Experimental neuroses according to Pavlov. Lecture: Experimental neuroses (I.P.
Based on the study of experimental neuroses, it was possible from the physiological side to approach the solution of the following basic questions of functional nervous pathology:
1) clarification of the main pathophysiological phenomenon or the neurodynamic essence of neurotic symptoms,
2) elucidation of the soil of the nervous type on which nervous symptoms arise,
3) and the study of the physiological dynamics of pathogenic causes that cause neuroses.
To what extent can these data be used for the physiological analysis of human neuroses?
To solve this problem, Acad. I.P. Pavlov came to the need to take into account the peculiarities of human higher nervous activity and make the appropriate increase:
“This increase concerns the speech function, which introduced a new principle in the activity of the cerebral hemispheres.
If our sensations and ideas related to the world around us are the first signals of reality, concrete signals, then speech, especially kinesthetic stimuli that go to the cortex from different organs, are second signals, signals of signals. They represent a distraction from reality and allow generalization, which is our superfluous, specially human higher thinking ”(Pavlov).
Thus, in a person, it is necessary to distinguish 3 instances of nervous activity: the subcortex with its most complex unconditioned reflexes, instincts, drives, emotions, the first signaling system (concrete thinking, directly addressing reality) and the second signaling system.
Depending on the prevailing significance and strength of the signaling systems, Acad. I.P. Pavlov distinguishes between the following particular types of the nervous system in humans (in addition to those described above common in humans and animals).
1. The artistic type is people who use the first signaling system and the subcortex closely related to it.
2. The second type - mental, works most of all by the second signaling system; these types are rare, but even less common are people in whom these two sides are strongly manifested (Leonardo da Vinci).
3. As a rule, in the middle type, the signaling systems do not reach great development, but are more or less balanced.
With a neurosis of a systemically balanced type, neurasthenic symptoms are obtained, due to various pathological conditions of cortical cells.
The main symptom of neurasthenia is irritable weakness - has its physiological substrate increased lability of the irritable process, which is called pathological explosiveness.
In these cases, due to a decrease in the limit of the cortical cell's working capacity, the irritable process quickly reaches the limit and causes transcendental inhibition. This mechanism can explain the symptom ejaculatio praecox.Weakness of concentration is explained by the weakening of the concentration of the irritable process, and some forms of insomnia are due to the weakening of internal, active inhibition. Neurasthenia can develop against the background of a strongly unbalanced or weak type. In the first case, the symptoms of excitement (excitatory form of neurasthenia) will prevail, in the second - symptoms based on the weakness of the irritable and inhibitory process, various phases of inhibition (depressive form of neurasthenia).
When a general weak or weakened type is combined with an artistic one, the soil is created for the development of a hysterical syndrome. The main physiological substrate for hysteria is Acad. Pavlov considers a weakening of cortical tone, mainly internal inhibition. From this follow particular physiological phenomena that explain both forms of behavior and symptoms of hysteria.
1. The weakness of the tone of the cortical cells determines that the usual stimuli are supramaximal and cause transcendental inhibition. Therefore, hysteria can be viewed as chronic hypnosis. This explains the physiological basis of increased suggestibility, concentrated irritation, accompanied by a strongly pronounced induction.
2. Due to the weakening of the cortex, the behavior of the hysteric becomes emotive, being controlled more by the subcortex. This also explains the concentration of nervous processes in individual points of the cortex.
3. When the cortex is weakened, first of all, the activity of the second signaling system is disrupted. As a result of its suppression, the activity of the first signaling system, which is controlled by the subcortex, increases. Hence the tendency to twilight states, fantasies.
4. Violation of mental synthesis is explained by the separation of the activity of signaling systems.
As for hysterical seizures, affective outbursts and convulsive seizures are the result of acute inhibition of the cortex and excitation of the subcortex according to the law of positive induction. If inhibition extends down the brain, then we see a passive state in the form of hysterical hypnotic catalepsy or lethargy. This difference is explained both by various degrees of weakness of the nervous processes, and by the strength relations of the cortex and subcortex.
When a general weak or weakened type is combined with a mental one, the soil is created for psychasthenic neurosis.
If the weakness is congenital, then the symptoms that are characteristic of Janet's psychasthenia are obtained: extreme indecision, fearfulness, loss of the function of the real, inability to live, but at the same time a tendency to hover in the world of abstract reflections. I.P. Pavlov was very interested in psychasthenics and studied them very carefully.
He understood psychasthenic stigmata as follows. Psychasthenia develops on the basis of a weakening of the subcortex and the first signaling system while maintaining the second signaling system. Since the subcortex and the first signaling system are instances that directly connect us with reality, when they weaken, we get an inability to live, fear it, and indecision. “If a person is hungry, he will not choose food for a long time” (Pavlov). The indecisiveness of the psychasthenic is explained by the weakness of the instinctive fund (food, sexual, aggressive). As in the weak type, the psychasthenic has a pronounced passive-defensive reflex. Hence his fearfulness, fear of everything new. The preservation of the second signaling system explains the tendency to abstraction. Constant doubts, an obsessive desire to check their actions and impressions are explained by the weakening of connection with reality and overcompensation on the part of the second signaling system. This propensity to obsessive states, which has as its basis the most nervous constitution of the psychasthenic, acad. I.P. Pavlov distinguishes it from the compulsion syndrome, which can develop against a different constitutional background.
At the heart of the symptom of obsession is, as we indicated above, the pathological inertness of the irritable process. It can be caused either by an overstrain of an irritable process or a collision of opposite processes. The same reasons can cause obsessive-compulsive neurosis in people. “Both abnormal development and temporary exacerbation of one or the other of our emotions (instincts), as well as a disease state of some internal organ or a whole system, can send to the corresponding cortical cells at a certain period of time or constantly, incessant or excessive irritation and thus produce in them, finally, pathological inertia - a persistent idea and sensation, when then the real cause has already ceased to act. Some strong and amazing life impressions could do the same. Not less, if not more cases of pathological inertia should have been created by our second reason (I.P. Pavlov) 1.
These reasons can concentrate pathological inertia in different instances of cortical activity: in the first signaling system or in the second signal or in both. It is also necessary to distinguish neuroses of fear and phobia from psychasthenic fearfulness. At the heart of the latter there is an overstrain of the inhibitory process, which acquires a special sensitivity, connecting, depending on the situation, with some external or internal stimulus (phobias).
Source of information: Aleksandrovsky Yu.A. Frontier psychiatry. M .: RLS-2006. & Nbsp - 1280 p.
The guide was published by the RLS ® Group of Companies
The most important side of Pavlov's activities is also
the fact that he managed to create new valuable installations in understanding
and the treatment of nervous diseases.
Pavlov found that the basis of the function of the nervous system
there are two processes - the excitation process as an expression
activity and the process of inhibition as an expression of temporary
attenuation of this activity. Pavlov considered these two
opposite processes in interconnection and interpenetration.
This was reflected in his transition from spontaneous dialectical
materialistic views on the foundations of dialectical mother-
alistic theory of knowledge.
Based on the study of the degree and nature of the response
nervous reaction, i.e., the study of patterns during
processes of excitation and inhibition, Pavlov developed
very important for the attending physicians teaching about temperaments and
neuroses.
Pavlov long ago proved that usually a conditioned reflex
in animals it is formed when, following the stimulus signal,
for example, behind the ticking of the metronome, the steps of a minister,
a powerful unconditioned reflex follows - food - or,
on the contrary, following the signal of danger - the rustle of a creeping
enemy-follows danger.
Conditioned reflexes are not as strong as unconditioned ones. They are
very capricious, fragile. The food irritant should
reinforce by eating, otherwise, if the signal
food (ticking of the metronome, sound of footsteps) is not supported
food, the conditioned reflex weakens, slows down, and then
disappears completely.
Pavlov's teaching on arousal and inhibition can be
is the basis for the understanding of neuroses. Neuroses arise
often under the influence of superstrong irritations, experiences,
unusual incidents. According to Pavlov, neurosis is a violation
inhibitory or excitatory activity of the cortex
brain due to its overstrain.
Rivers and canals overflowed their banks. Vivariums where they were kept
experimental animals Pavlov, flooded with water. Staff
led by Alexei Dmitrievich Speransky began
rescue animals, but to extract from the cells that surfaced
dogs, it was necessary to immerse them head first to the level
doors. The dogs resisted, they thought they were going
The dogs were saved, but soon A.D.Speransky turned
pavlov's attention that some of them have lost conditional
connections developed earlier. After a little work with the dogs
managed to restore these connections, but they became unstable,
disappeared easily (≪ conditioned salivaлю often ceased to be secreted).
At the same time, the dog was seized with anxiety: it
trembled, screeched, etc.
Pavlov became interested in this phenomenon and immediately took up
its decryption. To the room where the victim was
animal, water was run under the door. This had an effect:
the dog became worried, trembled with fright.
Pavlov and Speransky explained:
1. The dog got sick with what is called in the clinic.
to t and in about g about n e in roza.
The mechanism of this disease, therefore, is also reflex.
The dog has developed an abnormal conditioned reflex.
Such reflexes are also formed in people: for example, after
a train crash a person falls into an anxiety state,
when he hears the whistle of a locomotive.
From the side of the injured nervous system,
signs of the so-called irritable weakness т, i.e.
an easy response to minor irritations. Electric
a call of more or less noticeable force, hitherto
perfectly tolerated by animals, becomes for him
an irritating agent - the weakened brain cannot tolerate it.
On the other hand, frequent inhibitions of conditioned reflexes
can lead to the development of neurosis in animals. By creating
in the experiment, the conditions of the conflict between deceleration and
excitation in the cerebral cortex, I.P. Pavlov received
in dogs, varying degrees of functional damage
(peculiar breakdowns) of the nervous system, which were in some
features similar to neurotic conditionsobserved
in the clinic. Indeed, it is common knowledge that people have
with a weak nervous system, neurosis occurs, as a result
overloads of the cerebral cortex by inhibitory efforts.
Here is a mother caring for a seriously ill son. It
must hide from him for a long time her worries and sufferings, must
smile, comfort the patient. She wants to cry, but she
within a month suppresses his grief, keeps himself in control.
The tension of the BOLI (as we say), the mobilization of ≪ cortical
mechanisms ≫ she artificially inhibits her feelings.
As a result of this overvoltage, she develops a reactive
neurosis. In the end, there comes a breakdown: she falls into
into melancholy, no longer owns the mechanism of willpower.
≪ The same goes for dogs, - I repeated more than once
Pavlov his thought to his disciples. -C o d and y te p e r n a p r i -
w e n i e t o r m o s o p o c e s, ask the animal
difficult task - and its irregular system -
.
However, not all ≪ fail ≫. Some dogs have all sorts
reactions of excitement and inhibition quickly pass without any
consequences.
There are the following types of neuroses:
1. Neurasthenia (lat. - “ nervous exhaustion"). Reason: prolonged emotional stress, leading to exhaustion of the nervous system. Conflicts at work, family troubles, unsettled personal life. Mechanisms of psychological defense of the type of "denial", "rationalization", "repression". A patient with neurasthenia is worried about irritability for the most predestined reasons. It is difficult for them to concentrate their attention, they quickly get tired, they have headaches, heart pains, stomach functions are disturbed, insomnia appears, gets upset sexual function, the severity of sexual relations decreases. Sleep disturbance.
2.Hysteria - observed more often in women. They sometimes imagine themselves as seriously ill, unhappy, "misunderstood natures" and deeply get used to the image they have created. Sometimes an accidental unpleasant petty family quarrel, an insignificant official conflict, is enough for the patient to start crying bitterly, cursing everyone and everyone, and threatening to commit suicide. A hysterical reaction usually begins when the patient needs to achieve something from others, or vice versa, get rid of their supposedly unfair or simply undesirable demands. These reactions can be manifested by unrestrained tears, fainting, complaints of dizziness and nausea, vomiting, convulsive information of the fingers, and in general - symptoms of almost any disease known to this person, imaginary paralysis, deafness, and the voice may disappear. But with all this, a hysterical attack cannot be considered a simulation, it most often occurs in addition to a person's desire and makes him suffer physically and mentally.
3.Neurosis obsessions (psychasthenia) - persistent anxious thoughts appear, fears, for example, "to get infected with a disease", to lose loved one, blush when talking, stay alone in the room, etc. At the same time, a person well understands the illogicality of his fears, but cannot get rid of them.
Each of them occurs in people with a certain type of GNI, with specific mistakes in their upbringing and typical adverse life situations.
Pavlov based the classification of neuroses on the type of higher nervous activity. He also distinguishes three types of neuroses:
I. Neurasthenia (a disease of the middle type of higher nervous activity):
- hypersthenic form (periodically there are mood swings, general hyperesthesia, increased irritability; at the same time, even minor stimuli: loud conversation, door creaking, etc. unbalance the patient - he cannot control himself, raises his voice. Patients complain of difficulty falling asleep, excessive sweating, palpitations, headaches);
- hypasthenic form (lethargy, weakness, apathy);
- obsessive-compulsive neurasthenia (persistent anxious thoughts, fears appear).
II. Hysteria (neurosis of the artistic type of higher nervous activity).
III. Psychasthenia (mental illness).
Ways to prevent neuroses.
Prevention of neuroses is a complex task. Such prevention includes a number of psycho-hygienic and social activities, the main purpose of which is physical relaxation and release of emotional stress.
For this can be involved different ways... First of all, it is, of course, rest and normalization of the rhythm of life so that a person strictly adheres to a daily routine that suits him: work only in the hours allotted for this, at a certain time change of occupation and rest. Sometimes with developing neurotic disorder great benefit may be the use of regular or extraordinary leave with a complete change of the environment.
The creation of favorable external conditions and a positive environment is the main factor of all measures for the prevention and prevention of neuroses. This includes, among other things, but only a favorable family and household environment, but also good and calm working conditions, rational and reasonable professional orientation, prevention of emotional stress, elimination of harmful working conditions and other occupational hazards, etc.
Normalizing everyone external factors prevents the accumulation of nervous tension in the body, promotes normal and regular rest and helps relieve negative emotions if they arise.
But sometimes the creation of favorable external conditions is simply impossible, and then you have to take more drastic measures... In some cases, it becomes necessary to change the situation radically - for example, to change a job or even a profession. You should not be afraid of this - any disorder is easier to prevent than to cure later.
But if these measures do not help, and the nervous tension continues to grow, then the best way to cope with such a situation - without delay, seek advice from a psychotherapist.
Psychotherapeutic assistance as one of preventive measures
As a prophylaxis for neuroses, a psychotherapist will teach the patient autogenous training, methods of mental self-control, methods of mental relaxation. If necessary, the patient will be prescribed and drug treatment... But the main task of the doctor in prevention neurotic disorders - to mobilize and activate the natural forces of the personality, to aim them at recovery and normalization of the general mental state organism.
But for prevention nervous diseases you cannot rely solely on the doctor - the patient himself must take an active part in his recovery. It is known that the best protection against neurotic and anxiety disorders is work, but not just work as a means of existence and survival, but work for your own pleasure.
The broader the interests of a person, the more he has all sorts of activities, household attachments and hobbies, the more balanced he feels and the easier he endures life's troubles and failures. And in the arsenal of a doctor there are already not only preventive methods, but also effective medications, both for the prevention and for the treatment of anxiety and neurotic disorders.
Vegetative dysfunction.
Vegetative dysfunction is a complex of functional disorders caused by dysregulation of vascular tone and leading to the development of neuroses, arterial hypertension and a deterioration in the quality of life. This condition is characterized by the loss of the normal reaction of the vessels to various stimuli: they either strongly narrow or expand. Such processes disrupt the general well-being of a person.
Autonomic dysfunction is quite common, affecting 15% of children, 80% of adults, and 100% of adolescents. Women suffer from vegetative dystonia several times more often than men.
The autonomic nervous system regulates the functions of organs and systems in accordance with exogenous and endogenous irritating factors. It functions unconsciously, helps maintain homeostasis and adapts the body to changing environmental conditions. The autonomic nervous system is divided into two subsystems - sympathetic and parasympathetic, which work in the opposite direction.
Sympathetic nervous system weakens intestinal peristalsis, increases sweating, increases heart rate and enhances heart function, dilates pupils, narrows blood vessels, increases blood pressure.
Parasympathetic department reduces muscles and enhances gastrointestinal motility, stimulates the body's glands, dilates blood vessels, slows down the heart, lowers blood pressure, narrows the pupil.
Both of these departments are in a state of balance and are activated only as needed. If one of the systems begins to dominate, work is disrupted internal organs and the body as a whole. This is manifested by the corresponding clinical signs, as well as the development of cardioneurosis, neurocirculatory dystonia, psychovegetative syndrome, vegetopathy.
Etiology.Violation nervous regulation is the underlying cause of vegetative dystonia and leads to disorders of the activity of various organs and systems. Contribute to the development of the disease diabetes, obesity, hormonal changes, bad habits.
Symptoms.The initial stage of pathology is characterized by autonomic neurosis. Vegetative neurosis is characterized by vasomotor changes, impaired skin sensitivity and muscle trophism, visceral disorders, and allergic manifestations. At the beginning of the disease, signs of neurasthenia come to the fore, and then the rest of the symptoms join.
The main autonomic dysfunction syndromes:
· Syndrome mental disorders manifests itself as a low mood, impressionability, sentimentality, tearfulness, lethargy, melancholy, insomnia, a tendency to self-blame, indecision, hypochondria, decreased motor activity. Patients develop uncontrollable anxiety, regardless of a specific life event.
· Cardiac syndrome manifests itself in heart pain of different nature: aching, paroxysmal, pinching, burning, short-term, constant. It occurs during or after physical activity, stress, emotional disorder.
· Astheno-vegetative syndrome characterized by increased fatigue, decreased performance, exhaustion of the body, intolerance to loud sounds, meteosensitivity. Adjustment disorder is manifested by an excessive painful reaction to any event.
· Respiratory Syndrome occurs with somatoform autonomic dysfunction of the respiratory system. It is based on the following clinical signs: shortness of breath at the time of stress, subjective feeling of shortness of breath, compression chest, difficulty breathing, choking. The acute course of this syndrome is accompanied by severe shortness of breath and may result in suffocation.
· Neurogastric syndrome manifested by aerophagia, esophageal spasm, duodenostasis, heartburn, frequent belching, the appearance of hiccups in in public places, flatulence, constipation. Immediately after stress, the swallowing process is disturbed in patients, pain in the chest occurs. Solid food becomes much easier to swallow than liquid food. Stomach pain is usually not associated with food intake.
· Symptoms of the cardiovascular syndrome are heart pains that occur after stress and are not stopped by the intake of coronalytics. The pulse becomes labile blood pressure fluctuates, heart rate quickens.
· Cerebrovascular syndrome manifests itself as migraine headache, impaired intelligence, increased irritability, in severe cases - ischemic attacks and the development of stroke.
· Syndrome of peripheral vascular disorders characterized by the appearance of edema and hyperemia of the extremities, myalgia, convulsions. These signs are due to impaired vascular tone and vascular wall permeability.
Eliminate sources of stress: to normalize family and household relations, to prevent conflicts at work, in children's and educational groups. Patients should not be nervous, they should be avoided stressful situations... Positive emotions are simply necessary for patients with autonomic dystonia. It is useful to listen to pleasant music, watch only good films, and receive positive information.
Food should be balanced, fractional and frequent. Patients are advised to limit the use of salty and spicy foods, and in case of sympathicotonia, to completely exclude strong tea and coffee.
Inadequate and inadequate sleep disrupts the nervous system. Sleep at least 8 hours a day in a warm, well-ventilated area on a comfortable bed. Nervous system loosening over the years. To restore it requires persistent and long-term treatment.
tranquilizers - "Seduxen", "Phenazepam", "Relanium";
antipsychotics - "Frenolone", "Sonapax".
nootropic drugs - "Pantogam", "Piracetam".
sleeping pills - "Temazepam", "Flurazepam", etc.
Physiotherapy and hydrotherapy are indicated.