Rus Articles Journal

Neurosis of the excellent student. Part 1

In the last, most modern international classification of diseases (MKB - 10) neurosis as a separate disease or group of diseases will not be allocated in general. Only the name of wide group of frustration, obscure for profane persons, - “the neurotic, connected with a stress and somatoformny frustration“ remained. However, despite all innovations of physicians, the extensive group of sufferers still exists, and practical doctors (generally certainly, neuropathologists) still widely use the diagnosis of neurosis. So it it?

- It is absolutely awful! That is I want to tell that it absolutely awfully looks! - sadly, but the young, well dressed woman vigorously told. She sat on a chair, pressing to herself expensive bag from good skin and fingered - touched her long belt.

her daughter with a fantastic name Vasilisa sat in a chair opposite to me. At the girl was pleasant, not - how many the simple person, the large correct lines, a strong figure and strong legs which are hardly fitted by white tights. On Vasilis there was also heavy wide dress from darkly - a green velvet with a white lacy collar and lacy cuffs. Both the collar, and cuffs looked hardly starched. Above all Vasilisa reminded the Tsarevna who just passed transformation - a frog in whom something clearly frog still remained.

Vasilisa`s Mother told

simply, without excessive exaltation, but with the emotions going to business exactly as, in general, and has to build the story intellectually and emotionally full-fledged person. It was pleasant to listen to it though the story subject, it seems, did not dispose to that. The daughter listened very attentively, did not afford any remarks and even gestures. Though it was talked of it.

- Before school I was engaged with Vasilisa much. I just then lost work and time at me was enough. In general she is very capable girl, learned to read and consider very much early, and wanted to go to school in previous year. But I was against as by it then only - only six years were executed. Why to overload the child - so I then thought. Vasilisa went to school in seven years as all children. We chose school good, passed Vasilis`s test easily. However, I was very much surprised then by its reaction. She so was nervous as though decided goodness knows what. I calmed her, said that all these tasks for it just fie (so it actually also appeared) that, eventually, on this exactly to school there are other fish in the sea, and in the city five hundred more schools, many of which are even better than this, but she as if did not hear me. I speak about it because, maybe, it is important for understanding of what occurs today.

- I vigorously nodded because it validly was important. - And so, she as though did not hear me and heard only what occurs somewhere there, in it. But then everything somehow managed, that is did not manage even, and came to an end very well, all very much praised Vasilisa and enlisted in the best “and“ a class.

She from the very beginning studied very well, but we and expected. Really - the girl capable, prepared, accurate - why is not present? The teacher often held up Vasilisa as an example to other children, but you do not think that my daughter from it put on airs or still something. Vasilisa very responsible girl, she understood that if it is held up as an example, then it is necessary to study even better. And it is always ready to help others if it is necessary. Except study, in its class public life proceeds very active as it was called earlier. They put performances, prepare for different holidays, issue the wall newspaper. Vasilisa took active part in all this, sometimes something drew houses, learned, sometimes was late at school. I was not against because it seemed to me that it is useful for the general development. Perhaps, it was the overload? But many children study at school and at the same time visit several circles, and nothing happens to them. And Vasilisa did not visit any circles. I do not know.

the First class of Vasilis finished

on one five, the best schoolgirl in a class. For the summer with the grandmother went on the dacha. There bathed, sunbathed, went to the wood, ate berries and fruit - the word, had a rest. And when arrived to the city, and again went to school, at the end of the first quarter - began...

- How exactly it began? From what?

- Yes in that is continually that from anything. The night before everything was good. Vasilisa came from school happy, received three five, told that they will put a new performance and Veronika Ivanovnaobeshchala to it a leading role, normally made lessons (sometimes she sits late, but this day vsebylo quickly enough), has supper, went to bed. In the morning too everything was normal. Rose, did exercises, washed, sat down to breakfast. Did not manage to eat porridge as suddenly - vomiting. We awfully were frightened, about school, certainly, there could not be also a speech. Called the doctor. The doctor came, examined, rumpled a stomach, told:“ Everything is normal, there is no surgery, maybe, overfatigue from school. Make just in case tests and drink vitamins“. And she ate all summer these vitamins with centners. And I am not a doctor, of course, but what overfatigue from school in the first quarter can be? We, of course, right there made tests. Everything is normal. Every other day - again vomiting. Yes what! And again in the morning. Then - in the evening. Also went. Vasilisa pale as cloth. Tries to calm me, but it is visible that it is frightened very much. Still!

Here and we live the second month. Were examined already by all possible experts. Found noise in heart and flat-footedness. You understand that neither that nor another has no relation to our symptoms. And it will calm down, again. We do not know what to do. Here, advised to address you.

- whether Correctly I understood that Vasilisa on character was always an accurate and responsible girl?

- Yes, yes. She will not go to bed until she learns all lessons. And to adjust it as other children, are not necessary at all. In total.

- And you abuse Vasilisa for the two?

- And I never had two, - Vasilisa for the first time gave a vote.

- And if were how you think, mother would begin to swear?

- I think that I am not present, - having honestly thought, Vasilisa told.

- Call, please, the most hooligan act which you made in the life. Well, broke glass there or enclosed the button on a chair to the teacher...

- I never had such acts as you speak. Therefore I cannot tell... Once I incidentally broke a grandmother`s glass when wiped it with a towel.

- the Grandmother very much swore?

- Is not present

, she did not swear at all. On the contrary, it consoled me because I very much cried. The glass was very beautiful, I grudged it.

- Tell, Vasilisa, and you dream dreams?

- Yes, of course.

- And nightmares among them happen? Well that somebody pursues you, you where - nibud fall or on you something falls and so on...

- Is not present

, I do not remember it. Happens only that I did not manage to make something to school or left a notebook at home. Veronika Ivanovna speaks:“ Children, open notebooks“. I climb in a portfolio, and there instead of notebooks apples lie. From giving. - In this place of Vasilis dared to smile carefully. - But it is, probably, not a nightmare because Veronika Ivanovna kind.

- That is she would not begin to abuse you for the forgotten notebook?

- Generally she sometimes swears, but on me - never. And about notebooks I do not know because I never forgot them. Only in a dream. - Vasilisa smiled once again.

I sent to

After the end of conversation Vasilisa to other room to draw projective pictures.

- As you think that there is with it it?! - without hiding more than the alarm, mother exclaimed. - All doctors make a helpless gesture, and sometimes it seems to me that it something absolutely terrible. I do not sleep the second month at night, I swallow of tablets... How you think, it will pass?

- I think that it is neurosis, - I told. - And I think what to wait for until he passes (though it and it is possible), is not necessary. I think that he should be treated.

What is neurosis?

In the last, most modern international classification of diseases (MKB - 10) neurosis as a separate disease or group of diseases will not be allocated in general. Only the name of wide group of frustration, obscure for profane persons, - “the neurotic, connected with a stress and somatoformny frustration“ remained. However, despite all innovations of physicians, the extensive group of sufferers still exists, and practical doctors (generally certainly, neuropathologists) still widely use the diagnosis of neurosis. So it it?

In - the first, it would be desirable to specify at once: neurosis is an illness. Not simulation, not a dash of madness, not “the upset nerves“, - the illness demanding long-term and adequate treatment. The Western world through penetrated by freydizm fluids recognized neurosis as a “full-fledged“ disease for a long time, and at us, in our culture quite motley picture is observed today. The author had to hear, for example, such statements from husbands:

- I at first was frightened, thought, with it indeed something like that. But I am not a doctor, in all this I do not understand, I see - the wife badly and all. And then it descended to the doctor, he also got to the core of it at once. And wrote in a card:“ neurosis“. That`s all put. In total from nerves - I and spoke to it. Stop becoming hysterical and everything will pass. But unless she will listen to me?!

From fathers:

- it is correct

, and the doctor told us how you speak, - neurosis at it and all. It is necessary to walk on the street more, and to watch TV with these foolish movies less. And to treat? Well, how to treat neurosis is - I know that, take a belt and...

That is in these cases of idea of neurosis as about a disease, are absent absolutely. And it is wrong. Therefore I repeat once again: neurosis - an illness. She should be treated the same as tuberculosis, cold or a fracture of a hand treat.

All neurotic frustration is united by one - all of them are in a varying degree connected with the psychological reasons. The problem of an origin, development and even definition of neurosises is still disputable (it is necessary to think, partly therefore originators of MKB - 10 also refused this category). Nearly each serious researcher in the field of psychology for already nearly 100 years puts forward the concept or the classification of neurosises. 3 were the most famous such western researchers, certainly. Freud and his followers who developed own directions of psychology and psychotherapy - A. Adler, K. G. Jung, K. Horni. Our problems of an origin and classification of neurosises there is a lot of and fruitfully Myasishchev was engaged. And today in the field of typology and treatment of neurosises (including for children) many remarkable researchers and practical doctors, for example, A. I. Zakharov, E. G. Eydemiller, V. I. Garbuzov work.

the term “neurosis“ was entered by the great doctor Galen even in 1776. He means in translation from Greek - “an illness of nerves“. As some of numerous definitions of neurosises all the same it is required to us, it is possible to take something the definition given in “The explanatory dictionary of psychiatric terms“ and belonging to the prominent modern psychiatrist B. D. Karvasarsky is more modern, for example. It sounds so:

Neurosises are psychogenic (as a rule, conflictogenic) nervously - the mental disorders, diseases of the personality resulting from violation of especially significant vital relations of the person and which are shown in specific clinical phenomena in the absence of the psychotic phenomena“.

are characteristic

Of neurosises:

  1. reversibility of pathological violations, irrespective of their duration;
  2. the psychogenic nature of a disease which is defined by existence of communication between a clinical picture of neurosis, on the one hand, and features of system of the relations, the inherent identity of the patient, and a conflict situation - on the other hand;
  3. the specificity of clinical manifestations consisting in domination emotionally - affective and somato - vegetative frustration (that is disorders of function and a state, but not organic defeats).

Criteria of diagnosis of neurosises were formulated by A. M. Vane in 1982. They include:

  1. existence of the psychoinjuring situation (it has to be individually significant and closely connected with a debut and the course of a disease);
  2. existence of neurotic features of the personality and insufficiency of psychological protection;
  3. identification of characteristic type of the neurotic conflict;
  4. identification of the neurotic symptoms which are characterized by big dynamism and interconnected with the level of tension of the psychological conflict.

What neurosises happen?

At all variety of classifications and allocations of various forms of neurotic syndromes about which we already spoke nevertheless remains conventional existence of three classical forms of neurosis as the main - a neurasthenia (asthenic neurosis), hysterical neurosis and neurosis of persuasive states.

their

- that we, in avoidance of further confusion, will also consider.

Neurasthenia. At this frustration the main symptoms of an illness are complaints to increased fatigue, decrease in progress and efficiency in another matters, impossibility to concentrate, physical weakness and an exhaustion even after the minimum efforts, impossibility to relax. Often also other unpleasant physical feelings, such as dizzinesses, headaches, zheludochno - intestinal frustration join it. Also irritability, loss of feeling of pleasure of life, pleasure, various sleep disorders is usual.

Sometimes to a neurotic syndrome is directly preceded by a disease of flu, viral hepatitis or an infectious mononukleoz.

But most often asthenic neurosis arises in connection with for a long time influencing stress, a long sleep debt, intellectual or physical overfatigue, a life-threatening situation.

the Child at a neurasthenia is usually shy

and is not self-assured. Its style of adaptation to life - capitulation before it. Very clearly he as if speaks: “Leave me alone - I am sick!“ It is one of forms of psychological protection. As a rule, such child is really spared and felt sorry. He adapted.

But also such concept as the internal conflict exists. The internal conflict is, as a rule, opposition of the realized claims, desires and an extramental self-assessment or installation. Sometimes one of positions of consciousness contradicts another - it is the internal conflict too.

Happens and so that two installations (for example, the installation inspired by the father resist each other: “It is necessary to fight!“ And installation of the grandmother: “Safety - at any cost!“). Such internal conflict is entirely not realized.

the Internal conflict - a basis, a core of any neurosis. It halves the person, does it emotionally and behavioural unstable. The mental trauma or long psychological tension led to domination of one party participating in the conflict (for example:“ I can do nothing, I am afraid of everything“), but the second (“I want, I wish“) too did not disappear anywhere.

Continuation