The method of "curing by death" in addiction treatment and psychotherapeutic practice.

Vasylenko V.I., Buhtiy S.N., Gasul E.R.

1st Zaporizhia City Clinical Hospital, Rehabilitation center for drug addiction treatment.

A lot of techniques were used in practice of drug addiction treatment, but none of them can guarantee stable results. We propose a new approach, which is fundamentally different from all previously used methods. We believe that drug addiction can only be surmounted by adequate methods of treatment, i.e. those which are based on super stress impact on the psyche of drug addicts.

In our previous publications we have already pointed out the application of psychological and medical encoding and then the verification of the effectiveness of the injected polyvalent serum prepared in such a way that even the smallest dose of the drug released the encoded toxin into the body that caused clinical death.

Of course, the verification itself (or the so cold "provocation"), when done in the clinic under the supervision of physicians, surgeons, resuscitators, in the presence of psychiatrists, with urgent resuscitative measures excludes fatal (biological death) and possible subsequent complications that would significantly affect the health of patients.

The purpose of "provocation" is to convince the patient that the serum introduced into his body got acclimatized and has instant and deadly effect, especially in cases where there is no certainty that the patient is generally prepared for the complete refusal of the drug and does not show any fluctuations in his decision not to try anything else (alcohol, pills, marijuana, etc.).

The encoding process, as indicated in previous publications, consists of several phases:

1. Determining of encoding readiness. The decision is carried out after the conclusion of medical specialists - a team, consisting of psychotherapists, psychoanalysts, resuscitators, surgeons, internists, directly working with patients. Mental and physical condition of the patient, confidence in refusal of addicted lifestyle, voluntary consent to encoding and its terms, conditions of cardiovascular system, recovery of the liver and other organs, the state of higher nervous activity, determined objectively according to the EEG test results are taken into account.

Besides objective methods of determining readiness for encoding, a graded questioning of the patients is held (at the beginning of the treatment, in the middle of it, and then just before the encoding), and the patients fill out a questionnaire, expressing their subjective attitude as to their own readiness (pointing name) and the readiness of other patients (anonymous). Experience of using this questionnaires showed opportunities for sufficient objective judgment about the degree of readiness for encoding of each patient and the whole group.

2. The patients receipt on a special blank, which indicates that the patient refuses to use all kinds of drugs after the introduction of a polyvalent serum for the time defined by a doctor and consented by his family. And he is warned that even the slightest dose of a drug can disrupt the encoding and lead to immediate death or fatal complications shortly after receiving the drug. Moreover, a polyvalent serum applies to any kind of drugs (opiates, cocaine, ephedrine, marijuana, etc.).

The polyvalent serum is injected intramuscularly to the soft tissue of the abdomen. 10.0 to 20.0 ml of polyvalent serum corresponds to the encoding terms from 3 to 6 years. The amount of serum depends on the psychological and physical readiness of the patient (as mentioned above). Small doses calculated for 1 year or even a few months are used if there are somatic contraindications or lack of readiness for the encoding. The encoding procedure itself and the days after its assimilation into the body of patients are also a powerful psychotherapeutic technique.

3. Provocation (the verification of the effectiveness of encoding serum) is conducted with the consent of the patient and his relatives, by a medical team of experts, surgeons, resuscitators, internists, neurologists, psychiatrists, and qualified nurses. The procedure is performed in a special intensive care unit that is equipped with all necessary diagnostic and medical equipment, means of ambulance (respirator, oxygen, introducer, defibrillator; monitor for the dynamic control of blood pressure, oxygen saturation of blood, pulse rate, ECG, electric pumps; cardiac, ganglion blocking, polarizing mixtures, Cerebrolysin, Aktovegin, Piracetam, Cavinton, Epinephrine and other resuscitation facilities).

After the micro dose of a drug is injected to the patient, in a minute or so there comes cardiac arrest, respiratory depression, and the state of clinical death. Immediate resuscitation measures in a short time derive the patient from this critical state. Long lasting (from 30 minutes to several hours) are limb paralysis (hemi- and paraplegia), residual effects of amnesia, aphasia (non-recognition of relatives, medical staff). Sometimes patients with functional amnesia to the question about the date of admission to the clinic name the date of the beginning of their addiction. This speaks about great emotional significance for the personality of the moment of "collapse", "fracture" in his biography. These side effects have no consequences in result of intensive rehabilitation therapy. Sometimes patients experience the phenomenon of "the tunnel" at the moment of clinical death. These are hallucinatory images of "life after death", during which patients see visions of their living and deceased relatives and other people, sometimes they "leave the tunnel" or experience nightmares, fear of death. It is these phenomena that greatly increase the importance of life for the patients and make them surely quit their previous addictive lifestyle.

Our experience of provocation after encoding (conducted in 358 cases) showed several advantages over simple encoding, without further verification:

 1. The patients who have experienced the fear of death after the provocation are more acutely aware of their "second birth". One of such patients gave the precise description: “Dying was scary, but DEATH is even scarier!”

 2. Understanding of the inevitability of death after the relapse of encoding is more firmly anchored after the provocation in patient’s consciousness and sub consciousness.

 3. The state of euphoria that often arises after the provocation creates additional factors of "second birth" feeling, which reinforces the commitment in rejection of any drug.

 4. Very often among positive consequences of provocation, the patients that previously were prone to alcohol abuse, quitted not only drugs, but also alcohol without any special treatment measures.

The success of complex treatment (85.4% of the total and permanent rejection of drugs among patients) testifies to the correctness of the chosen approach of drug addiction treatment. Moreover, we have seen how the technique of "curing by death," was applied in our center (for the first time in history) in a case of severe neurotic disorder, expressed in clinically complex "anorexia nervosa-bulimia", and led to a full recovery. Due to the uniqueness of this case we give a short medical history of this patient (with names and data changed).

Patient Emma D., 22-years old, a university student and German citizen, was admitted to our clinic for the first time in 12.02.2002. She complained occasional "attacks" of famine, during which she irresistibly ate everything, devastating the entire refrigerator, and soon after vomiting and dismissing all the food. She was constantly monitoring her weight, afraid of getting fat, weight over 45 kg was surplus by her opinion, so she took urgent fitness steps (gym, swimming pool) up to exhaustion.

Evident depressive mood with suicidal thoughts occurred periodically (there were no attempts). These condition was alleviated by antidepressants (amitriptyline). Emma was critical to her disorders but could do nothing about it.

Emma had no mental disorders in her family line, she was born in an intelligent family: her father is an architect, reserved and introverted, and her mother is an economist, works in a nutrition sphere, emotionally labile and hypochondriac. The patient is the only child in the family, has always been under the overprotective mother.

The patient has Russian origins, till 11 years she lived with her parents in Tula, then the family immigrated to Israel, where she first encountered domestic and linguistic problems. The girl felt nostalgia; in public schools, which she had to change every time when they moved, she did not have friends, was closed and isolated. Her musical talent was revealed early, and she graduated her music school simultaneously with high school. The patient wanted to go to Music College. Her first sexual experience was at 16, with high school classmate. She did not want marriage due to her thoughts about her own defectiveness, was in a long intimate relationship with a 40-years older married man, she was hiding it from relatives and friends. On the moment of hospitalization she lived with her parents.

 

History of the disease: the patient's mother describes her as "very impressionable, vulnerable since early childhood, very capable". At the age of 5 she learned how to read and write, at the same time showed interest in drawing and music. However, she was unhealthy child with often colds. Before immigrating to Germany no clinical abnormality in the psyche was observed. First mental disorders appeared in the period after moving to Germany. When she turned 12, a fear of getting fat appeared (allegedly after a fellow student’s comment that she was fat). From that time until now she is constantly monitoring her weight, sharply restricting herself on food, up to several days of starvation; bulimic episodes alternate with uncontrollable eating of large amounts of food.

She received treatment in the best private clinics of Germany. She was constantly taking tranquilizers and antidepressants, massive psychotherapy (hypnosis, meditation, group and individual psycho-correction, psychoanalysis). Outpatient and stationary treatment took place, but it received only short-term effects for not more than one month. During this period she played music a lot, collected audio CDs and audiocassettes.

When her mother accidentally received information about our clinic, she contacted us by phone and received the consent of the medical treatment, though it was not our center’s speciality.

 

      Clinic and the course of the illness.

Since admission to the Center she easily communicated with the doctors, was friendly with the staff and drug addicted patients, listened to music on audio CDs (mainly classical pieces by Beethoven, Bach, Handel, Gluck). She showed signs of "leadership", desire to be in the limelight during psychological tests, when testing professional inclinations she revealed disposition to psychological sciences, medicine. Index of her aggressiveness was increased. She easily entered the state of trance during every session of super stress hypnosis in the course of treatment. At the sessions of holotropic breathing she remembered images of her childhood along with experience associated with her problem (she often saw food and felt disgusted).  

Despite the given treatment (super stress hypnosis, thiopental caffeine disinhibition, drug psychotherapy course, tranquilizers and antidepressants, amitriptyline, prodep, fluanxol, holotropic breathing sessions, psychological correction, psychoanalytic work with patients (Gestalt therapy, transactional analysis, psychodrama, NLP, etc.) during almost two months we could only alleviate the symptoms of anorexia nervosa: attacks were rarer, the mood was stable, the patient herself noted improvement, she could deter the onset of seizures of bulimia nervosa, started building real plans for the future, she wanted to continue study, to find work, to quit the "abnormal" relationship with an older "boyfriend". But at the end of the treatment seizures repeated and frequented, which very distressed the patient, reappeared suicidal thoughts, hysterical attacks. She wanted the doctor to conduct her provocation, because she saw how addicts rebuild their entire psychology, become other people.

Taking into account the persistence of symptoms of bulimia nervosa, small effectiveness of the previous therapy, signs of progressive neurotic development with bulimia nervosa content, unusual situation, personality traits, past and current suicidal thoughts, it was decided to carry out a session of "provocation". The patient was injected intramuscularly a small dose of anti-drug sensitizing serum and the next day a hundredth dose of promedol was injected. A state of clinical death came immediately, the patient was derived from it in 1 minute, later up to 6 hours pain and paresis of hands and feet was held. No impact on the physical and neurological condition of the patient was observed.

The entire recovery period (two weeks) the patient was in a good mood, she completely got rid of anorexia and bulimia attacks, she told that during her stay in a state of clinical death she was "moving in the tunnel", "returned to Tula, saw her floating above the cemetery, but without fear". After the return to Germany, she spent the first two weeks in complete remission for the first time in many years, she was free from attacks of bulimia, lived separately from her parents, as it was planned earlier, searched for a job, continued her studies. She missed the clinic, called to doctors in Zaporozhye. This condition lasted for two months, and then, without any additional stress factors, she relapsed, however, in a light form of anorexia – bulimia, the attacks became less intense and just once in 2-3 weeks, it was easier to deal with them, she didn’t stop her work and study. She decided to return to the clinic for a second course of treatment in August, 2002. On September 11, 2002 the patient underwent the second "provocation". This time the state of clinical death was eliminated with subsequent long (up to 20 hours) hemi- limb paraparesis that disappeared without a trace in a day. The patient told that during her state of clinical death she experienced the "tunnel" again. The subsequent rehabilitation period has passed without complications. After returning and up to this date the patient is completely healthy, lives with her parents, studies and works, has a close friend, plans to her future life with him, occasionally attends rehabilitation center in Germany for "supporting action" several times a year, travels a lot.

   

       DISCUSSION AND CONCLUSIONS OF TREATMENT.

The above mentioned history of illness tells about a firm, incurable for many years, case of anorexia nervosa. The patient has character traits with mosaic anomalies (combining features of hysteria, anancastic, cycloid, emotive traits with gifted personality with great artistic and musical abilities). Clinically, the main symptom is psychological duality. In one hand food is of great value for her (which revealed in bulimia attacks), on the other hand the desire not to be "overweight" (anorexia, artificial induction of vomiting). Constant iteration of this tandem caused the so-called borderline-anorexia, perfectly described and analyzed by several authors.

The disposition of the patient was determined by above-mentioned personal characteristics, situation of overprotective authoritarian domineering of her mother and passivity of her father. The provoking moments of the disease were: moving to Germany (which was later recognized by her mother as very painful moment for the girl), bullying hints of her classmates that she is fat, clearly infantile sexuality, which resulted in a long term relations with the "boyfriend" older than her own father (explicit "father replacement" of the Electra complex). The resistance and complexity of the illness genesis in this case determined its actual incurability. Doctors in our center managed to soften the patient's condition and make way for her subsequent recovery by a combination of psychoanalytic techniques and super stress hypnosis by Dr. Vasylenko, small doses of antidepressants, holotropic breathing, and psychotherapy. However, it is the "therapy by death" that allowed to achieve resistant recovery.

CONCLUSIONS:

1. The "provocation" or "death therapy" is a powerful psychotherapeutic treatment technique for patients with drug addiction;

2. "Death therapy", with all its extremeness, is a tool in cases of other mental incurable neurotic and borderline disorders; particularly its effectiveness was proved in severe, untreatable case of anorexia nervosa.

3. "Shocking" method of "death therapy" is reduced by all resuscitation measures that provide practical protection of the patient from possible complications.