4/2023, p. 49-62
Clinical aspects of narcology

Influence of alexithymia on the effectiveness of the rehabilitation process in persons with alcohol dependence

Grigoryeva I.V., Hhodzhaev A.V., Adamchuk T.A., Kononov S.S.

Аннотация:
Introduction. Correction of the emotional sphere in alexithymic individuals addicted to psychoactive substances in the process of rehabilitation makes it possible to realize the causes of their affects and develop adequate ways of their regulation through verbalization, comprehension and comparison with their life experience. Methods. Patients with alcohol dependence syndrome were under observation at the age of 21 to 60 years with alcohol dependence syndrome, who were in a medical and labor dispensary (LTP): the main group (n=41, persons undergoing the method of complex medical rehabilitation of persons with alcohol dependence syndrome and disorders mood (MCTAM), which included: pharmacotherapy, psychotherapy, psychocorrection and occupational therapy, group I) and a comparison group (n=40, undergoing a standard program, group II). The following methods were used in the study: Toronto Alexithymia Scale (TAS-20, 2009); the Hospital Anxiety and Depression Scale (HADS) to identify and assess the severity of depression and anxiety; Beck Hopelessness Scale; «Scale of Existence» by A. Langle; Methodology «Level of subjective control» (LSC); Bipolar Spectrum Diagnostic Scale (BSDS). Statistical data processing was carried out using the program IBM SPSS Statistics 21. For correlation analysis, the Spearman correlation coefficient was used. Conclusion. 1. The revealed high level of manifestations of various levels of alexithymia in 80% of persons with alcohol dependence syndrome confirmed that in order to overcome difficulties in identifying and expressing their own feelings, they used alcohol as a means of influencing their emotional state. Regular suppression of feelings and lack of empathic emotional reactions gradually turned into a dependent lifestyle, social distancing with the formality of family and work relationships. 2. Taking into account the presence of an alexithymic profile in alcohol-addicted persons in the process of rehabilitation makes it possible to build psychotherapeutic approaches that provide access to internal emotional experiences and bodily blocks, awareness of the causes of affective tension, modulation of their affects, development of adequate ways of responding with the help of verbalization, comprehension and comparison with their life experiences, use emotions as important symbols. 3. The data obtained on the relationship between indicators of alexithymia, affective-personal characteristics, existence and the level of subjective control made it possible to determine therapeutic “targets”, verbalize requests from alcohol-addicted persons and structure the optimal plan of psychotherapeutic interaction in the rehabilitation process. 4. The selected comprehensive approach included in the structure of the method of complex medical rehabilitation of persons with alcohol dependence syndrome and mood disorders made it possible to include a consistent study of all components of alexithymia (affective, cognitive and personal), gain access to internal resources and make information about internal experiences, to realize the causes of one’s affects and addictive behavior, to consolidate the skills of self-observation and a distant “look at oneself from the outside”, one’s own understanding of life’s meanings, one’s own understanding of life’s meanings, freedom to choose a way out of a dependent impasse and integration of the value of sobriety into the system of life, develop adaptive ways self-regulation through vital sobriety and internal coherence.

Ключевые слова:
alexithymia, mood disorders, alcohol dependence syndrome, complex medical rehabilitation.