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Как 100% БРОСИТЬ ПИТЬ АЛКОГОЛЬ самостоятельно? :: профессор Осипов А.И.

Как 100% БРОСИТЬ ПИТЬ АЛКОГОЛЬ самостоятельно? :: профессор Осипов А.И.

Channel: ИСТИНЫ ПРАВОСЛАВИЯ

Игорь Лазарев

зависимость

алкоголизм

зависимости

аддикция

нарколог

обсессия

00:00:00

we are all dependent on each other

00:00:03

gambling work social networks sweet coffee Well, or

00:00:08

something stronger every day we hear I do

00:00:12

n’t lie under the fence I go to

00:00:14

work Why The more dependent a person is,

00:00:17

the easier it is for him to come up with an

00:00:20

excuse within a person, a

00:00:22

split occurs within the personality on the

00:00:25

healthy part and the addictive you are at the very

00:00:28

bottom, but it seems to you that now you

00:00:31

will make this miracle bet and you

00:00:34

will get everything back. We generally have a chance

00:00:38

to resist this digital drug.

00:00:40

The more often the brain is stimulated, the

00:00:44

more intrusive the nature of the

00:00:46

addiction. We are moving away from reality

00:00:48

instead in order to correct reality

00:00:50

so that it becomes comfortable so that

00:00:52

relationships bring pleasure and so

00:00:54

on we begin to gradually leave

00:00:55

leave leave and notice Inno to salty

00:00:59

When the addiction syndrome is already developing,

00:01:01

obvious with obvious

00:01:12

consequences Hello everyone We are all

00:01:15

dependent on each other gambling

00:01:19

work on social networks sweet coffee Well or

00:01:23

something stronger where does this

00:01:26

passionate desire arise from which Sometimes it is simply

00:01:28

impossible to resist

00:01:31

Why we sometimes actually

00:01:38

submit We are to one degree or another

00:01:40

susceptible to this before we begin I

00:01:43

would like to remind our viewers that

00:01:46

this episode is in no way a

00:01:48

promotion of the use of tobacco

00:01:51

alcoholic drugs

00:01:53

participation in gambling and breaking the

00:01:56

law, but we believe that our nature

00:02:00

needs to be understood, so today

00:02:02

my guest is a brilliant doctor, psychiatrist,

00:02:05

narcologist Igor Lazarev Igor,

00:02:09

hello Good afternoon, thank you for

00:02:11

the invitation Well, look, I would like to

00:02:14

start with the definition of addiction in general

00:02:17

without any relation of any specific

00:02:19

type, as far as I understand in medicine,

00:02:22

there is still no such consensus on this matter

00:02:25

for you. What is it like? Well, yes,

00:02:29

in order to fully answer, you

00:02:31

will need to understand the terminology and I

00:02:33

think it will help us in the future

00:02:37

when I tell this an important

00:02:39

concept about which it’s probably

00:02:41

better to say at the very beginning is addiction, well, from

00:02:44

English it’s roughly translated as

00:02:46

dependence and was translated by a

00:02:49

psychiatrist from

00:02:51

Novosibirsk Korolenko who

00:02:54

developed this concept of addiction addiction

00:02:57

such as a painful stage of development

00:02:59

addiction When there is no diagnosis yet, so to speak,

00:03:01

but there are already defined

00:03:04

moments they are connected with the fact that a person

00:03:06

leaves reality from his internal

00:03:10

or external due to an altered

00:03:14

state of consciousness that is caused

00:03:16

either by taking some substances, alcohol,

00:03:19

drugs, or it can be achieved by

00:03:22

certain actions, that’s what you

00:03:24

said at the beginning, betting on sports I I don’t

00:03:27

know sex egoism shopping an altered

00:03:30

state of consciousness and the

00:03:32

so-called active personality begins to form,

00:03:34

that is, inside a person, within

00:03:35

the personality, a split occurs into a

00:03:38

healthy part and an addictive

00:03:41

addictive part, she is already beginning to solve all

00:03:45

her problems with the help of an altered

00:03:47

state Well, everyone has their own Yes, someone

00:03:48

drinks someone in a casino puts that is, getting away

00:03:52

from problems from negative emotions from shame,

00:03:55

feelings of guilt there from

00:03:58

active anxiety personally offers

00:04:01

one great solution for all problems to the one

00:04:04

who drinks, says Drink to the one who is addicted

00:04:07

to the casino there, says go play and

00:04:10

so on, the healthy part at first

00:04:13

resists But usually, if

00:04:16

psychotherapy is not carried out, an addictive

00:04:18

personality can win and

00:04:21

then In general, the development of

00:04:24

addiction as a clinical condition arises.

00:04:27

Listen, I came across such a

00:04:28

definition,

00:04:30

this is a neuropsychological disorder

00:04:32

characterized by persistent and strong

00:04:34

desires to perform actions that

00:04:36

bring quick rewards despite

00:04:39

significant harm to health and other

00:04:42

negative consequences Well, that is, if there is

00:04:45

no harm to health, then it is not considered an

00:04:48

addiction, no. That’s exactly it. Well, I would say

00:04:52

this, I don’t completely agree with this definition

00:04:53

that I adhere to the

00:04:55

biopsychosocial one, which is

00:04:58

the most common, that if everything

00:05:01

were so simple, that is, only some- then

00:05:05

neurochemistry is the component

00:05:08

concept of psycho - these are many

00:05:10

psychological mechanisms for escaping from

00:05:13

reality, irresistible feelings, often

00:05:16

shame, guilt, and so on, and social

00:05:19

- this environment is very

00:05:22

important and there was even an experiment

00:05:25

called Rat Park when rats

00:05:27

were given water from

00:05:30

Well and ordinary water and they

00:05:32

had nothing in the cage, they drank water with

00:05:34

morphine and gradually died and another

00:05:38

group of rats were made a Rat Park there

00:05:41

were rides of all sorts of wheels females

00:05:45

if they were males Well, that is, they

00:05:46

had the opportunity to have fun, so to speak,

00:05:49

and these rats they started drinking

00:05:51

regular water and

00:05:54

spending time in their sim park,

00:05:56

this is the kind of moment that speaks to the essence of

00:05:59

interactions, is it the same with people, are

00:06:03

they relatives, does the wife have

00:06:05

codependency, well, or the husband, it doesn’t matter, that is,

00:06:08

look at addiction only from the

00:06:10

point of view of neurobiology Well,

00:06:12

unfortunately this is a very narrow view. Although

00:06:14

all these changes are certainly

00:06:17

present and yes, causing these

00:06:20

symptoms. Well, maybe I’ll talk about them later,

00:06:22

and now there are a number of criteria

00:06:25

that already speak about the diagnosis. We

00:06:27

have an international classification of

00:06:28

diseases and there are clear criteria for ae in the

00:06:32

first place. we are talking about chemical

00:06:34

dependencies, alcohol, different types of

00:06:36

drugs, drugs, and so on, here

00:06:39

the first is an irresistible desire or

00:06:42

craving - this is the very first most important

00:06:44

criterion, the second is the loss of control

00:06:47

when a person tries to control the

00:06:50

amount of time, he fails, the

00:06:53

third criterion is tolerance then there are

00:06:56

growing dosages of alcohol and drugs, the

00:06:59

same with gambling, you need to

00:07:01

lose more money, and so on, the fourth

00:07:05

criterion is loss of interests, this is already

00:07:07

coming from the addictive stage when friends

00:07:10

turn into drinking buddies there in Sou

00:07:13

consumers work hobbies family everything

00:07:15

fades gradually into the background Well, another

00:07:19

criterion withdrawal syndrome is already obvious

00:07:21

if you have withdrawal symptoms or a hangover,

00:07:24

this is already a 100% criterion for

00:07:27

addiction and ignoring

00:07:30

the consequences, that is, despite the fact that

00:07:32

there are consequences for health or for

00:07:34

life, a person cannot stop

00:07:36

using these six criteria,

00:07:38

three of them are enough to set

00:07:40

strictly speaking, the diagnosis is yes, but

00:07:43

addiction begins a little earlier, so it is

00:07:45

very important to talk about it. What is clear is

00:07:47

when a person is already hungover, when

00:07:49

he is experiencing withdrawal, well, obviously they turn to us,

00:07:52

unfortunately, only at this

00:07:54

stage, but everything begins much much

00:07:57

many years earlier when we we leave

00:08:00

reality instead of correcting

00:08:02

reality so that it becomes comfortable so

00:08:04

that relationships bring pleasure and

00:08:06

so on we begin to gradually leave leave

00:08:08

leave and sometimes we notice

00:08:11

Unfortunately, only when an

00:08:13

obvious dependence syndrome with

00:08:15

obvious consequences has already developed, we will now

00:08:18

analyze all these criteria in detail,

00:08:20

but here we are There is also another

00:08:24

definition of addiction: this is a

00:08:26

compulsive attraction to stimuli that

00:08:29

have immediate reward.

00:08:31

This is always a compulsive attraction to

00:08:34

desires that must be realized

00:08:35

immediately. Here and now, I just

00:08:37

thought that delayed joys cannot

00:08:40

cause addiction. No, this is also a very

00:08:43

good definition and important in the initial

00:08:45

stages. This is pathological. the attraction

00:08:47

is precisely of a compulsive nature;

00:08:49

compulsive means obsessive. That is, a

00:08:53

person gradually develops such

00:08:55

constant obsessive obsessive thoughts

00:08:58

that it is necessary to change the state of consciousness,

00:09:02

who with what? Yes, we are talking about different things here, and

00:09:05

just when I’m talking about neurobiologists.

00:09:08

You said there are such

00:09:10

neurobiological features in addition to neurotransmitters

00:09:12

Well, maybe we’ll talk about this

00:09:14

there, dopamine serotonin norepinephrine

00:09:17

there are features of the work of the

00:09:19

brain itself, the prefrontal cortex of the brain, so let’s say a

00:09:23

deficiency of this frontal cortex, it

00:09:25

is responsible for the fact that a person can

00:09:27

delay receiving

00:09:32

this theory is often illustrated with a marshmallow

00:09:35

test, many may have heard When

00:09:37

children were

00:09:38

given an experiment, they could

00:09:41

eat one marshmallow, but now they could either

00:09:44

eat five marshmallows in an hour or

00:09:47

two, I don’t know, wait, and so the children

00:09:50

were divided into those who had to eat

00:09:51

right now and those who could wait, and

00:09:55

it turned out that those who were asked to wait would

00:09:57

sing later pleasure is a deficit of

00:10:00

just this prefrontal cortex, this is

00:10:02

very often found in addicts

00:10:04

because they need everything and at once right

00:10:07

now, it arises against the background of this

00:10:10

compulsive desire, the urgent

00:10:12

need to change the state does not matter,

00:10:14

you want to get pleasure or get away

00:10:16

from negative states, which is often also

00:10:19

occurs, that is, anxiety has appeared,

00:10:22

it can be caused by previous

00:10:24

use But a person cannot

00:10:26

wait, he has this kind of

00:10:28

obsessiveness to change the state, just about

00:10:31

obsession, what we

00:10:34

discussed in terms of symptoms is similar to

00:10:36

obsessive-compulsive mental

00:10:38

disorder, which in itself became an

00:10:40

obsession in the 21st century, and yet when we

00:10:43

think that this is just an obsession And

00:10:46

when does it definitely become an addiction?

00:10:48

Well, how do they have similar mechanisms in

00:10:51

compulsive ones? Yes indeed. Well, from the

00:10:53

point of view of psychotherapy, there are

00:10:56

similar mechanisms in development. Well, for

00:10:58

example it

00:11:01

’s called a person has a large number of

00:11:03

introjects, that is, different attitudes about

00:11:06

how it should be. Well, the man doesn’t cry

00:11:10

there, I don’t know, the doctor there should

00:11:13

look like this, different different

00:11:14

ideas about life, and we call this

00:11:17

psychotherapy, hard introjects and a person,

00:11:19

the more demands he has on himself the more

00:11:21

difficult it is to meet him and he is such

00:11:24

a person brought up with such Kimi

00:11:26

requirements, he begins to experience a

00:11:27

feeling of a lot of combined OCD and

00:11:32

addictions, in this compulsive

00:11:35

mechanism the feeling of guilt is such a

00:11:37

dominant emotion, that is, a person

00:11:39

makes demands on himself then they do not

00:11:41

meet them And and begins to experience a

00:11:44

feeling guilt, the feeling of guilt gives rise to

00:11:47

obsessive thoughts, maybe there really is

00:11:48

someone there, checking something, the pens are off,

00:11:53

he didn’t forget to turn it off or obsessive

00:11:55

thoughts, obsessions, this is all very closely

00:12:00

connected at such in the very early

00:12:02

initial stages of the development of addiction And

00:12:05

then when the addict starts

00:12:07

using That is he developed Well,

00:12:10

such a scheme Yes, there is use, then

00:12:12

a feeling of guilt for using it, he begins to

00:12:14

scold himself, then

00:12:18

obsessions arise again He uses again and in

00:12:22

hindsight

00:12:23

begins to come

00:12:25

up with, Well, not excuses, but the brain

00:12:28

Begins to look for

00:12:29

defense mechanisms that I drank

00:12:31

because I was tired I drank because there was stress

00:12:34

I drank because I had to drink at work

00:12:37

I drank because I had a fight with my

00:12:40

wife or vice versa to cheer up

00:12:42

all this happens as if in retrospect

00:12:45

initially it arises It’s the

00:12:47

obsessive attraction that we’re directly

00:12:49

dissecting

00:12:50

psychopathology here’s addiction now

00:12:53

let’s talk a little about it

00:12:55

addiction neuroscientists themselves said about the side or it’s an

00:13:00

irresistible craving and loss of self-control

00:13:03

about control a little later, but here’s how

00:13:06

craving is formed at the level of the biochemistry of

00:13:08

our brain, well, here it’s important to probably

00:13:12

talk about neurotransmitters because of

00:13:14

course it’s connected primarily with the

00:13:17

dopamine system of the brain and the

00:13:22

reward system Often in such people,

00:13:25

in addition to the fact that dependent people, in addition to the fact

00:13:27

that the frontal qi of the cortex, which I

00:13:30

said, there is also an imbalance of these

00:13:33

neurotransmitters, well, first of all,

00:13:35

Dopamine, serotonin, norepinephrine and

00:13:38

people. What Dopamine is responsible for, first of all,

00:13:41

for motivation, for some kind of

00:13:44

desire to achieve something receive Well, I don’t

00:13:47

know Passed the exam, achieved something, your

00:13:51

own Dopamine is released there and you have

00:13:54

such self-esteem growing VM

00:13:57

motivational Sphere it is also responsible for the

00:14:00

speed of thinking for motor

00:14:03

activity Well, first of all, this is what

00:14:05

concerns us, this is, of course, such a sphere of

00:14:07

motivation and

00:14:09

achievement in people who have a

00:14:11

certain deficiency, they tend

00:14:14

to correct dopamine with

00:14:16

psychoactive substances, then they

00:14:19

initially have some kind of defect, then let’s

00:14:22

say he used some kind of

00:14:24

psychostimulants VS, it jumped up there by

00:14:28

tens

00:14:29

and it seems to him that’s because I communicate a lot

00:14:32

with the guys, I always ask about the

00:14:34

first time how it was the first time, especially

00:14:37

if we are talking about psychostimulants,

00:14:39

says everything, I felt the energy, I

00:14:41

felt like a king, that everything was

00:14:44

working out for me, a lot of thoughts, a lot of plans, and

00:14:48

then that we pay for it and so there was a

00:14:51

certain deficiency Dopamine

00:14:54

begins to decrease even more and the person

00:14:57

ends up in such a situation I can say

00:14:59

dopamine in which

00:15:01

this obsessive desire appears, obsessive and

00:15:03

the desire for treatment to change

00:15:05

the state of consciousness again to repeat the cring

00:15:09

is also the name of this Yes again to

00:15:11

repeat that state to

00:15:13

return to where everything was good Everything

00:15:15

is fine And the further he accordingly

00:15:18

plunges down this ladder goes

00:15:20

down, the more difficult it is for your own dopamine

00:15:23

to be produced to participate in metabolic

00:15:25

processes and the more external

00:15:27

stimulation is needed and then at some stages

00:15:29

the desire from a new level can sometimes

00:15:33

reach such a psychotic

00:15:35

delirium when I had patients there

00:15:38

at the peak of addiction Well, I don’t know there were

00:15:40

an example That a person needs to

00:15:42

be discharged from the hospital in a day and he,

00:15:46

suppose, jumps out of the window Yes,

00:15:48

because he has such an

00:15:50

irresistible desire, it is no longer

00:15:52

obsessive, it is already due to such delusional

00:15:55

mechanisms, so he understands right

00:15:57

now yes Yes, you need to get out here VS and with the

00:16:00

frontal Koran the craving of a

00:16:02

psychotic level works, there are practically zero chances without

00:16:05

some kind of external support.

00:16:07

Yes, we said that one of the most

00:16:09

obvious signs that a person is addicted

00:16:12

is a refusal to admit dependence. Why

00:16:15

The more dependent a person is, the easier it is for

00:16:19

him to come up with an excuse Well, this is

00:16:21

called zazi or denying one’s

00:16:26

illness is not only

00:16:29

psychiatry for other mental

00:16:32

illnesses, for some

00:16:34

psychosomatic diseases, and so

00:16:36

on. Well, again, with addictions, there is a

00:16:39

criterion here that is about this.

00:16:42

I always say when we work with

00:16:43

addictions that it is necessary to separate one’s

00:16:46

own desire and craving craving is

00:16:49

called pathological attraction

00:16:51

because the person thinks that I

00:16:53

wanted to drink because I had to get rid of

00:16:57

a lot, but it is important to admit that you did

00:17:00

n’t want anything in this situation,

00:17:02

Craven worked for you using all these

00:17:04

mechanisms. That is, this is a

00:17:06

psychopathological E symptom complex,

00:17:09

yes which has a neurobiological

00:17:11

nature behind it, if you admit this, this is

00:17:14

always the first step towards recovery, in fact,

00:17:17

to admit that you are

00:17:19

not guided by your desires in

00:17:22

those states when you use

00:17:24

psychoactive substances, but in fact,

00:17:27

your psychological state is based

00:17:30

on this compulsive attraction and in

00:17:32

hindsight you come up with it, and if a

00:17:35

person’s awareness is formed a little bit,

00:17:36

you begin, of course, there is even an

00:17:39

addiction at the first stage,

00:17:40

for example, a

00:17:41

symptom. When a person himself comes up with some

00:17:44

kind of holidays, well, he adjusts his

00:17:46

attraction to the holidays, there on Friday

00:17:49

you have to drink the day I don’t know the fireman and so

00:17:53

on, holidays can be found every day,

00:17:55

but it is important to admit that

00:17:57

you use because of this

00:18:01

obsessive initial stages of attraction and

00:18:03

not because you actually had such a desire and

00:18:07

reason. Let’s talk

00:18:09

a little about withdrawal syndrome or withdrawal,

00:18:12

why this condition can always be so

00:18:15

painful Well, withdrawal syndrome is

00:18:18

such an obvious criterion of addiction and

00:18:21

usually speaks of the

00:18:23

transition of addiction from the first stage to the

00:18:27

second stage. Well, if we are talking about

00:18:29

alcohol addiction, the mechanisms in their

00:18:32

skin, again, are connected with these

00:18:36

primarily dopamine receptors, but and with

00:18:40

alcohol, naturally. For example, if we

00:18:42

take alcohol as an example, there is a

00:18:45

lot of the gamma aminobutyric

00:18:47

acid system, this is the main inhibitory

00:18:50

neurotransmitter of the brain

00:18:52

that is responsible for controlling excitation

00:18:55

and inhibition, alcohol imitates it, it

00:18:58

acts on the same receptors and,

00:19:00

accordingly, in a

00:19:01

person when he is on a binge, the brain

00:19:05

constantly in such a Slow down state

00:19:08

is in case of abrupt withdrawal,

00:19:11

on the contrary,

00:19:13

excitement occurs, release of

00:19:15

glutamate, the same goes for dopamine,

00:19:18

that is, Dopamine was released in large

00:19:20

quantities due to the fact that it was

00:19:21

stimulated by alcohol, if

00:19:24

we talk about alcohol, then for some time the

00:19:27

production of it in

00:19:29

greater quantities but alcohol no longer

00:19:32

comes because of this, these

00:19:34

syndrome symptoms arise: withdrawal

00:19:39

Insomnia pronounced cravings again

00:19:42

here the cravings are sometimes not of a compulsive

00:19:44

nature Yes, but

00:19:46

this is between

00:19:48

psychotic Well, when people do different things

00:19:51

there coming out of the window shoots sun

00:19:54

anything just to

00:19:57

howl sweating there are many somatic

00:20:00

symptoms of tremor,

00:20:04

palpitations, nausea,

00:20:07

anxiety, and all this can lead to the

00:20:11

development of delirium or

00:20:14

delirium tremens in the morning, usually just this. This happens on the

00:20:17

third day of complete withdrawal, that is, the

00:20:19

symptoms increase the first second third

00:20:22

day, usually this is the third sleepless night against the

00:20:25

background of withdrawal syndrome and appear

00:20:28

hallucinations are due to this

00:20:30

hyperstimulation of dopamine because

00:20:32

Dopamine in large doses always leads

00:20:35

to a psychotic state of delusion and

00:20:38

hallucination, this is one

00:20:40

of the mechanisms of schizophrenia, for example,

00:20:43

disorders of psychotic certain

00:20:45

areas of

00:20:47

the brain, from the point of view of

00:20:51

withdrawal from the opioid system Well, the mechanisms are about the

00:20:53

same Yes, there are also opioids involved

00:20:57

receptors and as a result of which opioid

00:21:00

receptors are the opioid system of the brain. It

00:21:02

allows you to deprive the brain of unnecessary impulses

00:21:06

from the internal systems of

00:21:10

organs from various pain receptors

00:21:12

in the body because there are a huge number of them

00:21:14

if they all enter the brain. Well, then this is

00:21:18

intolerance to the opioid system when it

00:21:20

is disturbed. Well if a person uses

00:21:22

opioids, then the following conditions arise:

00:21:25

When the brain receives excess

00:21:28

it, the person feels with pain that his

00:21:32

joints are being twisted, his lower back hurts. Well, the unbearable

00:21:36

state is purely from the point of view of the

00:21:38

sensation of pain, besides this, everything is the

00:21:40

same as with the abolition of alcohol in the

00:21:45

form of insomnia and anxiety for very

00:21:48

pronounced pathological cravings, this

00:21:51

can actually be even more

00:21:54

scary than such pain onia people

00:21:58

in this state. Of

00:22:00

course, they leave hospitals, then they often

00:22:03

use opioids again and

00:22:06

overdoses occur. Or those who try to

00:22:09

withdraw themselves from other opioids. In general,

00:22:12

each substance has a peculiarity

00:22:15

withdrawal syndrome, but there are more common

00:22:17

mechanisms than differences, look,

00:22:21

addictions are usually divided into two

00:22:23

groups: there are drug addictions to substances.

00:22:26

And there are behavior.

00:22:28

Well, some activities or People, let's

00:22:31

start with dangerous but not fatal. And

00:22:33

these are behavioral

00:22:35

addictions, you can get addicted to

00:22:37

any activity that brings

00:22:39

pleasure Well, relatively speaking,

00:22:41

I don’t know about reading books or sports. Well, yes,

00:22:46

very often such a question is asked

00:22:48

here, just classifications divide

00:22:52

addictions into chemical, non-chemical

00:22:56

and intermediate

00:22:59

chemical, then about the World Cup, I just

00:23:01

talked about alcohol, intermediate drugs

00:23:04

are food, because from we

00:23:07

cannot give up food as much as we can give up alcohol or

00:23:09

drugs, but it is important that a person begins to

00:23:14

use food not with the

00:23:16

goal of restoring the energy

00:23:19

balance there, but in order to change the

00:23:21

mental state, that is, the sun is common

00:23:24

in these

00:23:25

addictions of chemical non-chemical

00:23:28

that some substance or some

00:23:30

the action is used to change the

00:23:33

mental state and escape from

00:23:35

some emotions. Here are people who are

00:23:37

addicted to food, again they have difficulty

00:23:41

coping with stress, with some

00:23:44

emotional states and use

00:23:46

food to get away from these

00:23:49

experiences, then let’s say in the evening

00:23:53

A girl or a man there ate the cake Although he

00:23:56

promised himself not to eat, here the psychological mechanism comes into play.

00:23:58

That is, she has

00:24:00

a lot of demands, then she

00:24:02

or he does not comply with these requirements, eats

00:24:05

this cake, falls into a terrible feeling of guilt

00:24:08

and this addictive circle closes,

00:24:11

the person needs to change the state of

00:24:15

consciousness again with a new one when eating here,

00:24:17

sweets are the most

00:24:19

ideal Agent because sweets

00:24:22

also give a release of dopamine, and with

00:24:26

behavioral addictions, well, the mechanisms are

00:24:30

similar,

00:24:32

only certain ones. Well, there are specific

00:24:35

criteria, you can list them;

00:24:37

behavioral addictions, talk about each in a little

00:24:39

more detail, but the first is

00:24:41

various forms of emotional

00:24:43

dependence love addiction and they are

00:24:46

divided into love addiction and

00:24:48

sexaholism love addiction to

00:24:51

relationships is a very common story, such a story is often

00:24:55

treated with a psychotherapist with

00:24:57

love or emotional

00:25:00

addiction. Or, for example,

00:25:02

codependency is a variant of

00:25:04

emotional addiction; the wife,

00:25:06

suppose a drug addict or

00:25:11

alcohol addict, yes, she has a lot of her

00:25:14

own unprocessed ones there are

00:25:16

many emotional states. For example, she

00:25:18

feels guilty, she constantly

00:25:21

saves him, solves her husband’s problems,

00:25:24

I don’t know an alcoholic or a drug addict

00:25:28

from work, and so on, and accordingly in

00:25:30

this system he starts drinking even more

00:25:33

because all problems are solved for him,

00:25:36

because of her hypercontrol she begins

00:25:40

the option of such emotional dependence

00:25:43

with sexaholism depends more and more on it,

00:25:46

there are various such acute emotions, that

00:25:49

is, people begin

00:25:51

to delve further into some more

00:25:55

extreme

00:25:56

Ria, I don’t know, perversion or so I

00:26:00

filmed an interview with a girl, she had a

00:26:03

feeling there 10 partners every day and

00:26:08

this number increased only in

00:26:10

this state she received some

00:26:13

emotions Yes, as with any addiction,

00:26:16

tolerance grows Yes, I

00:26:18

told you one of the criteria is

00:26:19

tolerance, that is,

00:26:21

at first let’s say there were two partners, then there were

00:26:24

six, just like I don’t know with this with heroin,

00:26:27

at first there is one dose, then it grows,

00:26:30

that is, very similar general mechanisms, but the

00:26:33

basis of everything is an escape from reality

00:26:37

from some of your own, primarily

00:26:40

emotional states. But there is an

00:26:43

opinion that Gambling addiction, for example, is almost

00:26:47

incurable, is it so and If so, why Well

00:26:50

We never talk about

00:26:53

addictions like that because that’s what we

00:26:56

have

00:26:58

about addiction, people

00:27:00

often cling to these myths

00:27:02

that I’m in the third stage of

00:27:05

addiction, I can’t be cured, there’s no

00:27:07

point in helping me. Same thing with gambling addiction

00:27:11

We’re in rehabilitation now the

00:27:14

guys are taking

00:27:16

courses, in general there are some big differences

00:27:20

between gambling addiction from the point of view of

00:27:22

rehabilitation and other chemical

00:27:26

addictions.

00:27:29

But if they follow all

00:27:30

the recommendations to participate in the

00:27:34

treatment process, work with a psychologist, and so

00:27:36

on. That is, they also manage to achieve

00:27:39

remission, but

00:27:41

there are a number of peculiarities this is what we

00:27:43

notice when working with them, this is a very

00:27:46

high suicidal risk, again

00:27:49

associated with a large number of feelings

00:27:51

and people lose, if only I had been in

00:27:54

practice,

00:27:56

Gru said that he was addicted to the

00:28:01

casino or bets, I don’t remember, and he

00:28:03

lost the car, he felt fiercely terrible

00:28:08

feeling of guilt In front of his wife, he didn’t know how to

00:28:11

tell her, because of this, she developed

00:28:13

depression, and against this background of feelings of

00:28:15

guilt, the idea came to him that he

00:28:17

needed to get even, he needed to get even and

00:28:21

give some wife a gift for the fact that

00:28:23

she endures everything and In general, he

00:28:26

also lost the apartment and, as a result, he

00:28:28

lost his car and apartment, and only after

00:28:30

that he ended up in rehabilitation, that is, there are

00:28:32

very

00:28:34

complex mechanisms there. Yes, psychological,

00:28:37

because a person is always

00:28:39

trying to win back, any gambling addict. You are

00:28:42

at the very bottom, but it seems to you that

00:28:45

now you will make this miracle bet and

00:28:50

win it all back illusions such illusions you

00:28:53

can also work with all this, this is a distortion of

00:28:56

thinking

00:28:58

emotions that are similar to other

00:29:00

addictions. That is, it’s like the

00:29:03

problem is rather that such people,

00:29:05

first of all, lose all the money

00:29:08

and it’s difficult for them to get into for rehabilitation

00:29:11

because they can’t even pay for

00:29:12

it. And the second thing we don’t have yet

00:29:16

is that in society there is an understanding of the game of mani

00:29:19

Yes luda mani as a serious

00:29:22

addiction, I read some research about

00:29:23

what’s there That’s

00:29:26

exactly how

00:29:27

they measured Dopamine Yes, I don’t remember exactly in a

00:29:30

state of withdrawal from opioid withdrawal from

00:29:34

gaming, there were very similar

00:29:37

clinical and biochemical

00:29:39

indicators, although there is no substance, the

00:29:43

stimulation of these dopamine

00:29:45

receptors is approximately the same. Therefore, the

00:29:47

same severe depression with apathy,

00:29:49

lethargy and a feeling of guilt, but you

00:29:52

can work with it, it’s like that What is

00:29:54

incurable so you can’t say the list of

00:29:58

addictions is very long and you can

00:30:00

analyze each one individually, but I’m

00:30:02

interested in talking about our

00:30:05

addiction to gadgets of social networks of

00:30:09

the Internet, it seems we all suffer

00:30:13

from it to one degree or another and this

00:30:15

is explained by the fact that this dopamine

00:30:18

high due to its cheap availability is not

00:30:21

can be compared with no other drug Well,

00:30:24

Chiva,

00:30:26

in fact, the impoverished presence of the Internet and

00:30:28

gadgets in our lives, we generally have

00:30:31

a chance to resist this digital

00:30:34

drug Well, yes, this is a

00:30:36

really difficult question because

00:30:39

prevalence is the easiest

00:30:41

way to get away

00:30:44

from unpleasant ones something of emotion Yes,

00:30:48

get distracted,

00:30:50

switch, as if stuck in the phone Well, the

00:30:53

most accessible one, you don’t even need

00:30:55

to buy anything, neither alcohol nor drugs

00:30:57

But this is the easiest way to

00:30:59

this, they correctly said, fast

00:31:01

dopamine, the more often the brain is stimulated, the

00:31:06

more obsessive nature the

00:31:08

addiction is Why Electronic

00:31:11

cigarettes, too. We didn’t talk about that. In

00:31:13

my opinion, they are more dangerous than regular

00:31:16

cigarettes because people, I look

00:31:18

at people, they smoke

00:31:21

almost constantly, that is, the brain

00:31:23

is constantly under stimulation. The

00:31:26

amount of Yes, the amount of this

00:31:28

stimulation, the release of nicotine is

00:31:32

higher from electronic cigarettes. The phone is even

00:31:35

more stimulation That is, these are constantly

00:31:37

red, these likes, some reactions and

00:31:41

so on, but here it is important what to say, this is

00:31:43

probably when We moved on to Neo

00:31:45

chemical dependencies, the most important thing is that

00:31:49

this is not a diagnosis As such, the diagnosis is

00:31:52

still a chemical dependency

00:31:54

Now there is a classification of

00:31:56

the disease and

00:31:58

addiction to gambling, addiction

00:32:00

to computers, even not yet, but soon

00:32:03

it will be an international classification of the

00:32:05

disease from phones and there are options, in

00:32:08

fact, there are a lot of these addictions,

00:32:10

depending on all of these and when

00:32:13

people buy shares and it’s important there often it’s

00:32:15

not just some kind of work or

00:32:19

income, but again, monitor the fluctuations

00:32:21

and with some increase in quotes, the person is

00:32:24

again the same Dopamine, that is, we

00:32:27

Well, everyone is naturally dependent on something

00:32:30

and to say that this is some kind of then it’s a

00:32:33

disease for which you need to be treated. No,

00:32:35

there is a concept that says that you still

00:32:37

need to divide

00:32:39

addictions according to severity and start. If you

00:32:43

create awareness and want to

00:32:45

do something to recover, start with the more

00:32:47

severe ones. Because if you immediately give up

00:32:50

everything, a person will last for several

00:32:52

days he will experience very strong stress and the

00:32:55

usual way out of stress will be to

00:32:58

use again, he will again have

00:33:00

despair, there will be a feeling of guilt, and so on.

00:33:03

Therefore, if we are talking about drugs, of

00:33:06

course, this is the main thing, let’s say, and

00:33:08

such people there should not even think about

00:33:11

nicotine at first, much less there about

00:33:14

gadgets and so on That is, we need to

00:33:16

deal with a more serious

00:33:17

addiction, because you will die from

00:33:19

drug addiction from alcohol

00:33:21

addiction,

00:33:23

but the phone still Well, attentiveness may not suffer from the computer;

00:33:30

concentration, memory, but this is not fatal.

00:33:33

At this stage, it’s time if you

00:33:36

you discover yourself not having chemical

00:33:38

addictions, then engage in psychotherapy,

00:33:41

that is, look at what emotions are you running away from

00:33:44

and do you have this obsessive

00:33:47

compulsive mechanism do some

00:33:50

experiments put away the phone there,

00:33:53

suppose I don’t know when you get home or

00:33:57

hide it somewhere for a while there

00:33:58

4-6 hours to watch what is happening to you

00:34:01

to form awareness And gradually

00:34:04

this tangle can be unraveled Because

00:34:07

if you just run from one addiction

00:34:09

They are often mutually replaced and there a

00:34:11

person suffered from one then

00:34:14

goes to another returns to the

00:34:15

third from chemical to non-chemical

00:34:18

Let's do it now just about

00:34:20

chemical addictions, you often hear

00:34:23

about vodka, the same drug, tobacco is

00:34:26

generally the most deadly on the entire scale

00:34:29

of harm. But in your opinion, alcohol and

00:34:31

tobacco are comparable to the degree of

00:34:34

drug addiction. And of course, there are

00:34:38

simply legal psychoactive substances

00:34:41

and

00:34:42

there are illegal ones, and they are different in different countries

00:34:46

there are legal ones, there are illegal ones,

00:34:49

it is important to understand that it is a legal

00:34:51

Aspect that has nothing to do with

00:34:55

addiction as such,

00:34:57

and everyone has probably seen this table about the dangers of

00:35:01

psychoactive substances, there

00:35:03

alcohol, in my opinion,

00:35:05

in terms of harm to others, it generally

00:35:09

ranks first, but in the row as if

00:35:14

for myself on the third, that is, definitely

00:35:18

there with heroin, cocaine, alcohol is one of the

00:35:21

top three substances that cause

00:35:25

such harm, naturally, a

00:35:30

severe addiction develops from it, if you

00:35:32

take our practice, our work, well, well, a

00:35:36

narcologist seems to be what it

00:35:38

sounds like What works with drugs with

00:35:41

drug addicts but the bulk of the

00:35:43

patients are alcohol dependent people

00:35:46

suffering from alcoholism. When

00:35:49

they used to call it alcohol dependence, now

00:35:51

70-80 percent of patients are now

00:35:54

drug addicts. Well, in my practice,

00:35:57

they die from withdrawal syndrome extremely rarely,

00:36:00

but this may be there, there were isolated

00:36:02

cases with severe opioids, then from alcohol

00:36:06

lethal outcomes are such a routine

00:36:09

practice. This happens often because the

00:36:12

very serious consequences for purely

00:36:16

organic ones, that is, during the

00:36:18

withdrawal syndrome, cerebral edema increases, the

00:36:22

delirium itself, which I spoke about, is a

00:36:24

life-threatening condition there, according to the

00:36:27

data, up to

00:36:30

30%. These are the consequences, but also

00:36:33

alcohol itself due to the fact that it is legal It

00:36:37

just very often closes down with this it is

00:36:41

for gnosis denial of the disease we hear

00:36:44

every day I don’t lie under the fence

00:36:46

I go to work There I

00:36:49

have a wife I don’t know I only drink there for

00:36:54

what reasons something nikam or Well, different different things,

00:36:58

they’re about the same, well, the

00:37:02

main thing is that it’s the same. It’s sold in a

00:37:03

store, it’s not a drug, it’s drugs.

00:37:06

It’s clear. But alcohol is sold in a store; a

00:37:08

person may already have cirrhosis of the liver,

00:37:10

alcohol degradation, there’s encephalopathy,

00:37:14

and here he is in all seriousness due to

00:37:17

pronounced anosognosia, that is, denial of

00:37:20

the disease says that I buy in a store

00:37:22

and I have no addiction I drink

00:37:25

like everyone else Yes And this is the social Aspect of

00:37:27

alcohol addiction that it is

00:37:30

considered socially acceptable even in

00:37:31

childhood Yes, everyone there is already clinking champagne

00:37:34

children are included in this alcoholic ritual,

00:37:37

he is playing his own cruel joke and in

00:37:40

my opinion, for example, in rehabilitation,

00:37:42

working with alcoholics and people with

00:37:44

alcohol addiction is much more difficult

00:37:47

than with drug addicts because of these

00:37:50

all these denials of which there are a huge

00:37:53

number Yes, that’s what they say there Well

00:37:55

these are drug addicts here in the group Yes,

00:37:57

everything is clear with them But what am I drinking there?

00:37:59

Although a person can be in deep drinking bouts, I

00:38:02

don’t know, he is resuscitated and

00:38:05

restored every time, but denial is why

00:38:08

alcohol depends. In my opinion,

00:38:11

sometimes it’s even worse and worse than

00:38:14

some drugs and Nicotine addiction you

00:38:16

asked Nicotine addiction is the most

00:38:19

common chemical addiction in the world, the

00:38:21

most, in my opinion, billions of

00:38:24

people suffer from nicotine

00:38:27

addiction and they think that we just smoke,

00:38:31

it’s a bad bad habit, they often

00:38:33

say

00:38:35

a-a Although this is Nicotine addiction,

00:38:38

chemical addiction and in terms of consequences

00:38:40

for the cardiovascular system this is Well,

00:38:43

one of the most terrible Yes, what happens,

00:38:46

cardiologists will not let you lie that it is

00:38:48

almost impossible to fully

00:38:50

recover after surgery to treat

00:38:53

problems with blood vessels If a person has not

00:38:55

given up smoking, but if a person has

00:38:57

given up alcohol, for example, and

00:39:00

nicotine After what period can we

00:39:04

consider that the body has cleansed itself and

00:39:06

I’m not talking about mental rehabilitation now,

00:39:08

because it’s clear that this

00:39:10

needs to be maintained for the rest of your life,

00:39:13

but from the point of view of the body, that’s

00:39:16

when you can already assume that the body is

00:39:20

clean, it’s not an alcoholic, or it’s not even

00:39:22

addicted to cats. Well, in fact, everything is so

00:39:26

scary, the body recovers very quickly

00:39:29

here you need to look at

00:39:31

different organs But if you take the Liver

00:39:33

Liver For example, patients come to us

00:39:35

in the hospital and look at

00:39:37

the tests there. Well, sometimes there are such

00:39:43

off-scale withdrawals from alcohol if

00:39:45

alcohol withdrawal occurs even without

00:39:47

any medications without

00:39:48

hepatoprotectors after 3-6 months all

00:39:52

this is often restored, that is, the

00:39:54

body strives to stop. The

00:39:57

same thing happens to the brain,

00:39:59

even though it is believed that

00:40:02

some changes there are irreversible. Well, no, usually. It’s clear.

00:40:05

If it’s already some kind of third stage of

00:40:06

alcoholism with pronounced degradation there

00:40:09

with encephalopathy disorders. Well, this

00:40:13

may not be restored. And in all normal

00:40:15

situations, all this

00:40:18

is restored physically. Well, during the

00:40:21

first month,

00:40:23

such purely Physiological physical

00:40:25

consequences are usually restored

00:40:27

mentally in the form of

00:40:30

mood swings, the desire to drink. It lasts in

00:40:34

general for the first year, yes, but every month it

00:40:37

becomes easier, these outbreaks,

00:40:40

episodes of craving, cravings, it

00:40:43

becomes less frequent. intense and then

00:40:46

you should just watch out for all sorts of

00:40:48

triggers so as not to provoke this problem. The

00:40:51

Canadian therapist

00:40:55

swears at

00:40:58

addiction. You probably know him in

00:41:00

his Ted talk, he expressed

00:41:03

this idea in itself. Drugs are not

00:41:05

addictive. There are simply people prone to

00:41:08

addiction. This is the idea in principle

00:41:12

turns the

00:41:14

generally accepted idea on its head that if

00:41:16

anyone starts using, he will

00:41:18

immediately become a

00:41:20

drug addict. What do you think about this? Is it

00:41:22

true or not? There is a large, large

00:41:25

share of common sense in this. At the beginning, I

00:41:28

talked about this concept, it is important here.

00:41:30

So slightly- explain a little

00:41:31

biopsychosocial

00:41:40

frontal cortex

00:41:42

heredity psychological factors

00:41:45

this is often upbringing in dysfunctional

00:41:47

families when the parents were mentally

00:41:49

ill they themselves had an addiction there

00:41:52

were some conflicting demands

00:41:55

on children yes they have such a borderline sleepy

00:41:58

personal organization being formed Well and

00:42:00

social That is, if the parents besides the

00:42:02

fact that heredity was passed on,

00:42:04

he also constantly drank in front of the child,

00:42:06

used something there Yes,

00:42:09

a predisposition is formed in him when we

00:42:11

talk about addiction, there is no such clear-

00:42:13

cut genetics Well, as with genetic

00:42:16

diseases in psychiatry Well, in

00:42:19

narcology, as part of psychiatry, there is the

00:42:21

concept of predisposition or

00:42:24

the accumulation of risk factors, that is, there is

00:42:27

heredity, growing up in such a

00:42:29

family, the environment is constantly, these are all

00:42:31

risk factors, if their number is large,

00:42:35

then indeed in such people with a high

00:42:39

predisposition, even a single

00:42:40

sample of substances quickly leads to the development of

00:42:43

addiction, so he tried a drug

00:42:45

Yes, he had a deficiency and serotonin there and

00:42:48

Dopamine, he was apathetic all the time and

00:42:51

demotivational, he didn’t want anything, he

00:42:54

sat on the computers, played, Yes, then he

00:42:56

tried a drug, and he had a surge of

00:42:58

strength. Energy and such people are natural.

00:43:02

Yes, they go down this path very quickly,

00:43:05

they develop addiction And

00:43:07

other stories Here are I recently talked

00:43:10

about alcoholics, teenage alcoholism,

00:43:13

they studied

00:43:15

and teenagers at the age of 15 were diagnosed with

00:43:18

alcohol addiction, they started

00:43:21

at the age of 30, they were found and started questioning everyone. the

00:43:29

social

00:43:32

environment changes, psychological factors Yes and And

00:43:36

in adolescence all children Well, I

00:43:39

recently looked at statistics there, in

00:43:40

my opinion

00:43:42

60% try something to one degree or another,

00:43:45

teenagers Yes, there are

00:43:47

even more teenagers drinking alcohol, but not everyone

00:43:50

becomes addicted Yes It is precisely the

00:43:53

presence of risk factors that is necessary, therefore, in

00:43:56

this regard, he is naturally right. It is

00:43:58

very serious, I even watch his video

00:44:01

and he talks a lot about psychedelics.

00:44:04

And about trauma. Yes, how important it is. This

00:44:08

upbringing in psychotrauma conditions for the

00:44:11

development of addiction, but still should not be

00:44:13

underestimated and the substances themselves

00:44:16

Yes, even if you have Well, first of all, you don’t

00:44:19

know what your risk of development is Yes,

00:44:22

how pronounced the risk factors are,

00:44:24

anyway, if the risk is low, you hit the same

00:44:27

point Yes, but use it all the time,

00:44:29

use addiction will still

00:44:31

develop, but for example, alcohol

00:44:33

addiction I will say that there are people who at the

00:44:35

age of 23 get delirium tremens after

00:44:38

delirium tremens and die. I have had

00:44:40

such patients. And there are those who at the age of 45 get

00:44:43

a hangover for the first time, and

00:44:46

addiction also occurs at absolutely different

00:44:48

speeds depending on

00:44:50

these risk factors, see As far as I

00:44:53

know, in general, addiction is considered a

00:44:56

chronic relapsing disorder.

00:45:00

In fact, this

00:45:02

confirms the sales phrase among former chrome

00:45:04

Nav It doesn’t happen like that. Well, yes, it’s a

00:45:07

chronic

00:45:09

progressive mental illness. What does this

00:45:12

mean? What does this mean? What if a

00:45:15

person at some

00:45:17

point forgets that he has

00:45:20

an addiction? And this In my practice, there

00:45:23

were many different stories: there were people who were

00:45:26

completely sober for 20 years, 15

00:45:30

years, and then some kind of thought

00:45:33

came to mind that for sure I

00:45:35

had already recovered and now I can control my

00:45:38

use because 10-15 years have passed there

00:45:41

and now I had a bunch of stories. In a

00:45:44

few months they return to

00:45:47

the level at which they stopped. That

00:45:49

is, if they were. Here was a patient. I have a

00:45:51

very demonstrative story;

00:45:54

he was coded; it doesn’t matter, but he didn’t

00:45:58

drink anything at all for 15 years, and he had binges

00:46:01

like 2 weeks before he

00:46:04

went through some kind of procedure there at the beginning of the 2000s,

00:46:06

he snapped and within a month he

00:46:10

went into exactly the same state of 2

00:46:13

weeks of hard drinking and from there he only

00:46:15

came out through hospitals. Although he hadn’t drunk for 15

00:46:18

years, that is This suggests that

00:46:21

this is indeed a

00:46:22

chronic disease. But if we take other

00:46:24

chronic diseases, diabetes mellitus.

00:46:26

Yes, I don’t know.

00:46:28

But if you follow certain

00:46:31

recommendations, then

00:46:34

you can live with this chronic disease.

00:46:36

Alcoholics Anonymous say they have a rule: an

00:46:37

alcoholic should not be hungry. Lonely,

00:46:40

angry, tired, yes. there are such

00:46:43

trigger situations that an ordinary person did

00:46:45

n’t notice there, endured it, then the addict will

00:46:48

relapse; the risk of breakdowns is very high and

00:46:51

if he is sober, he is forced

00:46:53

to become conscious. Yes, there is a patient attitude

00:46:56

towards

00:46:58

one’s health, and so on, but you always

00:47:01

need to understand that there is only one glass.

00:47:05

the road will most likely quickly lead

00:47:09

to the state in which you

00:47:11

stopped. And often this ends

00:47:12

in death because

00:47:14

tolerance falls and all people, after a

00:47:16

long break, very often die

00:47:19

when they break down. I just heard

00:47:21

that the cornerstone of getting rid of

00:47:24

addiction is a

00:47:27

person’s own desire you can

00:47:30

forcibly

00:47:31

take an addicted relative or friend

00:47:34

to a rehab as much as you want, but he comes back and starts

00:47:38

doing the same thing that should happen

00:47:41

for a person to come to the point of

00:47:45

quitting why it even happens in

00:47:48

such the most terrible bad situations

00:47:52

When your addiction is in some way in general

00:47:54

Peak when often You can’t even

00:47:57

get out of bed But this is happening This is

00:47:59

what needs to happen This is a good question

00:48:01

because relatives often ask it

00:48:04

How to persuade an addict there and so

00:48:06

on Is it possible Yes somehow forced Well,

00:48:09

of course, forced there are

00:48:11

violent methods, they are also

00:48:13

legal are prohibited and ineffective,

00:48:16

here it is important to understand the psychology of

00:48:20

the addict, that is, the thinking of addicts, so

00:48:22

at the beginning I talked

00:48:24

about this splitting of the ego Yes into an active

00:48:29

and healthy personality This splitting

00:48:31

persists at all stages of development of

00:48:34

addiction and we usually begin this kind of work

00:48:38

with motivational counseling,

00:48:40

that is, a special method like this not

00:48:42

directive psychotherapeutic work

00:48:45

to expand this contradiction

00:48:48

between a healthy Personality and a dependent

00:48:50

Personality. Yes, these can be experiments

00:48:52

when a person is just there on one chair

00:48:55

speaking on behalf of a healthy person on

00:48:57

one chair on behalf of a dependent personality. It is

00:49:00

important to understand here that there is always

00:49:02

this splitting even if the person

00:49:04

says I don’t have any problems Yes,

00:49:06

I’m

00:49:07

fine, we’re looking, that is, first He

00:49:10

writes out the pros of using then the

00:49:12

cons of using Yes, and usually there are

00:49:15

some pros Well, what they often say there is that

00:49:17

it helps me relieve stress,

00:49:19

relax, improve communication skills, improve

00:49:22

something else cons Yes problems of the earth with

00:49:26

family with work when this BC

00:49:31

signs, especially if yes,

00:49:34

he talked about it. Is it possible to have communication skills

00:49:36

there in another way? And are these

00:49:38

people, for example, with whom talkativeness

00:49:40

appears in general? Is it necessary to communicate with them

00:49:42

by subjecting them to such and

00:49:44

therapeutic work and the disadvantages are they?

00:49:47

they are obvious, problems cannot be avoided

00:49:49

by any addict

00:49:52

in almost all areas, that is,

00:49:54

we support this splitting

00:49:56

therapeutically, and when a person admits

00:49:59

that Yes, there are advantages, but there are a hundred years of

00:50:01

disadvantages, he can already be offered to start

00:50:04

some kind of treatment. Well, try to go through

00:50:06

there,

00:50:08

detoxification further on, gradually they

00:50:10

persuade him, for example, to go to rehabilitation.

00:50:12

Because if I tell you right away, you need to

00:50:14

go there for a year to a rehab, any addict

00:50:17

in active use, he you Well, mail

00:50:20

him it will be directive, this is

00:50:23

directive, push him, what is important here is a non-

00:50:26

directive approach to this

00:50:27

contradiction and for relatives Well, that is,

00:50:30

this is one tool for working with the

00:50:32

addicted person himself. Yes, and it is important for relatives to

00:50:36

work on their codependency. I

00:50:38

told you about this at the beginning

00:50:40

that codependency is a Form of

00:50:42

emotional dependence. Yes, this is also not

00:50:45

chemical dependence.

00:50:47

And what is the problem there? that the

00:50:51

addicted person is not is faced with the

00:50:53

consequences of his use due to the

00:50:56

fact that a codependent relative solves the problem for him.

00:50:58

Well, I don’t know,

00:51:00

rudely, if you say adj there, I don’t know, he’s all

00:51:02

dirty, he peed himself, he lay down in the corridor,

00:51:05

his wife will wash him, they’ll feed him soup. And

00:51:08

naturally, he didn’t face the

00:51:10

consequences of his

00:51:13

addictive behavior. gradually gradually

00:51:15

further Yes, here it is important for relatives to

00:51:18

stop saving, stop

00:51:22

helping, listen to themselves,

00:51:26

dependents may have some

00:51:27

secondary benefits there, material,

00:51:29

emotional, and so on Well, this is a

00:51:31

very important point, and

00:51:33

further practice there are a million cases

00:51:36

when the wife and

00:51:37

mother set specific conditions Yes

00:51:40

I don’t seem to be happy with it And you have

00:51:43

that here, there’s no need Pressure again, but

00:51:45

here a person must be forced to

00:51:48

choose what is the option If you want to

00:51:51

save the family, there are such and such

00:51:52

treatment programs there, well, he’s not ready for

00:51:56

some kind of long-term yes there Outpatient

00:51:58

Well at least start somewhere, if you

00:52:01

do all this correctly, it usually

00:52:04

works, but if a relative

00:52:06

corrects addictive behavior

00:52:09

and the psychotherapist at this initial stage

00:52:12

works on the contradiction, the majority,

00:52:15

but if everything is done correctly, then people

00:52:17

agree to treatment. Well, then it’s

00:52:19

just technical You have to work with them,

00:52:21

but I rather not when they persuade you,

00:52:24

but when you yourself come to the

00:52:27

understanding that that’s all I don’t want this anymore, that’s

00:52:30

what’s happening at that moment,

00:52:32

no, this happens, this happens, but in

00:52:34

fact you Sing here is the story of what it is

00:52:37

There is Insight, but the motivation of

00:52:41

addicts is unstable, so let’s say

00:52:43

he woke up and that’s it. He’s sure that I wo

00:52:46

n’t do this again for the last time, and

00:52:48

in the evening he gets drunk again. Yes,

00:52:51

therefore, focus on what the

00:52:54

person wants, even if he wanted it, yes.

00:52:57

Then he also stopped wanting and left there, from

00:52:59

treatment, the motivation is unstable. And at

00:53:03

one time I even conducted a study of

00:53:06

people who were removed from the

00:53:08

drug treatment register, that is, they were 5 years old. It

00:53:10

was definitely confirmed that they were sober. And

00:53:13

only, in my opinion, 5% of them had

00:53:15

such spontaneous remissions that something

00:53:17

clicked in his head Yes, and he still, well, without

00:53:21

treatment there without anything Stopped

00:53:23

using them there, in

00:53:26

fact, isolated cases, the rest were still

00:53:29

either visits to groups of anonymous

00:53:31

drug addicts or there are some kind of

00:53:33

religious ones Well, some kind of

00:53:35

constant participation in in this

00:53:37

recovery process That’s why

00:53:39

group therapy, in particular the

00:53:41

12-step program, is such an effective method, it’s

00:53:44

effective and in combination with others

00:53:48

But now, right away,

00:53:51

people start going to groups less and less often

00:53:53

due to the fact that they are getting younger addicted and

00:53:56

it’s very difficult after rehabilitation, this is the

00:53:59

time, yes, but it’s effective because,

00:54:04

firstly,

00:54:06

they are addicted, they seem to have different

00:54:10

self-help groups there with

00:54:13

cancer, anonymous, there are depressed,

00:54:16

different, different, that is, people with the same

00:54:18

problem, when they unite in a group,

00:54:21

this in itself

00:54:24

has because it goes well, mirror

00:54:27

neurons Yes,

00:54:31

mirroring is the same thing,

00:54:33

trust arises, that’s why in

00:54:36

rehabilitation the main work for us

00:54:38

is done by former addicts Because

00:54:42

I will say one thing, but from the

00:54:45

doctor’s side, it still doesn’t inspire

00:54:47

trust in a person with the same

00:54:50

problem, it’s clear that he has something the same thing

00:54:53

There is the same suffering, the same trial,

00:54:56

it has an effect Well, the steps themselves are

00:54:59

like a twelve-step system Yes,

00:55:02

there goes a certain stage which,

00:55:06

firstly, the beginning is the acceptance of powerlessness,

00:55:09

that’s what we talked about almost the entire

00:55:11

episode today, yes that this is a

00:55:14

chronic mental disease, relapsing

00:55:17

Yes, it is progressive, you need to accept powerlessness,

00:55:20

that you cannot control addiction with your will,

00:55:22

and this is the first

00:55:25

step of powerlessness, a lot of examples should be given of

00:55:28

how you tried to quit with your will, promised

00:55:31

someone there, I don’t know, made some kind of

00:55:33

agreement that you won’t drink And he violated everything,

00:55:36

violated everything, Yes, sooner or later he broke down, that’s

00:55:38

the Will, it can only

00:55:42

play a cruel joke here, and then an important point

00:55:44

in the step program is compensation for

00:55:48

damage when people Well, first they have

00:55:51

an audit, that is, they rewrite their lives, the

00:55:54

damage is connected with the feeling

00:55:56

guilt This is what I’m actually

00:55:58

talking about, and the basic book on

00:56:01

addiction psychotherapy is called shame,

00:56:04

wine and alcoholism, that is, these two emotions are

00:56:06

very, very strongly expressed in

00:56:09

addicts, the feeling of guilt and when a person,

00:56:13

well, really, in using it,

00:56:15

has caused a lot of trouble to relatives I know

00:56:17

he stole something Yes, it’s very important and part d of the

00:56:21

step program helps to compensate for the

00:56:23

damage, that is, in a sober life

00:56:26

you begin to compensate for the damage to people

00:56:29

who suffered from your behavior

00:56:32

during addiction and this reduces

00:56:36

this pathological feeling of guilt Well, that’s the

00:56:39

end of the bottom of the step program this is helping

00:56:41

people, this also works when they

00:56:43

begin to share their

00:56:45

experience in

00:56:47

groups, go to the hospital there

00:56:49

to tell, yes, or here, for example,

00:56:51

after rehabilitation, going

00:56:55

through resocialization means

00:56:57

volunteering, that is, the guys also

00:56:59

share their experience in the revolutionary center,

00:57:02

they help and all this together

00:57:05

really gives such

00:57:07

and psychological problems, solutions and

00:57:10

spiritual growth, the most important thing is that spiritual

00:57:12

growth from such a selfish

00:57:15

consumer from whom everyone suffered,

00:57:17

you turn into a person who

00:57:21

develops spiritually, compensates for the damage

00:57:24

to people and this restores self-esteem,

00:57:28

which is always reduced in addicts. I

00:57:30

know that many drug treatment clinics

00:57:32

use so-called hypnosis The

00:57:35

dovzhenka method is actually hypnosis, which is

00:57:38

based on suggestion before death,

00:57:41

how powerful is this? Trigger,

00:57:44

I’m asking because from Gabor the swear words

00:57:49

that we mentioned earlier. I heard

00:57:51

such a thing that a drug addict is not afraid of death, but a

00:57:53

drug addict is afraid of life.

00:57:56

Absolutely

00:57:58

true. Well, I’ll say this right away, I’m not I’m a

00:58:01

supporter of such methods and for the last

00:58:06

5 years I personally

00:58:09

haven’t done any coding or even more Yes,

00:58:12

because well, that’s what our whole conversation is about.

00:58:15

Today’s dialogue I talked about some

00:58:17

complex biopsychosocial There

00:58:24

is a miracle solution to the problem, it’s

00:58:27

not being solved He needs to sobriety,

00:58:29

learn to first restore the

00:58:31

biological sphere, that is, your

00:58:33

health. Yes, that over time, the balance of

00:58:35

neurotransmitters should be restored,

00:58:38

which directly affects cravings; there are

00:58:41

psychological states; correct

00:58:43

these emotions; work with them; and, well,

00:58:46

the social; yes, recover there at

00:58:48

work; environment; support;

00:58:51

form coding; it is in in this

00:58:54

regard, it can help, but today I also

00:58:57

talked about the fact that there are different

00:59:00

predispositions to addiction and Well,

00:59:03

or for example, we take on drug addicts

00:59:05

for them in general, this has never worked, a

00:59:07

drug addict, he immediately starts

00:59:09

using on them, this doesn’t work, there is no

00:59:11

feeling of fear Yes, because for him

00:59:14

it really is death every day He

00:59:16

overdoses and so on there

00:59:18

is just a gradation for addicts, there are people

00:59:21

who Well, let’s say the initial stage of

00:59:23

the development of addiction

00:59:25

and not the beginning, but his

00:59:28

risk factors are not so pronounced, he does

00:59:31

n’t have any social problems,

00:59:32

let’s assume psychologically how - something is

00:59:35

compensated there and for them such

00:59:38

one-step methods can help if they have

00:59:41

high motivation. But this is, for example, a book

00:59:43

An easy way to quit drinking Yes, in general,

00:59:45

it seems like it’s not therapy, but there is also

00:59:53

qi suggestiveness

00:59:56

and not very pronounced risk factors for

00:59:58

addiction, he can quit Both from the book

01:00:01

and from coding and so on, but we

01:00:05

still, even if our

01:00:08

hypnotherapists use these methods, we

01:00:11

say that this is only the initial stage,

01:00:13

then psychotherapy is required,

01:00:14

supportive

01:00:16

drug correction. And this is not that is,

01:00:20

this is not a Magic pill. Yes, this

01:00:22

can be in complex therapy at the

01:00:24

initial stage. stage for

01:00:26

people with such a low level of

01:00:29

risk factors But this is for sure In general, it’s not a

01:00:32

Panacea because

01:00:34

it won’t teach you to live sober anyway. Finally, this is a

01:00:36

philosophical question, someone said that

01:00:39

addiction is the search for happiness in the

01:00:41

opposite direction from God,

01:00:43

this is right for me I really liked it as a

01:00:46

researcher and healer of the human

01:00:49

psyche. You probably thought about the

01:00:51

connection in general,

01:00:53

natural dependence. The desire for happiness,

01:00:57

the desire for happiness. Well, in fact, it’s

01:01:00

very accurate; someone would

01:01:02

say that in each of us there is

01:01:07

a hole in the soul the size of God Yes, this is That’s also what

01:01:10

we’re talking about: the spiritual search, so

01:01:13

to speak, is embedded in human nature, and

01:01:17

in the 12-step program that

01:01:19

we talked about there is the concept of a higher power.

01:01:21

Well, that’s what a higher power sounds like as we

01:01:23

understand it, that is, it has nothing to

01:01:25

do with religion, but spirituality

01:01:28

spiritual search is inherent in

01:01:32

human nature and when a person has something to do

01:01:36

with the consumer society into

01:01:38

which we seem to have

01:01:39

moved where there is no such hunger in

01:01:43

most places and spirituality, in

01:01:47

principle, it is not needed to survive, you can not have

01:01:50

some such serious things and people

01:01:52

go into this consumption, they lose the

01:01:55

meaning of their existence, the

01:01:58

semantic sphere is violated Yes, everything seems to be

01:02:01

as it is now, most of these problems are

01:02:03

all there, but something in the soul is missing;

01:02:06

depression is constantly and so on,

01:02:10

so spiritual search It often

01:02:14

helps people if they go into

01:02:17

spirituality to get away from addictive behavior

01:02:20

and I do this in almost every conversation

01:02:22

with Get Well addicted floggings Yes, that

01:02:25

society consumption is constantly

01:02:27

selfish consumption, you and the drug addict are an

01:02:31

ideal consumer He just

01:02:32

constantly constantly needs and everyone around

01:02:35

him should give him like a baby,

01:02:39

the opposite is a person who

01:02:42

follows the path of spiritual development, he

01:02:43

begins to give Yes, this is very important for

01:02:47

all addicts who are already somewhere at

01:02:48

some stage of recovery, I say

01:02:50

now we need to move to this stage Yes,

01:02:53

and start giving, maybe some little thing is

01:02:56

not necessarily great

01:02:58

some kind of missionary to be, well, help

01:03:00

people there in rehabilitation, there’s something else there

01:03:04

and it’s very energizing, I just

01:03:07

see it. Yes, how a person was so

01:03:09

empty, and he begins to fill up,

01:03:13

fill up, fill up, Therefore, this is

01:03:16

very important, Yes, to give,

01:03:19

to give, Well, the world Now you can see for yourself in

01:03:22

what state any

01:03:25

warmth that you can

01:03:28

give to someone will be useful to people, the most

01:03:32

important thing is that it will fill you with meaning and

01:03:34

then dependent mechanisms will not be needed

01:03:37

yes For happiness Igor Thank you for helping

01:03:41

to understand in such detail what

01:03:44

addiction is I really hope that

01:03:47

understanding how this mechanism works

01:03:49

will help someone in the forest,

01:03:54

I would like to wish it to the viewers, dear

01:03:56

friends, Be the masters of your own

01:03:59

life, I say goodbye until the next episode. Bye

01:04:01

everyone. Please subscribe to

01:04:04

our channel, this is very important. See you again

01:04:09

[music]

01:04:23

Thank you

Description:

Откуда возникают зависимости, которым сложно противостоять? Об этом и не только расскажет врач психиатр-нарколог Игорь Лазарев. Как формируется аддиктивная личность? Когда обсессия становится зависимостью? Чем нейробиология объясняет появление тяги? Почему мы отрицаем свои зависимости? Как выражается синдром отмены? Излечимы ли зависимости? Имеет ли цифровая зависимость навязчивый характер? Сопоставимы ли алкоголь и табак с наркотическими веществами? Что должно произойти для осознания зависимости? Насколько эффективны методы групповой терапии и кодирования? Связаны ли зависимость и стремление к счастью? В этом выпуске: 00:00:00 Тизер 00:02:13 Зависимость: что это такое и почему она возникает? 00:04:27 Вредные привычки и их влияние на здоровье человека 00:08:17 Компульсивное влечение у зависимых 00:10:31 Обсессия VS Аддикция 00:12:54 Тяга - непреодолимое желание употребить 00:16:08 Отрицание зависимости 00:18:09 Синдром отмены, или Как бросать вредные привычки без последствий 00:22:20 Поведенческая зависимость 00:24:35 Сексоголики — кто они? 00:26:43 Лудомания неизлечима? 00:29:56 Признаки телефонной зависисмости 00:34:19 Ученые признали алкоголь и табак самыми опасными наркотиками 00:38:56 Очищение организма от курения и алкоголя 00:40:51 Какие наркотики не вызывают зависимость 00:44:52 Как развивается зависимость 00:47:20 Как бороться с зависимостью? 00:52:21 Помогите, у меня зависимость! 00:57:30 Врач Игорь Лазарев о гипнозе при зависимости 01:00:36 Зависимость и религиозность

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