著者

黒川順夫

出版者

双葉社

雑誌

主人在宅ストレス症候群

巻号頁・発行日

1993

被引用文献数

1

著者

米澤 紗智江 鎌田 穣 黒川 順夫

出版者

一般社団法人 日本心身医学会

雑誌

心身医学 (ISSN:03850307)

巻号頁・発行日

vol.56, no.2, pp.157-164, 2016 (Released:2016-02-29)

参考文献数

9

---

過食嘔吐の症状が消失後, 身体と心の不一致感を主訴とする事例に対し, ヨーガ療法による介入が奏効したので報告する. ヨーガ療法は, 独自の人間観, 病理論, 治療/指導論, 技法論を有する心理療法体系である. 摂食障害専門ヨーガ療法の通所施設にて約3カ月間 (1回/週・90分), ヨーガ療法を実施した. プログラムは身体面からのアプローチを主軸としたが, 主な介入のターゲットとしたのは身体的改善や呼吸機能改善以上に, 身体感覚の意識化や感覚に対する認知などの心理的側面であった. その結果, 失体感症傾向や気分状態の改善が認められ, 主観的症状も快方に向かった. 以上から, ヨーガ療法による身体感覚の意識化の促進が, 本事例でみられた心身の不一致感および摂食障害でよく認められる失体感症傾向の改善に有効に作用したと考えられる. また, 病理が身体性と深く関連している摂食障害に対し, 予防・回復支援・再発防止それぞれの段階で奏効する可能性が示唆された.

著者

黒川 順夫 河合 雅代

出版者

一般社団法人 日本心身医学会

雑誌

心身医学 (ISSN:03850307)

巻号頁・発行日

vol.32, no.5, pp.399-405, 1992

被引用文献数

7

---

Of the patients with anorexia nervosa (A. N.), those with body weight less than 20 percent of the standard body weight and particularly those whose body weight decreased below 40 kg may see their weight loss rapidly accelerate to 35 kg, 30 kg or less and fall into a dangerous mental and physical condition, which might lead to death. The treatment of A.N. is very difficult and not much about it has been grasped although various characteristics have been mentioned. According to studies, these A. N. patients with a marked body weight loss were found to have a strong feeling of rejecting hospitalization as follows : ・They have an image of the hospital where patients are made put on weight like a broiler. ・Why should I be hospitalized when 1'm getting along very well ? ・I don't want to be alone, ・I don't want to part with my family members, ・My daily life will be restrained. ・I doubt if the attending physician will understand me when I'm hospitalized. ・I am worried that the weight gain might not stop. ・Worrying about the hospital life. We therefore fixed an out-patient body weight limit (body weight requiring hospitalization) by which to take the hospitalization measure in accordance with patient's mental/physical conditions in case of their body weight decreasing below that limit. We also had them make efforts not to break below the level of the body weight in hospital by the period promised and had them gradually increase their body weight on their own. By this method, eighty percent of 18 cases of A. N. who met the diagnostic criteria of DSM-III-R were able to escape from the critical body weight zone and to receive treatment at the out-patient clinic. The merit of this therapy lies in that even intractable A. N. can receive treatment only at the out-patient clinic and escape from the critical loss and that extreme thinness can be prevented by setting up the body weight requiring hospitalization, if A. N. is discovered early. From the standpoint of medical economy which has recently been taken up actively for debate, this therapy can be said to have the cost merit since the whole cost of hospitalization is saved. It is therefore concluded that this is an excellent therapy for A. N.

著者

黒川 順夫

出版者

一般社団法人 日本心身医学会

雑誌

心身医学 (ISSN:03850307)

巻号頁・発行日

vol.49, no.2, pp.99, 2009-02-01 (Released:2017-08-01)

著者

黒川 順夫

出版者

一般社団法人日本心身医学会

雑誌

心身医学 (ISSN:03850307)

巻号頁・発行日

vol.28, no.6, pp.507-513, 1988-10-01

被引用文献数

3

---

The most important portion of the original Morita Therapy is concerned with showing the patient how he is preoccupied by means of work and diary, and also with helping him learn through absorption in work, that he can do anything in spite of any pains and anxiety. But Morita Therapy is difEcult to practice under the current medical insurance system, or in the setting of modern cites where the doctor's ofEce is located in a high storied building with no provision materials for work. Therefore the author proposed "Walking Training Therapy (Modification of Morita Therapy)" in which walking is adopted instead of working. This therapy is conducted according to the following formula after the period of preparations which consists of one week of absolute rest. l. The patient decides together with the therapist where the final destination of walking will be. It is suitable to choose a station or a bus stop which is located within a 30 minute walk. 2. The patient decides the course of walking. 3. The patient decides the time of walking. 4. Speed of walking is left to the patient. 5. The patient walks by himself. 6. Distance of walking is gradually extended in so far as the patient can keep up the pace. 7. The stance the patient walked yesterday can certainly be covered today, despite the patients mood or the weather. 8. If the patient can walk to the final destination, he should begin to walk twice at his pace at different times. 9. The therapist must make a consistent evaluation of the patient according to the accomplishment of walking the routine distance in spite of pain or anxiety rather than the improvement of his symptoms. lO. It is desirable to guide the patient by means of the diary and also to add daily work besides walking. The author considers this therapy is more useful than the original Morita Therapy in psychosomatic medicine because it is possible for any doctor to practice it in hospitals of any modern city as well as on outpatients. Besides it does not change the essential part of the original Morita Therapy, that is, that he learns from experience. Also this therapy is very effective for such those with a phobia 6f going out, depressive state or anxiety neuroses and psychosomatic disorders.