There is an opinion that awareness and acceptance of a problem is 50% of its solution. However, medicine has proven that this, at first glance, a simple step can not be taken by everyone. So, at the beginning of the last century in psychiatry, a term such as "anosognosia" appeared. This is a special condition of the patient when he denies the presence of a mental disorder or a physical defect and even tries in every possible way to prevent therapy. Why is this happening and is treatment possible?
Medical rationale
In 1914, the Polish neuropathologist Joseph Babinsky first described the phenomenon of anosognosia. And initially it was understood as a violation of the perception of the left half of the body, its physical defects (paralysis or paresis of limbs), as well as ignoring the surrounding reality. From a medical point of view, this process is due to extensive destructive lesions in the brain, namely in the right parietal lobe. In another way, this condition is called "Babinsky syndrome."
Classification
Today anosognosia is a broader concept characterized by the absence of a critical assessment by patients of their disease, dependence, and defect. Simply put, the patient is not aware of the presence of a pathological process in the body. This mainly concerns motor and speech disorders, loss of vision and hearing. From this position, anosognosia is classified into several types:
- Anosognosia of hemiplegia (a phenomenon when a sick person after a stroke claims that his movements in his left limbs are preserved, and if he wants, he can move freely).
- Anosognosia of blindness / deafness (visual and auditory images appear in the patientās mind, which he perceives as real).
- Anasognosia of aphasia (the patientās speech is defined as āverbal crumbā, but he himself does not notice errors and speech defects).
- Anosognosia of pain (partial or complete loss of reaction to irritating external influences).
Experts consider this condition of the patient not an independent ailment, but attribute it to the symptoms of more complex and difficult processes in the body. On the one hand, anosognosia is one of the manifestations of any mental disorder (manic syndrome, dementia, Korsakovās psychosis). On the other hand, it can be considered as a warehouse of the patientās personality (for example, with alcoholism, anorexia). There is also a third perspective: a sick person, for example, under guilt, subconsciously applies a psychological defense mechanism. It is appropriate to talk about psychosomatic disorder.
Alcoholic anosognosia
Currently, the most common psychological condition is alcoholic anosognosia. This is the patient's denial of his dependence on alcohol or an underestimation of the severity of the habit (hyponosognosia). Moreover, as an objective assessment, the patient should be accurately diagnosed with alcoholism.
With this type of anosognosia, the patientās behavior and self-criticism can develop in two directions. He can argue that in his life everything is going well and alcohol does not bother him. Moreover, according to the patient, if desired, he may not drink alcohol at all. However, practice shows the opposite.
Another model of the patientās behavior is the partial recognition of alcohol problems, but nevertheless, in his opinion, their severity is not so great as to resort to treatment. Listening to others, he can even try to switch to light alcoholic drinks, since at the unconscious level of the patient remains the belief that at any time you can simply and irrevocably stop drinking.
Each model equally assumes dissimulation - the concealment of the symptoms of a developing disease. A sick person deliberately reduces the amount, frequency of alcohol consumption and the degree of intoxication when communicating with family and doctors.
Korsakovsky psychosis
According to some psychiatrists, anosognosia is a complex phenomenon, sometimes summarizing the symptoms of severe pathological processes. So, as a result of prolonged alcohol dependence, malnutrition and a lack of nicotinic acid and vitamin B1, the patient undergoes destructive changes in the peripheral nervous system. The consequence of this is Korsakovsky psychosis. This ailment was discovered back in the nineteenth century by the Russian psychiatrist Sergei Sergeyevich Korsakov.
The disease is characterized by the patient's inability to navigate in space and time, memory loss, physical defects (paresis of limbs), as well as false memories (a shift in time and place of reality or completely fictitious situations). Such mental disorders with the absence of a critical assessment of the patient's surroundings and their condition are referred to as one of the types of anosognosia.
Psychosomatic disorders
Anosognosia and psychosomatic disorders, their cause-effect relationships are currently being studied in more detail. It has long been established the influence of the somatic system of a person (that is, his mental disorders) on physiology. So, some serious ailments (alcoholism, rheumatoid arthritis, stomach ulcer) are not amenable to traditional drug treatment only because they are literally a figment of the human imagination. That is, certain processes occurring in the subconscious (the emergence of guilt, unforgiveness, envy, constant hatred) find a way out on the physical level. At the same time, the patient is convinced that in his head in the psychological sense there are no problems, and the disease is not a consequence of his mental burden. This condition has been defined as somatic anosognosia.
Is treatment possible?
All experts insist that recovery depends on the patient and his desire. To cope with the disease, you need to soberly assess your condition and look for ways to solve the problem. First, the patient has to get rid of illusions, false ideas. And this requires the help of a specialist. It will help the patient to take an objective look at the problem, and only after that you can proceed to the treatment of the disease itself. Of course, do not forget that neglected, severe disorders can be eliminated much more difficult or not at all.