3) Tell patients not to talk about symptoms to relatives and friends, and also tell relatives and friends not to listen or answer their complaints;
Chinese scholars treated 16 patients with neuropathy by outpatient treatment, and achieved good results. The specific method is 30 to 60 minutes for the initial visit, 5 to 30 minutes for the follow-up visit/kloc-0, once a week in the first month, and then two weeks 1. The main treatment methods are oral instruction and diary annotation. First, guide patients to understand the relationship between their symptoms and personality characteristics, inform the related factors that form symptoms, ask patients to write their understanding and experience in a diary, and ask patients to use two diaries. The healer will annotate the problems exposed in the patient's last diary during the follow-up visit, and on this basis, give oral guidance and put forward the next request. At the same time, patients are required to read the relevant materials of Morita theory. Experts believe that because in outpatient treatment, the therapist can't personally observe the daily life and behavior of the patient, so it is the central link of treatment to let the patient keep a diary and guide the patient through the notes in the diary. Therapists should pay special attention to the following points in treatment guidance: first, treatment should always focus on the patient's personality problems, don't dwell on his symptoms, let him ignore them, and let him be indifferent naturally; Secondly, under the condition that patients know the main points of treatment, they are required to experience it consciously in life practice.
indicate
Neuroticism, obsessive-compulsive disorder, hypochondria, anxiety, depressive neurosis.
The basic task of psychotherapy is not only to eliminate patients' distress, but also to help patients grow up. To be a real person, we should know more about human nature, and also help others to know their own human nature, which is very useful for removing their mental pain. Psychotherapy is to help patients understand their own humanity, accept the reality, and make patients feel satisfied with life. In order to achieve satisfaction with life, they must live a realistic life in a realistic way, and the result will be happiness. This is the true meaning of psychotherapy and life. Psychotherapy is basically to help a person live a real life.