食行動の正常化が心身のバランスを回復させた1症例(指定発言)(食行動と心身のバランス)
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概要
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I have proposed the concept that main pathogenesis of eating disporders results from nonplastic restraint of the higher brain on hypothalamic control of food intake. To release the hypothalamic function from this pathological regulation of the cereberal cortex, patients with eating disorders were admitted to take a low-calorie-diet, starting from 800 Cal/day, and strictly restricted to get in contact with the circumstances outside the hospital by means of letters, telephons, visits and so on ("Behavior Restriction Therapy"). The restriction was removed according to an increase of food intake and weight gain.In the process of therapy, constant stimuli were provided to patients in the therapeutic frame, in which the therapist tried to maintain an emotionally steady attitude toward them and gave active support to their healthy mind, through stable and proper comments without being affected by perpetual and entrapping incitation of their ill mind. Daily amount of caloric intake was kept constant according to the therapeutic master plan, so that the patients could receive metabolically constant signal from feeding. Thus, constancy not only in psychological stimuli but also in bodily sensation was evaluated as one of the most important factors for the cure of the disorders. The way of therapeutic constancy made it possible for the patients to resuscitate their own bodily perception including humger and satiating sensation, which reinforced development of normal feeding behavior governed by the hypothalamus, not by the cortex.A 20-year old college girl, complaining of bulimia and vomiting, was shown as a case example in the process of improvement in abnormal feeding. It can be concluded that recovery from eating disorders may only be possible in restoration of unrestrained and regular feeding behavior. Once the patients learn to realize how they can release bodily functions depending on the hypothalamus from their ill-mind, they are consequently potentiated to call up vivid emotions and behave freely, as characterized in the adolescents, without any restraint from over-meddling of the higher brain.
- 1989-04-01
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