「通信自律療法」の開発(2) : 第1公式(四肢重感練習)の指導を通して

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1. The medical and psychosocial problems of the case As I described in the former paper (1), Ms. N.G. has suffered from a dissociative anxiety disorder (DSM-IV), by which she could not go out absolutely more than 10 years. She had also various somatic and psychological complaints as well as behavioral disturbances. In her past history of illnesses, since her childhood, she had suffered from tonsillitis, conjuctivitis, otitis media and cystitis in somatic disorders, as well as mysophobia, sleep walking, mutism, and school refusal in psychological and behavioral disorders. Furthermore her only sibling (brother) had school phobia and now he is in the home every day and no job and she had not any social supports from her parents. 2. The criteria of the indication of autogenic training of this case Autogenic training would not be effective in this case, because she would suffer from "exogene Fremdneurose," that comes from the severe environmental factors, as well as "charaktogene Kernneurose," that comes from the internal causes of oneself by Schultz's classificatory criteria. As she had a lot of medical and psychological problems, we should have done many adequate medical examinations and then should have given the standard psychotherapy with drug therapy and physical therapy. However, more than ten years, she could not take the orthodox therapy with drug therapy at all. Under the situations, she started autogenic training, mastered the first standard exercise (heaviness) through 51 practice days, and got quite a therapeutic effect. As the reasons why she could master the first exercise smoothly, we list the followings: 1. She has the strong motivation. 2. As she had an instruction manual that was written by the author, she could read it if necessary. 3. She had a plenty of time for doing the autogenic training periodically because of her phobia. In this article, I report all the record of the first 3 practice days without abbreviation. As you can see the record, she experienced the heaviness of arms and legs as well as many "autogenic discharges." 3. On the autogenic discharges As the consciousness decreases under autogenic training, there trait to happen a variety of mental activities spontaneously which are different from ordinal mental activities in both the contents and formalities. Those are related to mind the past events or to become aware of the new ideas. The autogenic state, that is the altered state of consciousness under autogenic training, may give an opportunity of changing the mind. In the protocol of 31th day, she recorded "I felt twitching at calves. My jaw jerked. My left arm moved as if skipping." In 32th day, she recorded "During autogenic exercise, I felt as if my body becomes light and floats in the air, and goes down as it was. Then I saw 3 birds are flying in an instant as if dreaming." As I mentioned above, there happen various autogenic discharges such as sensations, feelings, emotions, motions, and visual images ect. under autogenic state. 4. On the therapeutic effects When she mastered the first standard exercise, her appetite was increased and she had confidence in herself. The dependent tendency to her mother is decreased step by step, and she hit upon some ideas concerned with coping with her disorders actively. 5. The spontaneous appearance of the sensation of warmth She recorded in the protocol of 43th day that she felt slight warmth at her finger-tips after she had heaviness at the extremities, and then became warmer and warmer at her palms so much that she wondered. On the next day, she experienced these warmth again. The spontaneous sensation of warmth appeared probably as the result of vessels dilatation of her arms that took place by the muscle relaxation. 6. The spontaneous imagery in her elementary school period During autogenic training, she imagined spontaneously the place where she and her class mates went and played every summer vacations. She recorded in her protocol: "As I knew the method of application of imagination in autogenic training, I tried it during the practices. I am at peace very much." As I mentioned in the previous article, she suffered from mutism, 'kinder-garden refusal', and was buttered by the school mates. The tendencies continued to the first half of the elementary school period. In the second half, she suffered from the total school refusal. By the reasons, she disguised to remind her school period and she could not remind them actually. Even though she reminded only amusing experiences, she must have been able to remind them because she got better. 7. Conclusive comment Through the process I mentioned above, Ms. N.G. mastered the first standard exercise (heaviness) on February 23 (50th day). In her letter dated on February 20, the following contents were contained that she would have gotten the therapeutic effects by autogenic training. "In these days, the foods that I have hated have become good taste so much. Those experiences continue 5 times. I think it must be one of the therapeutic effect by the practices." Because of the results of personality tests, symptom checklist, and her personal history of illnesses, I did not have confidence that she would master autogenic training and would get better in the various complaints. Even though she continue to practice the standard exercises, she would not be able to get the sensation of heaviness. However, she could continue to practice the exercises 3 times every day for 50 days, and she could master the first exercise. At the result, she got some therapeutic effects.
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「通信自律療法」の開発(2) : 第1公式(四肢重感練習)の指導を通して

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