There is an opinion that awareness and acceptance of a problem is 50% of its solution. However, medicine has proven that not every person can take such a seemingly simple step. So, at the beginning of the last century, such a term as "anosognosia" appeared in psychiatry. This is a special condition of the patient, when he denies that he has a mental disorder or a physical defect, and even tries in every possible way to prevent therapy. Why is this happening and is there a cure?
Medical rationale
In 1914, the Polish neurologist Joseph Babinski 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 the limbs), as well as ignoring the surrounding reality. From a medical point of view, thisthe process is due to extensive destructive lesions in the brain, namely in the right parietal lobe. In another way, this condition is called "Babinski's syndrome".
Classification
Today, anosognosia is a broader concept, characterized by the absence of a critical assessment by the patient of his disease, addiction, 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 he has preserved movements in his left limbs, and, if desired, he can move freely).
- Anosognosia of blindness/deafness (visual and auditory images appear in the mind of the patient, which he perceives as real).
- Anosognosia of aphasia (the patient's speech is defined as "verbal crumb", but he himself does not notice errors and speech defects).
- Anosognosia of pain (partial or complete loss of response to irritating external influences).
Specialists consider this condition of the patient not an independent disease, but attribute it to the symptoms of more complex and severe processes in the body. On the one hand, anosognosia is one of the manifestations of a mental disorder (manic syndrome, dementia, Korsakov's psychosis). On the other hand, it can be considered as a warehouse of the patient's personality (for example, whenalcoholism, anorexia). There is also a third perspective: a sick person, for example, under a sense of guilt, subconsciously uses a psychological defense mechanism. It is appropriate to talk about a psychosomatic disorder here.
Alcoholic anosognosia
At present, the most common psychological condition is alcohol anosognosia. This is a denial by the patient of his dependence on alcohol or an underestimation of the severity of the habit (hyponosognosia). At the same time, as an objective assessment, the patient must be accurately diagnosed with alcoholism.
In this type of anosognosia, the patient's behavior and self-criticism can develop in two directions. He can claim that everything is going well in his life and alcohol does not interfere with him in any way. Moreover, according to the patient, if desired, he may not drink alcohol at all. However, practice shows the opposite situation.
Another model of the patient's behavior is the partial recognition of problems with alcohol, but still their severity, in his opinion, is not so great as to resort to treatment. Listening to others, he can even try to switch to light alcoholic beverages, since at the unconscious level of the patient there remains the belief that at any moment you can simply and irrevocably stop drinking.
Each model equally assumes dissimulation - hiding the symptoms of a developing disease. A sick person deliberately downplays the amount, frequency of drinking and the degree of intoxication when communicating with family and doctors.
Korsakov psychosis
According to some psychiatrists, anosognosia is a complex phenomenon, sometimes generalizing the symptoms of severe pathological processes. So, as a result of prolonged alcohol dependence, malnutrition and lack of nicotinic acid and vitamin B1, the patient experiences destructive changes in the peripheral nervous system. The consequence of this is Korsakov's psychosis. This ailment was discovered back in the nineteenth century by the Russian psychiatrist Sergei Sergeevich Korsakov.
The disease is characterized by the patient's inability to navigate in space and time, memory loss, physical defects (paresis of the limbs), as well as false memories (shift in time and place of reality or completely fictional situations). Such mental disorders with the absence of a critical assessment of the patient's environment and his condition are referred to as one of the types of anosognosia.
Psychosomatic disorders
Anosognosia and psychosomatic disorders, their causal relationships are currently being studied in more detail. The influence of the somatic system of a person (that is, his mental disorders) on physiology has long been established. So, some serious ailments (alcoholism, rheumatoid arthritis, stomach ulcers) are not amenable to traditional drug treatment only because they are literally a figment of a person’s imagination. That is, certain processes occurring in the subconscious (the emergence of feelings of guilt, unforgiveness, envy, constanthatred) find a way out at the physical level. At the same time, the patient is convinced that there are no problems in his head in the psychological sense, and the disease is not a consequence of his mental burden. This condition has been termed somatic anosognosia.
Is treatment possible?
All experts insist that recovery directly depends on the patient and his desire. To cope with the disease, it is necessary 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 objectively look at the problem, and only after that it is possible to proceed to the treatment of the disease itself. Of course, we should not forget that neglected, severe disorders can be eliminated much more difficult or not at all.
