RU2429025C2 - Method of drug-free correction alexithymia and psychosomatic health gain in sportsmen - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention can be used in sports medicine, restorative medicine, psychosomatic medicine, medical psychology, occupational psychophysiology, clinical psychophysiology, social psychophysiology and aims at correction of alexithymia and its consequences in the form of psychosomatic disorders. It involves carrying a complex of health-improving actions which involves relaxation breathwork, sensual perception techniques, art therapy techniques, psychotechnical sport games and creative visualisation techniques. A group makes two cycles of exercises: a correction training cycle consisting of 25 lessons and a support cycle consisting of 10 lessons; each lessons of the correction training cycle lasts for 50-60 minutes 3 times a week, while the supporting cycle includes the lessons of 50-60 minutes 2 times a week.

EFFECT: prevention of somatic health disorders and enables more efficient medical rehabilitation following psychosomatic diseases.

2 cl, 1 dwg, 1 tbl, 2 ex

Description

The invention relates to the field of medicine, psychology and psychophysiology, can be used in sports medicine, rehabilitation medicine, psychosomatic medicine, medical psychology, psychophysiology of professional activity, clinical psychophysiology, social psychophysiology and is intended to correct alexithymia and its consequences in the form of psychosomatic disorders.

Sports activities, especially professional ones, can be considered as a chain of physical and emotional stressful situations. Stressful conditions in sport are the most important means of improving the psychophysical capabilities of a person and the development of his working capacity. Training and competitive activity of athletes is the basis of the adaptation processes taking place in the body. Special preparation for stressful situations entails the formation of stress resistance. Psychosocial circumstances in the form of crisis situations in personal life and sports activities (sports failures, interpersonal conflicts, intense competition, the danger of lowering socio-economic status) are superimposed on high training and competitive loads. In a certain situation, especially in the presence of alexithymia in the personality structure, this leads to maladaptation: overstrain, deterioration of the functional state, a significant decrease in working capacity, the occurrence of affective disorders (anxiety and depression) and, as a consequence, the occurrence of diseases and injuries, i.e. the development of psychosomatic disorders. At the same time, the psychoemotional component of stress in the development of the pathological process can be much higher than the excessive exercise. Psychosomatic disorders resulting from long-term and intense stressful influences may be a kind of “payment” for adaptation to the extreme conditions of modern sports. In this regard, psycho-correctional work with athletes is of great importance. It can be not only a means of specialized training, but also a form of rehabilitation, psychophysical discharge, outdoor activities.

Disadaptation in sports always has a psychosomatic characteristic. The studies conducted by the authors showed that athletes with alexithymia in the personality structure are characterized by increased anxiety, a tendency to depressive reactions, a decrease in self-confidence and in their abilities, and quick exhaustion. These psychopathological manifestations testified to the state of pronounced psychoemotional stress. If the stress reaction is cyclically replaced by a relaxation reaction, then the adaptive capabilities of the body for a long time remain at the same level (training reaction) or increase (activation reaction), which helps to increase stress resistance. However, in athletes with alexithymia, due to a limited awareness of emotions and cognitive processing of affect, emotional arousal (unreacted emotions) is focused on the somatic level, which leads to increased physiological reactions to stressful situations, disruption of adaptation mechanisms and the development of psychosomatic disorders.

Alexithymia not only leads to the development of psychosomatic pathology, but also carries unfavorable prognostic information about the course of the disease as a whole, and also reduces the effectiveness of ongoing rehabilitation measures. A high level of anxiety in alexithymic patients increases their resistance to therapy. Due to the difficulty of differentiating bodily sensations and emotional states, athletes with alexithymia experienced psychological discomfort, but complained only of a somatic nature, mostly associated with loss of energy (fatigue, rapid exhaustion) and algic manifestations (pain in muscles and joints). During rehabilitation, most of them were configured to eliminate the pain syndrome, and not to psychoregulate their emotional state. The long-lasting state of psychoemotional stress complicates complex actions and intellectual functions: the amount of attention and memory is reduced, the processes of perception and thinking are disturbed, and extra, non-directional actions appear. All this negatively affects not only sports, but also any other activity.

There is a method of treating alexithymia in angina pectoris (cl. RF No. 2203053 and cl. RF No. 2161969), which consists in taking medications.

There is a method of non-pharmacological correction of psychoemotional, neurohormonal and immune statuses of a person, selected as a prototype, including a complex of effects (p. Of the Russian Federation No. 2314132). The method consists in the integrated use of rhythmic coherent light, sound and vibrotactile influences.

The objective of the invention is to provide a highly effective method for non-drug correction of alexithymia, preventing the occurrence of somatic health disorders and increasing the effectiveness of medical rehabilitation for psychosomatic diseases.

The method of non-drug correction of alexithymia and improving the psychosomatic health of athletes, including a set of health-improving actions, according to the invention, the complex contains relaxation and breathing techniques, techniques from sensory awareness, art therapy techniques, psychotechnical games in sports and creative visualization techniques, the group performs two cycles: Correctional-training, consisting of 25 lessons, and supporting, consisting of 10 lessons, while each lesson consists of 4-6 exercises and begin It is used with relaxation-breathing techniques with the inclusion of exercises from the method of sensory awareness, and the rest of the exercises are completed on the basis of analysis of previous classes.

The duration of classes in the correctional-training cycle is 50-60 minutes 3 times a week, and in the maintenance cycle - 50-60 minutes 2 times a week.

Relaxation and breathing techniques consist of 17 exercises: a tired arm, mental movement I, mental movement II, figurative relaxation, differentiated relaxation, diaphragmatic breathing, relaxing breathing, counting breathing, breathing in the rhythm of the pulse, spontaneous breathing, breathing control, directional breathing, hand feels hand breathing through the palms, circular breathing, healing breathing, analgesic breathing.

Techniques from sensory awareness consist of 29 exercises: distributed attention, getting to know yourself, letting your imagination go outside, telling the truth is easy and pleasant, a mental examiner, puppet, standing, standing is an attitude, examining your feet, walking, posture, body awareness, contact hands, back contact, hand dialogue, blind guide, patting the body, touching, give a touch, teach touching, give support, feeling circles, double consciousness, bifurcation, traveling through states, sounds, gesture score, desks Tour conditions genre trial.

The art therapy techniques consist of 8 actions: drawing a person, a mirror, drawing in the air, individual drawing, drawing a “non-working” hand, creating a group mural, group drawing in a circle, drawing with a partner.

Psychotechnical games in sports include 24 exercises: fingers, a fly, focusing, a lazy person and a hard worker, super attention, a labyrinth, a magic pencil, a thermometer, anti-time, running associations, dominoes, wonders of technology, synesthesia, reincarnation, reflection, coin, homeostat, wall, robot , docking, suspended animation, scout, on guard, discussion.

Creative visualization techniques include 9 exercises: a holy place, a guide, healing meditation, pain relief meditation, goal setting, a value map, health and beauty, a mental screen, and self-confidence.

The proposed method for non-drug correction of alexithymia is the result of the synthesis of previously known methods of body therapy, performed in a certain sequence and adapted to a specific contingent of people, for example, young athletes, taking into account the specificity of their type of activity, their psychosomatic health, and is a reasonable set of exercises ( table) aimed at eliminating psychoemotional stress, correcting alexithymic personality traits and improving psychosomatic health of athletes.

In contrast to the known methods, the proposed method is based on a comprehensive biopsychosocial approach to the patient. A person is considered as a system consisting of three main elements: somatic, mental and social.

The effectiveness of the method is due to the fact that it is based on the impact on various levels: neuro-vegetative, muscular-fascial and psycho-emotional. The impact on the body provides for a decrease in psychoemotional stress, correction of alexithymic personality traits and improvement of athletes' psychosomatic health.

The use of relaxation and breathing techniques is based on training athletes with alexithymia to launch a universal relaxation reaction using self-regulation techniques. The psychophysiological substantiation of the mechanisms of the effectiveness of relaxation and breathing techniques is that if, at the level of the autonomic nervous system, partly accessible to conscious control, the tension reaction is generally associated with the activation of its sympathetic (ergotropic) section, then the relaxation reaction represents a transition to parasympathetic (trophotropic) predominance. The same is true for the psychoemotional component of the relaxation reaction. The practical significance of this approach is undeniable: regular targeted use of the relaxation reaction normalizes the psychoemotional state in general and the functional state of internal organs in particular. Relaxation and breathing techniques allow you to consciously adjust the level of stress stress to prevent destructive distress conditions. With the help of relaxation and breathing techniques you can reduce the metabolic rate, blood glucose and cholesterol, the level of hormones of the adrenal glands and the thyroid gland, the level of anxiety, reduce muscle and psycho-emotional stress, eliminate pain, normalize blood pressure, heart rate, breathing rhythm , enhance the alpha activity of the brain. Thus, the relaxation reaction is a universal mechanism for relieving psychophysical tension, increasing stress resistance and combating psychosomatic disorders.

Another equally important aspect of relaxation is that it is a way to achieve the natural, “childish” state of the nervous system — physiological age regression. During relaxation, a return to childhood occurs, as it were: both on a psychological level - a return to children's primary perception and informational susceptibility - an artificial sensitive period, and on the physiological one. The latter is a temporary transition of the nervous system to certain functional states peculiar to childhood and characterized by increased learning ability due to increased activity of the right hemisphere of the brain. It is believed that alexithymia is the result of an insufficient connection between the left (conscious, speech, low emotional) and right (subconscious, non-verbal, emotional) hemispheres. Moreover, alexithymic compared to ordinary people is more pronounced in the dominance of the speech hemisphere and the suppression of the non-verbal, unconscious. In this regard, relaxation techniques, contributing to the achievement of a state of age-related regression, not only open access to deep adaptation resources and allow the discharge of accumulated psychological stress. By smoothing out interhemispheric differences in brain activity, they create a favorable background for the impact of other “right-hemispheric” techniques (sensory awareness, art therapy, psychotechnical games, creative visualization) on the athlete’s emotional, cognitive and personal spheres with alexithymia, thereby increasing the efficiency of its correction .

The techniques of sensory awareness are the training of athletes in the differentiated perception of bodily manifestations and emotions, the establishment of the relationship between them, the development of the ability to recognize emotions and express them openly, increasing the level of sensory and sensory perception, concentration of attention. At its core, the techniques of sensory awareness are therapy with movement, breathing and relaxation, training of mental balance and psychological stability based on self-observation, studying your own body, detecting and eliminating areas of stagnant muscle tension, as well as psychological stereotypes associated with them. Thus, sensory awareness implies, first of all, awareness of kinesthetic sensations. At the same time, the fullness of awareness of one’s own body is achieved through deautomatization of perception - drawing attention to usually ignored sensations, disabling its intellectualization, and suspending verbalization of sensory experience. Thus, through physiological age regression, the revitalization of children's bodily memory, a person learns to feel his body with "childlike spontaneity", returns to itself the natural, natural fullness of experiences inherent in a small child.

Another significant aspect of the method of sensory awareness is the study of the process of non-verbal communication between group members, in particular, touches, with the help of which athletes learned to feel at a bodily level the degree of closeness and distance, a sense of environment, mutual assistance and responsibility, as well as various emotional states (aggressiveness, anxiety, joy, etc.) with tactile interaction.

The techniques of sensory awareness are an important tool not only for correcting alexithymic personality traits, but also for treating psychosomatic disorders in athletes. The rationale for this provision are the psychophysiological aspects of this method. A person’s full contact with his feelings is represented as his awareness of the whole range of bodily sensations associated with emotions. The more emotion is realized, the greater the ability to control it. Therefore, the skill of self-observation, tracking kinesthetic sensations helps to manage not only attention, but also emotions. The psychophysiological basis of sensory awareness is the focus on right-hemisphere activity, while left-hemisphere activity is associated with some monotonous, partly automatic, activity. Thus, one of the most important aspects of this method is the acquisition of the skill of self-observation, which is the basis of self-control in all areas of the psyche and physicality, available for self-regulation. In addition to controlling emotions, an athlete with alexithymia develops the ability to control and control the state of consciousness. As you know, uncomfortable psycho-emotional states are largely created and “nourished” by negative thoughts (self-accusing, disturbing, pessimistic) that violate a person’s self-esteem or threaten other values that are significant to him. Sensory awareness by switching attention allows you to break the vicious circle of maladaptive thoughts and thereby eliminate the cause of emotional disorders. In general, these exercises are aimed at suppressing excessive rationalization, at returning to naturalness, immediacy and openness of feelings. Physiologically, this effect is achieved by temporarily reducing left hemisphere activity — turning off the logical interpretation of reality, “devastating the mind” - and filling it with non-verbal content, kinesthetic images (right hemisphere activation). For athletes with alexithymia, sensory experience is limited to experiencing comfort and discomfort. At the same time, uncomfortable bodily sensations are somatization of anxiety, leading to a specific disturbance in perception - lowering the thresholds of somatosensory (kinesthetic and visceral) sensitivity. Such an increase in sensitivity (hyperesthesia) leads to an increase and inadequate interpretation of natural, normal bodily sensations, which begin to be regarded as manifestations of the disease. In this regard, the skill of sensory awareness is especially important for dealing with the bodily manifestations of psychosomatic disorders in athletes.

Art therapy techniques are used to diagnose and correct the psychosomatic state of athletes with alexithymia. The test "human figure" allows you to most fully and adequately assess the non-verbal, unconscious attitude of the patient to himself and his body. At the same time, individual parts of the body acquire an individual meaning for him and can become an expression of emotions, a significant sphere, an “axis of adaptation”. Analysis of the picture test reveals a close relationship between the nature of the image of a person and the highlighted zones of “lightness”, “tension” and “pain”. The respondent unconsciously grabs and depicts areas of the body in such a way that in the style of the image and the nature of the drawing of individual parts of the body, one can see the manifestation of both mental and somatic dysfunctions. In the language of psychophysiology, this is explained by the neurophysiological support of the drawing process. An obvious or latent physical defect is always present in the cerebral cortex, which is expressed in a change in blood circulation or metabolic processes in a certain area of it. Therefore, when portraying some part of the body, the patient involuntarily distorts the area of the graphic image that corresponds to the “damaged zone” in the functional system that provides the drawing process. Thus, the “human figure” test, in contrast to verbal diagnostic methods, has more informational content, which is of particular value in working with alexithymic athletes who experience certain difficulties in verbal description of emotions, as well as in differentiating feelings and bodily sensations. Using this test, you can get an adequate “psychophysical portrait” of an athlete, determine the main directions of individual correctional work and observe the dynamics of his psychosomatic state.

Along with diagnostic value, art therapy techniques have great therapeutic value. The effectiveness of applying art in the context of treatment is based on the fact that this method allows you to experiment with feelings, explore and express them at a symbolic level. Art therapy not only improves the overall physical and mental state of patients, but also helps to correct psychosomatic disorders. The objectivity of these data is confirmed by psychophysiological studies. In the process of art therapy, the patient’s attitude to his own past traumatic experience, experiences and illnesses is changed, the state of psychological comfort is achieved, and the resulting therapeutic effect is expressed in the ordering of psychosomatic processes.

The rationale for the inclusion of art therapy techniques in the technique of correcting alexithymia in athletes is that they:

- Develop attention to feelings and contribute to emotional self-expression. The figure arises as a result of a creative act, which makes it possible to clarify visual, kinesthetic sensations and various emotions, and allows you to experiment with them.

- Provide an opportunity for the expression of negative emotions, aggressive feelings in a socially acceptable manner. Drawing is one of the safest ways to discharge voltage. The product of fine art sublimates the destructive, aggressive tendencies of the author and thereby prevents their direct manifestation in actions.

- Allow you to work with thoughts and feelings that seem insurmountable. Sometimes a non-verbal tool is the only tool that reveals and clarifies intense feelings and beliefs. This is especially significant for athletes with alexithymia, who can communicate their problems and feelings in a non-verbal language, learn to understand and analyze their emotions.

- Contribute to a sense of internal control and order. Drawing leads to the need to organize shapes and colors.

- Enhances the feeling of personal value. The “by-product” of art therapy is satisfaction arising from the identification of hidden skills and their development.

- Solve the problem of active, creative participation of an athlete in the correction process, increasing his competence in matters of self-regulation of his psychosomatic state.

- Accelerate progress in corrective work. It is easier for an athlete with alexithymia to express inner experiences with visual images than in conversation during a verbal psychocorrection. Non-verbal forms of communication are more likely to avoid conscious censorship.

- Provide grounds for interpretation and diagnostic work in the correction process. The content and style of the drawing provides adequate information about the psychosomatic state of the athlete.

- Allow you to develop communication skills through the activation of non-verbal, and then verbal forms of communication. The elements of coincidence in the visual creativity of the group members accelerate the development of empathy and contribute to the emergence of persistent positive emotions. This, in turn, helps to resolve intra-group conflicts, overcome social exclusion, and build harmonious relationships with the team.

Psychotechnical games are used to develop in athletes with alexithymia attention, memory, imagination, reflective thinking, empathy, self-control skills, self-regulation and non-verbal communication. These techniques are aimed not only at correcting alexithymia, improving interpersonal relationships, increasing stress resistance and the effectiveness of sports activities, but also at improving the psychosomatic health of athletes.

Attention is the dynamic side of all cognitive processes, it is associated primarily with memory, thinking and emotions. Attention creates the best conditions for mental activity, helps various mental processes to more effectively reflect reality. All human activities, their orientation and adaptation in the surrounding world depend on the state of attention. Memory is the most important cognitive function that underlies development and learning. One of the fundamental mechanisms of human mutual understanding is reflection - the ability to represent oneself in the place of another person, to mentally see and “lose” the situation for him. Reflective thinking is the most important element of an athlete’s tactical skill. The higher the qualifications of athletes, the finer the psychological struggle. In martial arts, the mutual reflection of rivals forms one of the internal plans for their duel. According to experts in the field of sports psychology, the ability to predict the intentions of the enemy and mask their own is one of the most important qualities of an athlete. Reflective thinking is significant not only in a duel. It is reflection that underlies the “teamwork” of a sports team. In complex and unpredictable situations, the strength of the players lies in a lively, immediate and instant understanding. A clear and well-coordinated game is impossible without the ability to on the fly to grasp the intentions of the partner and see the situation through the eyes of a teammate. However, the basis of a well-coordinated game is not only the work of thought. Harmony of actions on the field is hardly achievable if the players do not have a “sense of partner”, emotional contact with each other, and the skill of wordless communication.

In addition to disorders of affective functions, athletes with alexithymia have cognitive impairment (memory, attention, thinking), which is a serious reason for reducing the effectiveness of sports activities. Psychotechnical games for attention allow the athlete to get acquainted with the main characteristics of his own attention (concentration, stability, switchability, volume, distribution) and train him. Receptions mnemonics significantly expand the capabilities of memory. Exercises for the development of reflective thinking, empathy, and nonverbal communication skills help to develop the skills necessary for sports: put yourself in the place of an opponent or partner, make the most likely decisions for him and coordinate his own actions with him, take into account his attempts to “think for you” and act adjusted for this thinking, be in emotional contact with partners, use the language of game communication (gestures, nods, facial expressions, interjections). For people with alexithymia, a predominance of visual-effective thinking is characteristic. In general, psychotechnical games contribute to the development of the ability to play, through which the transition to abstract logical thinking, as a later stage of the ontogenetic development of thinking, is carried out.

The poverty of imagination and imagination with alexithymia significantly limits the possibilities of ideomotor training, which has firmly entered the arsenal of means for training athletes. Exercises for the development of imagination contribute to a more productive use of ideomotor training for the athletes to master new movements and improve motor coordination. Self-regulation techniques help solve many problems in sports: increasing the athlete’s stress resistance, bringing him to the highest level of performance at the time of a responsible start, managing the recovery process, rehabilitation after an unsuccessful performance, and mobilizing forces. Self-regulation is used not only for the purpose of a more flexible and full use of the reserves of a healthy body, but also to combat psychosomatic disorders. Often, the undesirable consequences of pre-launch stresses are manifested in apathy, muscle weakness, coordination disorder and other sports-impairing disorders. Arbitrary regulation allows you to compensate for the effects of psychophysical overloads. Exercises for the development of self-control and self-regulation skills from psychotechnics were included in the methodology of correcting alexithymia and improving the psychosomatic health of athletes as a game supplement to the systematic course of relaxation-breathing techniques and exercises from the method of sensory awareness.

Creative visualization techniques are included in the technique of correcting alexithymia in athletes with the aim of developing imagination and its active use for the sanogenous control of one’s own physical condition, harmonization of psychosomatic relationships. With the help of imaginative thinking, a person can set himself up for recovery. The clearer the patient sees with his mind's eye his body and its affected areas at the level of consciousness, the more successfully his subconscious mind reads these messages and coordinates the internal defenses. It is believed that controlled fantasy and visualization are transmitted and act on the immune system. The development of visualization techniques involved establishing a connection between the internal bodily processes that take place in the body and are usually not amenable to conscious control. At the same time, diffuse, slightly differentiated interception, symbolically translated into the language of images, gradually becomes more accurate, accessible to observation, understanding and control. Creative visualization contributes to the acquisition of a positive experience of self-esteem and self-acceptance, strengthening self-esteem, positive correction of the motivational sphere in general and the formation of the need to achieve success in any activity in particular.

This method offers two cycles of classes: correctional and supportive. Both cycles are mandatory for the correction of alexithymia and cannot be used separately. The number of classes, the duration and order of exercises were obtained experimentally as a result of obtaining positive results after a series of health cycles proposed in this method.

The use of this method affects the emotional, cognitive and personal spheres and allows, in addition to the above, to improve interpersonal relationships, to increase the effectiveness of educational and professional activities.

Patent studies have not identified methods characterized by the claimed combination of features, therefore, we can assume that this method meets the criterion of "novelty."

The use of a combination of distinctive features is also not known, which indicates compliance with the criterion of "inventive step".

The inventive method can be carried out in any specialized medical institution, therefore, it meets the criterion of "industrial applicability".

The essence of the method is illustrated in tables and diagrams:

Table - exercises included in the methodology of correction of alexithymia in athletes.

Scheme 1 (drawing) - an approximate list of exercises for each lesson.

The Encyclopedic Dictionary of Medical Terms (1984) defines rehabilitation as a complex of medical, physical, psychological, social, professional and pedagogical measures aimed at restoring health, physical, psychological and social status lost as a result of illness or injury. The proposed method for correcting alexithymia and improving the psychosomatic health of athletes is a system of measures to restore psychophysical capabilities, improve physical qualities, increase psycho-emotional stability, functional state and adaptive reserves of the athlete’s body by means and methods of physical rehabilitation. The physical, psychological and social aspects of this method allow us to consider it not as a narrowly targeted technique, but in a broader sense - as a physical rehabilitation program for athletes with alexithymia, developed from the perspective of the psychosomatic approach.

The development of a method for correcting alexithymia and improving the psychosomatic health of athletes, as well as constructing the proposed exercise regimen, was carried out in accordance with physiologically sound principles of rehabilitation, described below.

An individual approach to each athlete. The preparation of the rehabilitation program was carried out taking into account the age of the athletes, their sports qualifications and specialization, the severity of alexithymia and the nature of somatic disorders. These criteria were taken into account when forming groups for classes. For example: one of the groups included 10 qualified athletes (II, III adult rank), representing playing sports (volleyball, basketball, football, hockey), aged 18-22 years. Of these: 6 people had alexithymia in the personality structure (74 or more points on the Toronto alexithymic scale), 4 - were at risk for alexithymia (from 63 to 73 points). All athletes had psychosomatic disorders: 2 - reactions, 4 - conditions, 4 - diseases. The modification of exercises borrowed from previously known methods is also based on the principle of individuality. Of 87 exercises, 35 are adapted to a specific contingent of individuals (young athletes), taking into account the specificity of their type of activity and the state of psychosomatic health (table).

The complexity of applying the necessary means of physical rehabilitation. The technique for correcting alexithymia and improving psychosomatic health is a set of exercises (table) that allows you to influence various components of the health of athletes: physical, somatic, mental and social. At the same time, the implementation of the developed program was carried out against the background of rational construction of the general mode of life of each athlete and the use of restorative means in high achievement sports (balanced nutrition, vitamins, adaptogens, massage, balneotherapy, etc.). The selection of restorative means, the specific gravity of one or another of them, their combination, dosage, duration and tactics of use were determined by the sports doctor depending on the specific state of the athlete, his level of fitness, type of sport, stage and training method, training session regimen, etc. work with athletes with organic damage to certain organs (as an extreme degree of violation of psychosomatic relationships), the proposed method does not exclude the use of other physical means rehabilitation (diet therapy, physiotherapy, herbal medicine, mechanotherapy, massage, etc.), appointed by specialists in accordance with the principle of individuality. In the classes according to the developed methodology, music therapy was used - a method in which music is a means of influencing the psyche and through it on the patient's body. Musical works with the sounds of nature (birds chirping, the sound of the forest, the murmur of water, the rustling of waves, etc.) contributed to a more effective relaxation when performing relaxation exercises.

Social orientation of rehabilitation measures. One of the main areas of rehabilitation is the restoration of the patient’s personal properties, increasing his working capacity, maintaining his professional status at the optimal level that allows him to maintain and develop his mental and physical capabilities. The proposed method allows to reduce the level of alexithymia and, therefore, to reduce its manifestations especially significant for sports activities in the form of somatic disorders and a tendency to injuries, minimize anxious and depressive tendencies, improve interpersonal relationships, increase motivation for success, as well as self-confidence and oneself forces. All this contributes not only to the growth of sportsmanship, but also to success in any other activity.

Staged rehabilitation. Compliance with this principle provided for the implementation of the developed program in two cycles (Scheme 1). The first cycle (25 lessons) - correctional-training, the main tasks of which were: correction of alexithymia and psychosomatic disorders, training athletes in techniques of arbitrary regulation of their psycho-emotional state. The second cycle (10 lessons) - supporting, the main tasks: maintaining the psychosomatic state of athletes achieved in the process of training the first cycle of rehabilitation, consolidating the formed skills of self-regulation.

Consistency is the basis of the effectiveness of rehabilitation, since only systematic exercises can provide the optimal effect, which allows to improve the functional state of the patient's body. Classes according to the developed methodology were conducted 3 times a week every other day (correctional-training cycle) and 2 times a week with an interval of two days (maintenance cycle). The general course was 35 lessons (Scheme 1). Despite the fact that the proposed method for correcting alexithymia and improving psychosomatic health is a rather lengthy process (3-3.5 months), its training orientation allows athletes to further monitor their psychosomatic condition and actively use the mastered self-regulation techniques (daily and / or in stressful situations). Thus, not only therapeutic, but also preventive tasks are solved.

The consistency (sequence) of exposure. Due to the fact that athletes with alexithymia are in a state of psychoemotional stress, causing an increase in somatic manifestations, work with this contingent of people should be carried out in two directions: relaxation (decrease in psychoemotional stress) and impact on the emotional, cognitive and personal spheres (correction of alexithymia) . Taking into account the psychophysiological aspects of the methods included in the rehabilitation program, the sequence of exercises in the lesson was determined: 1) relaxation and breathing techniques; 2) creative visualization techniques; 3) techniques of sensory awareness; 4) art therapy technician, exercise games. Relaxation and breathing exercises not only reduce anxiety, relieve muscle and psychoemotional stress, and eliminate pain. Due to the temporary transition of the nervous system to a state of physiological age regression (increased activity of the right hemisphere of the brain), the hemisphere differences in brain activity are smoothed out (in alexithymia, the left hemisphere is dominant), which significantly increases the effectiveness of exercises from the “right hemisphere” methods (sensory awareness, creative visualization, art therapy, psychotechnical games). Each lesson of the methodology for correcting alexithymia and improving the psychosomatic health of athletes consists of 4-6 exercises with the mandatory inclusion of relaxation and breathing techniques and exercises from the method of sensory awareness (Scheme 1). Despite the fact that the techniques of creative visualization, art therapy and exercise games are in addition to the systematic course of relaxation-breathing techniques and exercises from the method of sensory awareness, their role in the rehabilitation process is quite high. Visualization contributes to the development of imagination, a positive correction of the motivational sphere. Art therapy develops attention to feelings, communication skills, promotes emotional self-expression. Psychotechnical games help to develop attention, memory, imagination, reflective thinking, empathy, skills of self-control, self-regulation and non-verbal communication. Thus, these techniques allow a more complete impact on the emotional, cognitive and personal spheres of an athlete with alexithymia, contributing to a more effective one. her correction. In addition, they create a favorable emotional atmosphere, increase interest in classes, improve relationships in the group, thereby accelerating progress in correctional work.

The principle of gradualness. The selection of exercises for the entire rehabilitation program, and for an individual lesson was carried out in accordance with the principle of "from simple to complex." So, the first lessons of the technique include elementary relaxation and breathing techniques and exercises from the method of sensory awareness (Scheme 1). Moreover, each subsequent lesson is built according to the following scheme: repeating the exercises of the previous lesson, then learning new, more complex exercises. Depending on the degree of difficulty of the exercise, it takes 2-3 lessons to fully master it. In the future, in the classes of the supporting cycle, the formed skills are fixed. Exercise “Relaxing breathing” is leading to the exercises “Respiration counting”, “Respiration breathing”, “Respiration control”, therefore it is learned in the 4th lesson, repeated in the 5-11th and fixed on the 28th. The techniques of creative visualization, art therapy, as well as exercise games are evenly distributed throughout the entire rehabilitation process in accordance with the principle “from simple to complex”, many of them are not repeated. The author’s modification of individual techniques of atr-therapy (“Mirror”, “Drawing in the air”, “Drawing with a“ non-working ”hand”) and creative visualization (“Healing meditation”, “Health and Beauty”) provides 2-3 options for performing these exercises.

Monitoring the effectiveness of rehabilitation. For an objective assessment of the effectiveness of the developed methodology, the following research methods were used:

- Experimental-psychological - testing on the Toronto alexithymic scale (TAS), proposed by G.J. Taylor et al. (1985) and adapted at the St. Petersburg Psychoneurological Research Institute. V.M. Bekhtereva (Eresko DB et al., 1994) Athletes who scored 74 or more points in TAS were considered “alexithymic”, “non-alexithymic” - 62 or less points, persons with the number of alexithymia were assigned points from 63 to 73. The examination was carried out before the correction, after the first, second rehabilitation cycles and a month after the end of classes in groups. As an additional psychodiagnostics, we used the “Human Drawing” test (at 1, 25 and 34 lessons) and the “Individual Drawing” exercise (at 2 and 35 classes) from art therapy techniques, using which a “psychophysical portrait” of each athlete was compiled and indirectly evaluated the dynamics of his psychosomatic state in the process of correction.

- Clinical - the study of the data of ambulatory cards of athletes, the collection of anamnesis and methods of objective medical examination. The survey was an additional method in the study of the subjective assessment by athletes of the dynamics of their condition.

- Paraclinic - depending on the location of somatic manifestations, before and after rehabilitation, an examination was performed using electroencephalography (EEG), rheoencephalography (REG), electrocardiography, ultrasound, electromyography, fibroesophagoduodenoscopy.

The technique of correcting alexithymia and improving psychosomatic health was used in 30 athletes (16 men and 14 women) aged 18 to 24 years: 17 people with alexithymia and 13 at risk for it. Of these: 5 people - with psychosomatic short-term reactions (headaches and muscular-joint pains), 11 - with more persistent psychosomatic conditions (heart, headaches and muscular-joint pains), 14 - with psychosomatic diseases (vegetative-vascular dystonia, arterial hypertension , gastritis, gastroduodenitis, peptic ulcer of the stomach and duodenum, hyperthyroidism). After the first cycle of studies, the level of alexithymia decreased in 27 people, after the second - in all 30 people. Of these: 14 people - did not have alexithymia, 11 - were at risk, and only 5 remained alexithymic. A month after the end of training, the level of alexithymia decreased in 21 athletes. In 12 people, the absence of psychosomatic reactions and conditions was noted, in 2 - the conditions turned into rare short-term reactions. All 14 athletes with psychosomatosis showed a decrease in the number of relapses of the disease. A decrease in the number of injuries was noted in 27 people, all of them pointed to the positive dynamics of their condition. Improvement of EEG indicators (increased alpha activity of the brain, indicating a decrease in anxiety and psychoemotional stress) was observed in 25 athletes, REG indicators - in all 30.

Thus, the proposed method is effective not only for the correction of alexithymia, but also to prevent the development of distress, as well as the treatment of psychosomatic disorders without the need for medications. In addition, after passing a set of classes for this method, it becomes possible to independently support the body.

Example 1. Athlete M., 19 years old. Has been engaged in wrestling for 14 years, a candidate for master of sports. Has alexithymia (76 points) in the structure of personality. Complaints: frequent pain in the muscles and joints. Considers himself ill for 2 years. She notes a tendency to sports and domestic injuries (more than 10 per year).

Athlete corrected alexithymia and the proposed method. Before the start of the course, the patient had an explanatory conversation about the causes of deviations in his state of health, the need to correct alexithymia and psychosomatic disorder in the form of pain, the possibility of restoring psychological and somatic health by a non-drug method. The patient attended all 35 classes: 25 - 3 times a week, 10 - 2 times a week. He mastered the techniques of emotional-muscle relaxation, which he successfully practiced in stressful situations. The level of alexithymia decreased to 70 points (risk zone) after the first cycle, 64 points (risk zone) - after the second cycle, 60 points (absence of alexithymia and risk zone) - a month after the end of classes. Over the indicated period, the patient noted the absence of muscular-joint pain and injuries, an improvement in the general condition, interpersonal relationships (in the family, academic team and sports team), and an increase in the effectiveness of educational and sports activities. In the private spectrum of the encephalogram, a decrease in the representation of fast fluctuations in the beta range and a corresponding increase in the specific power of alpha waves were observed, which indicated a decrease in psychoemotional stress and a dynamic restructuring of the functional asymmetry of the hemispheres (smoothing of interhemispheric differences and synchronization of activity of the left and right hemispheres). Positive dynamics was also noted in the overall REG picture (normalization of pulse blood supply to the arterial bed, improvement of venous outflow).

Example 2. Sportswoman V., 21 years old. Engaged in volleyball for 10 years, has 1 adult rank. The level of alexithymia is 80 points. Diagnosis: chronic gastroduodenitis. Registered with a gastroenterologist for 4 years. Exacerbation of the disease - 2-3 times a year. Over the past year, the number of relapses has increased to 8, their clear connection with stress factors associated with sports activities (competitions, injuries, conflicts with the coach) can be traced. Complaints in addition to the underlying disease: frequent pain in the muscles and joints, periodic (1-2 times per month) headaches. Notes a decrease in the effectiveness of his sports activities, frequent conflict situations in the team. Thinking of leaving the big sport.

The athlete corrected alexithymia and psychosomatic disorders in the proposed way. Despite the fact that before the start of the course the patient had an explanatory conversation about the causes of deviations in her state of health, the need to correct alexithymia, the possibility of restoring psychosomatic health by the non-drug method, athlete V. was determined to eliminate, first of all, somatic discomfort, and not to psychoregulate her emotional state. The patient noted an increase in interest in classes after 6-7 visits, when emotional and muscle tension decreased, a feeling of comfort appeared, and friendships appeared in the group. The patient attended 33 classes: 23 - 3 times a week, 10 - 2 times a week. She showed a hidden ability to draw. Acquired the status of leader in the group. The level of alexithymia decreased to 73 points (risk zone) after the first cycle, 64 points (risk zone) - after the second cycle, 62 points (lack of alexithymia and risk zone) - a month after the end of classes. In the overall picture, EEG and REG are positive dynamics. The patient noted the absence of headaches, a significant decrease in the incidence of muscle-joint pain, an improvement in the somatic state in general, and the absence of exacerbations of the existing psychosomatosis in particular. The positive dynamics of chronic gastroduodenitis under the influence of corrective measures is confirmed by fibroesophagoduodenoscopy data. Relations with a coach and a sports team have been established. In connection with the improvement of his state of health and setting new personal goals, he is not going to leave the sports arena.

Table The method of non-pharmacological correction of alexithymia and improving the psychosomatic health of athletes No. Exercise name Target setting Source Relaxation and breathing techniques one Tired hand Emotional muscle relaxation Sandomierz M.E. Psychosomatics and body psychotherapy: practical. hand-in / M.E. Sandomirsky. - M .: Independent firm "Class", 2005. - 592 p. 2 Mental Movement (I) 3 Mental Movement (II) four Shaped relaxation * 5 Differentiated relaxation 6 Diaphragmatic breathing * Respiratory Self-Regulation 7 Relaxing breath 8 Breath on account 9 Heart rate breathing 10 Spontaneous breathing eleven Breath control 12 Directed breathing 13 Hand feels hand fourteen Palm breath fifteen Circular breathing 16 Healing breath 17 Pain relief Sensory awareness method eighteen Distributed attention * Attention management and sensory awareness Sandomierz M.E. Psychosomatics and body psychotherapy: practical. hand-in / M.E. Sandomirsky. - M .: Independent firm "Class", 2005. - 592 p. 19 Getting to know yourself twenty Release your fantasy 21 Telling the truth is easy and enjoyable * 22 Mental Auditor 23 Puppet* 24 Stand * Sensation awareness Malkina-Pykh I.G. Body therapy: reference book / I.G. Malkina-Pykh. - M .: Eksmo, 2007 .-- 752 p. 25 Standing is an attitude * 26 Foot study * 27 Walking 28 Posture* 29th Body awareness * thirty Hand contact Non-verbal communication 31 Back contact 32 Hands Dialog * 33 Blind guide 34 Slapping the body 35 Touch 36 Give a touch * 37 Teach the touch 38 Give support 39 Feeling circles * Sensory and sensory perception, attention management 40 Double consciousness * 41 Bifurcation* 42 State tour * 43 Sounds * 44 Gesture score 45 Score of states * 46 Sample of the genre * Art therapy 47 Human figure Psychodiagnostics, expression of emotions on a symbolic level, non-verbal and verbal communication Malkina-Pykh I.G. Psychosomatics: the latest reference book / I.G. Malkina-Pykh. - M .: Eksmo, St. Petersburg: Owl, 2003 .-- 928 s. 48 Mirror* 49 Drawing in the air * fifty Individual drawing 51 Drawing a "non-working" hand * 52 Create a group mural * 53 Group drawing in a circle 54 Drawing with a partner Psychotechnical games in sports 55 Fingers Attention development, self-control Tsen N.V. Psychotechnical games in sports / N.V. Tszen, Yu.V. Pakhomov. - M.: Physical education and sport, 1985. - 160 p. 56 Fly 57 Focusing 58 Lazy dog and hard worker 59 Over Attention * 60 Maze Development of imagination, memory, self-regulation 61 Magic pencil * 62 Thermometer 63 Anti-time * 64 Association Run * 65 Dominoes 66 Wonders of Technology 67 Synesthesia 68 Reincarnations * 69 Reflection The development of reflective thinking, empathy, the skill of wordless communication 70 Coin 71 Homeostat 72 Wall* 73 Robot 74 Docking 75 Anabiosis 76 Scout 77 On guard 78 Discussion* Creative visualization 79 Holy place The development of imagination, its active use in self-regulation of the psychosomatic state Malkina-Pykh I.G. Psychosomatics: the latest reference book / I.G. Malkina-Pykh. - M .: Eksmo, St. Petersburg: Owl, 2003 .-- 928 s. 80 Conductor 8t Healing Meditation * 82 Pain Relief Meditation 83 Goal setting * 84 Value Map 85 Health and beauty* 86 Mind screen * 87 Self confidence* Note: * - exercises modified by the authors

Claims (2)

1. A method for non-pharmacological correction of alexithymia and improving the psychosomatic health of athletes, including a set of wellness actions, characterized in that the complex contains relaxation and breathing techniques, techniques of sensory awareness, art therapy techniques, psychotechnical games in sports and creative visualization techniques, in the group they perform exercises specified in table 1, contained in the description, in two cycles: correctional-training, consisting of 25 lessons, and supporting, consisting of 10 classes, the number of exercises for each lesson of each cycle is indicated in Scheme 1 contained in the description. 2. The method according to claim 1, characterized in that the duration of the classes in the correctional-training cycle is 50-60 minutes 3 times a week, and in the maintenance cycle - 50-60 minutes 2 times a week.

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