The method of non-verbal inductive hypnosis for overcoming psychological addiction.

(by Dr. Vasilenko, Dr. Sarzhevsky, Dr. Shevchenko)

The most difficult and hard to cure part in narcological treatment is the overcoming of a person’s psychological dependence on psychoactive substances. Courageously enduring the abstinence phenomenon, the patients persistently ask to clear the drug from their heads, to make them forget the craving, they describe it as a very painful condition.

The psychological defense mechanisms subconsciously interfere in the process of overcoming this dependence. This is actually kind of adaptive response of the individual. The most commonly used version of this protection is the “displacement”.

Integrated methodology applied by doctors in rehab center is centered upon the authoritative version of group hypnosis, aimed at concentration on every negative experience of abusing drugs or alcohol that a patient had.

With the help of this hypnosis sessions all states of fear, anxiety, pain, suffering that a person hides deep inside are revealed. They emotionally experience “death from the drug”.

Daily sessions are held with the increase of hypnotic impact force that generates disgust and even "aggression towards the drug".

The effectiveness of such method suggests further greater efficiency in patients’ achievements.

This method had been under surveillance for 2 years.

Patients from different countries took part in it: Russia, Ukraine, Germany, Greece, Israel. They had different experience of abusing drugs and were of different age range (from 14 to 47 years). The surveillance allowed to define general patterns of behavior in a state of trance during the sessions.

As a rule, the state of stupefaction is partially or completely sunk, in this state the pain threshold is significantly changed. «Responsiveness» to the hypnosis is manifested as "phenomena of exclusion":

1. Screams, followed by falling, functional seizures (usually tonic) with reiterations of single words, phrases, crying, sometimes with incongruous speech excitation;

2. Nausea, vomiting, tremor of the limbs and severe autonomic reactions;

3. Significant emotional responce with tears and remorse for what the patient did in the past;

In some cases, this condition manifested with symptoms of catalepsy, fetal position and automatic oral reflexes.

In the end of sessions the general conditions of all participants were defined with severe physical fatigue of vegetative symptoms. Everything that happens on the sessions is under control and regulation of the psychotherapist and is completely reduced after the sessions of hypnosis.

The securing of the fixed negative facts from the past and strengthening of sensations during collective sessions is held in individual psychotherapeutic conversation. The problem is solved by active memorizing of situations that happened previously due to drug intoxication. Very often they are seen as long-forgotten or very difficult to remember. The patient with closed eyes is persistently invited to relive those tragic episodes, focusing on every single image. This image is fixed, mentally imposed externally, changed in shape and color under the guidance of a doctor. Therapist observes the patient, his sensory, motor, autonomic and ocular manifestations. In order to improve the effect one is left for 10 - 15 minutes alone, in front of his own memories of the tragic result of the situation described.

The high efficiency of this integrated approach (87.2 % of patients) was tested on catamnesis during the year.

The end of sessions does not alter the presence of disgust, or aggression to the "drug".

The presence of similar manifestations  response during the collective sessions, the presence of an emotional response often facial expressions, gestures, appearance and voice modulation is primarily allowed to try work in the group of patients without the possibility of direct voice communication. The example is the patient from Greece, who absolutely did not know Russian language and spoke through the interpreter. In this case a non-verbal hypnosis takes place through collective sessions, the hypnotic impact in this case is non-verbal and is embedded inside the patients group. The interpreter only gave the keywords - "codes" that shape attitude to drugs - "drug is death», "drug is the pain," "drug is suffering."

We give a brief statement of the history of this patient due to the uniqueness of this case.

Patient K., born in 1974, a citizen of Greece, came to the hospital on 19.11.2004. On admission, he complained of anxiety, irritability, tension, physical weakness, and malaise. His sleep was superficial, intermittent, with frequent awakenings; dreams were with a "freaky content". He suffered from expressive pain in muscles of the arms, legs and waist, especially in the evening. Now he suffers from severe sweating, chills, nasal itching and runny nose, watery eyes, profuse diarrhea. Periodically there are mood swings with decreased self-esteem, pessimism about the future, irritability with proneness to conflict; during these periods all his thoughts are concentrated on drugs, a constant desire to prick is present.

The history of illness.

Patient’s heredity is not burdened by mental illness. He was born in Greece in a working class family. He was the first child, has two younger brothers. Received his secondary education and decided not to study further. He hasn’t been working anywhere for the last 3 years because of heroin addiction. Previously he worked for his father, so as his two brothers do now. His brothers do not abuse drugs. The patient is single, his first sexual experience was at 18, but he had no particular interest to women or creating a family. He lives with his parents. Evaluates himself as a calm and sociable person. He tried
heroin for the first time at the age of 19 during his service in the army. After the first episode he felt nausea, vomiting, and high temperature. However, after repeated episodes (smoked or snorted) he started to feel euphoric, when a warm wave rose from the bottom and up. It was accompanied by feeling of joy and happiness; this period did not last long. He tried to smoke cannabis, but did not like it, because comparing to heroin, he "looked stupid", he noted he acted silly and felt unmotivated risibility. Occasionally he tried
cocaine, but quitted because of financial considerations. Psychological addiction was formed on the 1-1.5 month of abusing heroine and the use of the drug became regular. The tolerance increased to 1.5 - 2.0 grams per day, as euphoric effect was reduced in its duration and quality of sensations. A month later physical dependence was formed with manifestations similar to complaints in the present admission. In the beginning he tried to work, to help his parents, but could not cope with the responsibilities. He had undergone three rehabilitation clinics in Germany, Italy and Greece for the period of his addiction in total time of 15 months. The treatment included the use of tranquillizers and anti-depressants, psychotherapy with psychoanalysis and group correction, and subsequent psychological rehabilitation. The longest remission after treatment was
observed - 1.5 months sober, and then he returned to heroin. He notes that particularly difficult period was during the 2d-3d week after rejection of psychoactive substances, he felt fatigue, had sleeping disorders, decreased mood, mental discomfort, irritability, malignancy with a distinct deterioration in the evening. At this time, it was almost impossible "to resist the drug". His parents found out about our clinic from previously treated Russian Greeks, they saw the effectiveness of therapy and then connected with Medical Center of Dr. Vasylenko and received consent to treatment.

Clinic and course of the illness.

Within four days from admission to the center a marked withdrawal syndrome showed and was accompanied by the above mentioned complaints. From the first day the patient had the mood for treatment, but doubted its effectiveness. Complex detoxification was conducted with sedatives and tranquilizers included (sibazon, thiopental Na), and antidepressants (saroten, prodep). The contact with the patient during this period was not very productive, it remained tension and was explosive in periods of conflict with

an interpreter, this period was burdened by lack of sleep. Conspicuous was the appearance of the patient -  he had severe emaciation, sunken cheeks, wary and hunted look, his state was accompanied by a decrease of appetite and was exacerbated by the lack of opportunity to communicate with other patients because of the language barrier.

After 6 days, during the first session he mostly watched the others, did not close his eyes peeping all the time. Crying and screaming of other patients he perceived with fear. During individual conversation with the therapist he requested clarification on what is happening to others and why.

However, after detailed answers could not understand the situation. Only specific translation of the repeated phrases associated with the negative influence of the drug was quite effective. During the second week the patient willingly went to the psychological conversation, but had no interest to the tests. The immaturity of judgments, psychological infantilism was revealed, especially in the revaluation of his past lifestyle, thinking about prospects for the future, and understanding of the creation of family. He showed the highest scores in the tests of Leonhard: alarm (24) and cyclothymic (21) character traits, the
anxiety scale (18) is also significantly higher than the norm (12). When answering the tests "A house, a tree and a man" he showed no real plans for the future, denied potential help of relatives, he showed selective perception of information about his abilities.

After the third group session of super stress hypnosis the patient felt expressive vegetative manifestations in the form of sweating, numbness and cold legs, he felt the "hot wave" throughout the body; thought it was the initial manifestations of the results of treatment. After another week of attending sessions the patient achieved the trance state with the whole body tremors, vomiting and screaming. This state was secured by electroconvulsive

therapy in its pre comatose parameters. Similar effects created opportunity for induction with other patients. By the beginning of the third week doctors managed to generate lasting negative effect relating to a drug substance that was manifested even at the physical level. At the sight of a syringe or a conversation about the "high", the alarm appears and the whole body started to tremor, nausea was sometimes accompanied by vomiting. The patient became much stronger physically, he regained 8 kg, and formed confidence in his possible future sober life, increased self-esteem. This effect has been fixed by the end
of the third week and after the "encoding" from opium derivatives the patient was discharged on 14.12.2004. Before the discharge he understood only a few words in russian, mostly greeting and farewell. However, during his last week he tried to be active in the environment of convalescent patients, feeling the emotional support and empathy. He told that does not remember the "high", claimed that the sessions "wiped it out of my head."

At the moment we have the patient that does not use drugs, works in a factory with his parents and intends to raise a family.

Discussion of the results of treatment.

In this clinical observation, we have seen a patient with a long term opiate (heroin) addiction with formed withdrawal syndrome. He tried rehabilitation for several times in various European countries with a maximum remission of 1.5 months; it means we are talking about a very difficult case. Personality traits with increased anxiety, emotional lability, and emotional explosiveness contributed to "breakdowns" and raised pessimism about recovery.

The complexity of the case is also connected with absent direct speech impact on the patient. However, a combination of super stress hypnosis and individual work formed a lasting effect. The suggestion during the group sessions was shown on nonverbal level and was emotionally secured.

 

Conclusions:

1. Super stress group hypnosis sessions with authoritarian manifestation version with episodes of altered consciousness are an effective method to overcome the psychological dependence with different variants of addictions.

2. Supplement of "visual update" of negative manifestations of the psychoactive substances abuse is a successful method for the preparation of an individual to group sessions and further consolidation of the effect.

3. Availability of nonverbal perception of suggestion is a unique opportunity for the effective treatment in case of absent direct voice contact or even verbal communication.