Detox Mind, Heal Body

By Alex Vernocci

✓ How to treat pathologies related to stress with main psychological techniques?
People can learn to control the effects of psychological stress using relaxation techniques based on experimental demonstrations:
★ Mindfulness-based stress reduction
★ Relaxation response
★ Autogenic Training
★ Progressive muscle relaxation
★ Biofeedback

✓ How psychopharmacology are used in stress-related diseases?
Drug treatment with antidepressant medications can help improving anxiety and sleep disorders in a few weeks, and can be effective for:
♥ Changes in mood
♥ Anxiety disorders
♥ Restoration of the HPA axis
♥ Raising the pain perception threshold
♥ Improvement of cognitive functions

✓ How the relation stress and depression works?
A prolonged exposure to stress that does not determine a favorable adaptation, can have pathological consequences, mainly, but not exclusively, related to mood disorders.

✓ How to transform stress in well-being and health with culture?
With “culture” we mean “quality of life", such as eating and smoking habits, genetic heritage, exposure to toxicity or stress, but also the level of income or quality of relationships, and doctors a relatively minor role on the expectation of life.

✓ Which are the most updated tools to diagnosis stress and somatization disorders?
The DSM-5 tool contains symptoms, descriptions, and other criteria for mental disorders diagnosing, to provide professionals with clear indications on how to treat patients, in order to identify:
⚠ Somatization symptom disorders
⚠ Acute Stress Disorder
⚠ Post-traumatic stress disorder
⚠ Adaptation disorder

✓ How to find a diagnosis of stress-related diseases in legal-medical field?
Helpful tools are:
◆ Work-related stress, Mobbing in the workplace, Post-Traumatic Stress Disorder - PTSD
◆ Minnesota Multiphasic Personality Inventory-2, Rorschach
◆ Assessment of psychic damage in civil liability

If you want to learn more, buy with confidence… and start your journey!

• Language: English
• Publisher: Lulu.com
• Release date: Jan 4, 2021
• ISBN: 9781716260391

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Preface

Only a few and illuminated specialists have realized that the modern approach to a whole series of pathologies so-called functional requires an integration between the two visions and philosophies, an effort of mutual humility, and a strong sense of collaboration.

Somatization is often a source of bewilderment in medicine. The doctor-patient relationship, which is key to manage and solve any critical aspect of the health sphere, is put under serious threat by the presence of non-physical and non-explained symptoms, of which somatization is a frequent example.

Just as Freud, at the beginning of the last century, free both the patient and the doctor by the tyranny of unexplained symptoms, offering a model for understanding the genesis of some symptoms and a method of psychological intervention, so now a new generation of empirical studies conducted in the modern clinical and psychophysiological psychological field are providing rational treatment models that allow empowerment of the operators called to face these problems in clinical practice.

In medicine, it is emerging the awareness that the human body is not a machine, and its malfunction cannot be analyzed just by breaking the system down in its parts and by considering each of them in isolation. Neither the disease nor human behavior is predictable and they can’t be modeled with a simple system based on cause-effect relationships.

Taking up the words of the father of biodiversity: The biggest challenge today, not only in cell biology and ecology but in all science, is the accurate and complete description of complex systems. Scientists have factored many systems in small pieces. They think they know most of the elements and forces. The next task will therefore be to reassemble them, at least in mathematical models that capture the key properties of whole sets, i.e., say connections, nodes and hubs, or carrier nodes.

A complex phenomenon adapts to the environment and works to adapt the environment to itself. And what we call environment is often another multitude of complex phenomena. The problem is that complex phenomena cannot be understood using simple cause-effect models. The non-linearity of these phenomena is such that in their functioning and development, they behave as if their effects were the cause of their causes.

This book deals with the theme of therapies by illustrating, through empirical data, the results of research, psychological techniques, and proven clinical efficacy of drug therapies.

The issue of the relationship between environment and stress is also presented through an in-depth study of two very recent areas that have emerged in recent years, both empirically and socially: culture and stress, work organization, and stress.

Finally, the new perspectives are deepened in clinical and research field describing the DSM-IV modification proposals experts will bring to the fifth edition of the APA manual, the new diagnostic criteria for psychosomatic research, and clinic diagnosis on stress-related diseases in the medical-legal field.

Chapter 1 - Psychological techniques to treat pathologies related to stress

1.1 History and applications of the main relaxation techniques in stress management

The interdependence between mind and body finds in the history of the human and natural sciences, a constant validation from which many theoretical approaches on the etiopathogenesis pathologies originate.

The modern man, who often lives in a hurry, sometimes looking towards the future, is not aware that he is an active agent in his reactions to life events, and therefore to be able to influence the impact of a stressful factor through cognitive, emotional, and behavioral strategies. Indeed, people can learn to control the effects of psychological stress to achieve a greater well-being and a more pleasant and peaceful life.

In particular, in the last few decades, the demonstration of the effectiveness of relaxation training has taken a particular relevance, especially in the treatment of stress symptoms. To date, among the many relaxation techniques, those comforted by more experimental demonstrations have been the progressive muscle relaxation, the biofeedback, the autogenic training, the mindfulness and the stress inoculation training.

In each of these techniques, relaxation represents an interactive process, where the psychological and physiological aspects are not simply related to each other, but they are integral and inseparable parts of the same process. Before examining the modalities of the technical specifications, it should be highlighted that the relaxation produces physiological effects with opposite characteristics to those provoked from psychological stress.

Therefore, the relaxation response can be considered as the mirror image of the activation image. In fact, on a physiological level, it is possible to observe a multiplicity of reactions: slowing down the heart frequency and respiratory rate, increased skin resistance, peripheral vasodilation, decrease in skeletal muscle tone, increase in EEG synchronization, reduction of oxygen consumption, and prevalence of anabolic processes.

In addition to specific changes in the body's activity, the relaxation produces, on a psychological level, enterocceptive (i.e., which receives information from the sensory receptors of the skin, stimulated by agents placed outside the body), feelings of well-being, calm and tranquility.

Although the psychophysiological responses vary according to each individual, a deeply relaxed subject typically shows a decrease in the sympathetic system response and an increase in parasympathetic activity. It was precisely this peculiarity of the relaxation response that it has suggested its use in behavioral interventions. Especially since learning relaxation techniques determines a greater individual self-efficacy, which is associated with a greater ability to resilience to stress.

Although it is possible to trace the origin of the relaxation techniques to studies on animal magnetism and hypnosis of the 70s and 90s centuries, it is only with the scientific progress in the field of anatomy and neuro-psychophysiology that relaxation techniques have taken on a greater scientific connotation.

The history of relaxation techniques based on standardized administration protocols is relatively recent, just think that the first scientific publications date back to the early 20s.

It is important to emphasize that the universe of relaxation techniques or activities that fall within this category is quite vast and varied, both in relation to the theoretical bases and to the areas of application. For this reason, within this chapter, the techniques that follow the evidence-based paradigm will be exposed mainly used to reduce harmful stress (distress).

The progressive muscle relaxation technique will be illustrated in the following, together with autogenic training, biofeedback, mindfulness-based stress reduction. If the first two are based on the classical conditioning theoretical construct, and the biofeedback on the operant conditioning, mindfulness sinks its roots in the millenary oriental culture and philosophy. It is possible to classify relaxation techniques both in relation to directivity and to different involvement of the physiological and cognitive response systems.

In fact, on one side, we find techniques such as the progressive muscle relaxation and the autogenic training, which are based on physiological response systems, and on the other side, there are techniques that fall within the category of hypnosis and meditation. As for biofeedback, many agree that it is more an aid procedure to learn relaxation than a real technique.

This classification highlights, in addition to the different focus of the techniques, the fundamental role that the therapist plays in the presentation and administration of the techniques. We believe that the presentation of any relaxation technique needs an adequate explanation about (1) the purposes of relaxation in relation to the patient's problems, (2) in what the technique consists in general terms, and what are its constituent parts, including the current one, and the importance of domestic practice."

Also, patients' expectations regarding results shouldn’t be underestimated that can be obtained through the use of these techniques. Indeed, as he reported in one of his publications, patients with chronic somatic long-lasting stress have higher expectations than relaxation and simultaneously show the most negative attitudes towards relaxation. All this to emphasize that the therapeutic effects are not due to the simple application of the relaxation technique, since, even when the techniques of relaxation aim directly at learning strategies useful for reduction of physiological activation, the implications that indirectly are obtained on a cognitive level.

For this reason, it is legitimate to talk about the direct and indirect effects of relaxation techniques. It is believed that the relaxation is an interactive phenomenon in which psychological and physiological aspects are inseparably integrated, covering both the role of causes and effect of the process.

In fact, there is no doubt that the direct effect, at least in most cases (except for rare exceptions), is found in the reduction of physiological activation, the implications in terms of increasing empowerment and self-efficacy are not to be overlooked, resulting from the ability to control (intentional reduction) your psychophysiological activation. Below are the relaxation techniques that have received more scientific evidence.

1.2 Mindfulness-based stress reduction

In recent years there has been growing attention from clinical psychology and health psychology towards one of the oldest practices of the world: mindfulness meditation. In particular, mindfulness has found fertile ground, especially in the context of cognitive-behavioral therapies, to the point of distinguishing that part of denominated theorizations named third generation from cognitive-behavioral therapy.

The increasingly creation of specific intervention protocols, and therefore evaluable in terms of effectiveness in relation to the various ailments has favored the birth of numerous treatment programs. Among these, we mention the Mindfulness-Based Stress Reduction (MBSR), the Mindfulness-Based Cognitive Therapy (MBCT), the Mindfulness-Based Relapse Prevention (MBRP), the Acceptance, and Commitment Therapy (ACT), and the Dialectical Behavior Therapy (DBT).

Given the number of mindfulness-based approaches that exist in the literature, in this discussion, we will refer only to that addressed to stress reduction or the mindfulness-based stress reduction program. Mindfulness practices, as they are used today in the clinical setting, arise contemplative practices from the ancient Buddhist of Theravada tradition.

Theravada literature describes two types of meditation: samatha, practiced to achieve concentration, and vipassana, used to induce in the mind a state of awareness and understanding of nature as it is. When we talk of mindfulness, we refer to an active process of awareness and acceptance of own physical sensations, emotions, and feelings, own thoughts as they are experienced in the hic et nunc by the subject.

Mindfulness consists of paying attention to a particular way: intentionally, in the present moment and in a non-judgmental way, that is, without connoting own positive or negative quality experiences. It is a particular exercise of uncritical self-observation of the flow of internal or external stimuli when they occur.

From what has been said so far, it is clear that this is a non-verbal personal experience and, therefore, impossible to teach theoretically, but to learn necessarily through direct practice. Furthermore, the concept of mindfulness is difficult to define. Another difficulty is represented by the fact that the term assumes different connotations according to authors and contexts, sometimes referring to a mental ability, others to one technique, or to a psychological process.

Many have tried to give an operational definition of this construct. For example, scholars consider it a mental skill that develops and