A Case From Medical Practice. Headaches In People With Visual Vector

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A Case From Medical Practice. Headaches In People With Visual Vector
A Case From Medical Practice. Headaches In People With Visual Vector

Video: A Case From Medical Practice. Headaches In People With Visual Vector

Video: A Case From Medical Practice. Headaches In People With Visual Vector
Video: Science of Headaches 2024, December
Anonim

A case from medical practice. Headaches in people with visual vector

It's about a young woman with a visual vector. Persistent paroxysmal headaches, with vomiting, that began in the girl in adolescence, persisted in puberty and after it, stopped as soon as she began her first serious relationship with a man.

In practice, there are often cases when a true migraine or episodic headaches are somehow emotionally conditioned. Those familiar with the system-vector psychology of Yuri Burlan know that a deficit or absence of a deep emotional connection, empathy, sympathy is the basis of many ailments in people with a visual vector. Thus, the assumption that a paroxysmal headache without visible, morphologically determined reasons can be found in persons with a visual vector seems reasonable.

The nature of these ailments depends on a number of parameters, which apparently include a specific reaction to stress, structural features of the visual analyzer and properties of the central nervous system, especially its vegetative part, which does not lend itself to direct conscious control and takes an active part in the regulation of work. heart and vascular tone (everyone knows examples of how, for example, blood pressure can jump against the background of any experiences). The potential amplitude of experienced emotions in visual people, as we know, is an order of magnitude higher than the emotional amplitude of the owners of all other vectors. And the peaks of emotions, according to physiology, are always reflected, for example, on the activity of the cardiovascular system, blood circulation in the brain, CSF dynamics, etc.

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Probable nature of mental adaptation disorder

At the moment, it will be difficult to pave a step-by-step path from changes in the psyche to their morphological manifestations, but today the guidelines provided by system-vector psychology allow us to draw a number of conclusions.

For example, a strong desire for an emotional connection, a pronounced need to consume it without restrictions is normal when it comes to children with a visual vector who have not yet had time to go through all the stages of their development. However, the same needs are often observed in adult spectators: not everyone and not always acquire the skill of mature realization in the process of growing up. The requirements of society are high, adults, and the abilities and desires do not meet these requirements, since they are, in fact, at the children's level, are not developed. In such conditions, a person often faces the inability to satisfy his desires - to receive a lot of attention where it is not appropriate, for example, and constant dissatisfaction can lead to various psychosomatic diseases.

Spectators potentially have a high imaginative intelligence, they are cultured, intelligent, sociable people. However, the crooked path of incorrect education or insufficient implementation often leads them in a completely different direction. The desires that live by us are hidden from awareness, do not ask permission, they only shout about their emptiness. If these desires, for example, in the case of an undeveloped visual vector, which requires love and attention to itself, could not correctly go through the processes of maturation and development outward, then at 40 and at 50 they will be infantile in nature.

Such a person will not be able to love himself, giving his feelings out, but will constantly demand expressions of love and increased attention to his person. Not out of bad motives, but just trying to fulfill a natural task - to survive at all costs according to the archetypal (primitive) program. Among the obstacles to survival, such an observer will consider a break in relations, and subjectively insufficient attention from loved ones, and an unkind word accidentally dropped by a colleague. Such people are demonstrative, exalted, often fearful of being alone, afraid of being abandoned, unloved, etc.

Such states create a high internal tension, which is difficult to resolve if you are not aware of your unconscious desires and do not understand what exactly requires filling. And the constant internal dissonance prevents such a person from receiving the expected satisfaction from fulfilling his role in society, a team, interpersonal relations, drawing on himself a lot of attention and strength.

The same thing at certain distances, and not as a life scenario, can happen with a developed but unrealized visual person who has nowhere to throw out his emotional amplitude.

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The details of the pathophysiology, how exactly and why such tension and contradiction arise “I passionately desire, but I cannot receive,” that is, the inability to adequately and correctly fulfill their true desires while hidden from understanding. However, the result of such an unconscious forced-violent limitation of these latent desires is often striking in the form of persistent attacks of headache, migraine, which is more common in females with a visual vector, often without any other upper vectors.

Case from practice

It's about a young woman with a visual vector. Persistent paroxysmal headaches, with vomiting, that began in the girl in adolescence, persisted in puberty and after, stopped as soon as she began her first serious relationship with a man. It can be systematically assumed that entering into a close emotional connection with him filled her life with meaning, balanced her internal psychoemotional state, as it usually happens with the owners of the visual vector, which ultimately led to the disappearance of the headache.

It was possible to predict systematically that as soon as the relationship begins to lose the sharpness of the emotional connection, built on the initial sharpness of attraction, headaches may resume. The couple lived in a civil marriage without formal obligations for more than 5 years. There were also no children who, as a rule, strengthen the bond in the early stages of marriage. As a result, the girl experienced a latent fear of losing a partner, breaking an emotional connection, even if it was not conditioned by anything.

Although for herself she explains the disappearance and resumption of headaches in a slightly different way, systemically this case deserves consideration.

Further in the dialogue format.

The first call was with a request to consult a girl, allegedly an acquaintance.

- Yes, you remember her, Tatiana, such a flirtatious one, several years ago she worked in the marketing and advertising department under the former CEO, now a secretary.

- Mm … We suspected her of an acute attack of appendicitis in the summer and sent her to the hospital, but she was transferred to gynecologists, she turned out to be ovarian apoplexy, like, is it she?

- Well, yes, they sent a taxi then, they did not wait for an ambulance, - answered on the other side of the tube.

- Yes, I remember …

Probably, every profession related to people leaves an imprint on the way of remembering clients. In doctors, diagnoses and clinical cases are firmly glued to the image, and names and surnames fly out of the head almost simultaneously with the farewell.

- What's the matter with her now?

- Yes, every day we have been treating her for a headache, no use.

- Clear.

- Listen, she still has a young man there recently, either left, or they had a fight, I know her from her relatives, but did not touch on this topic with her. For several days already like one. Maybe it also intensified somehow, then a couple of months ago she was seriously ill, and at work, well, you know who she works for now … In general, you will figure it out, then tell me your opinion and what to add to the treatment or examination, well?

- Ok, I'll be there in the evening, let him come to my office.

A girl of more than 20 years old came to the reception, her height is slightly above average, slender, facial features are soft, rounded, eyes are dark, expressive, long hair. A face without visible signs of makeup, a look, as it were, slightly embarrassed, after a brief visual contact, it quickly went somewhere down or to the side. More likely on the face than on other grounds, it was noticeable that she had a few extra pounds since the last visit.

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- Hi, it's cold in the office, we are saving a little, you know, so leave your jacket … Maybe some tea? - there was an attempt to arrange and remove some stiffness from the first minutes.

- Hello. No thanks,”she replied with a smile and sniffled.

- Are you a cold?

- No, or rather, I have already recovered, it seems, two months ago I was ill.

- And what happened two months ago?

- Pneumonia, bilateral pneumonia, I was in the hospital for a month.

- What are you? That's no luck. This is serious, this is not a runny nose. - It was an attempt to show sympathy.

- Well yes. - The expression on her face shows: she was pleased with the participation of the doctor.

- Tell me what else happened? They called me, they say, you don't want to get well.

- My head hurts very much for five days already. In the morning, nothing seems to be the case, and then by lunchtime it begins and intensifies, everything is completely, entirely, nothing helps, I'm already tired. As soon as you shake it wrong or shake it harder, the pain immediately intensifies. In the evening I go to bed, and it also gets stronger in bed, I can't find a comfortable position.

It took several minutes for an objective examination and assessment of the neurological status. As you would expect, there are no clinically significant abnormalities. The pulse is weak, the arterial pressure is below average, a bright pink, slowly disappearing dermographism, pronounced hyperhidrosis of the palms.

- Can you tell us in more detail what happened the day before, maybe a week, maybe a month, what examinations did you do, analyzes.

- Nothing special, I worked as always, I am now, however, in a slightly different capacity. All tests are normal, well, when there was pneumonia, then they were bad.

- Yes, I was told that you have now changed the office.

- Well, my head ached five days ago. It hasn't happened for six years. And now, exactly as then, six years ago, headaches have resumed. With nausea, and vomiting was, but relief did not come.

- And what, you already had exactly the same headaches?

- Well, yes, I say, I already forgot to think about them, I thought that they were gone forever, and then again. It hurts constantly.

- Does your head hurt now?

- No, it doesn't hurt now … - she smiled slightly embarrassed and very restrained, - well, it almost doesn't hurt, I'm afraid to move my head, such an impression, it's about to hurt.

- Maybe you can tell us what circumstances in your life, what happened, is happening, maybe there were some joyful events or not very joyful ones, maybe some changes? I remember you, you always smiled, so cheerful, cheerful, and here I look, you won't even smile.

It was necessary to try delicately, but somehow to find the modalities.

- I, as the headaches resumed, am afraid to smile and laugh and, probably, only cry. I know feeling sorry for myself is wrong, but I can’t help it,”she sniffed, smiling embarrassedly.

- Do you live alone? Big family?

- Not really, well, yes, with a family, there is a brother, sister, I live with my husband.

- Oh, are you married?

- Well, we are in a civil marriage.

- How long?

- Five years, a little more.

- Have you got a children?

- Not yet.

- As a young man, do you live together? -the question was on the verge of a foul.

- Well, we probably live like everyone else. - After a short pause: - It happens, we quarrel, it happens, we make up.

- It's good. What I wanted to say, we are all people, it happens, we lack something, but we do not always understand what exactly, this also causes problems. When you want lemonade, you know exactly which one, you went and bought it, but it so happens that he or she does not even know what they want, and then, it happens, relatively speaking, the stomach starts to hurt, but why is not clear. Well, I figuratively …

“I understand what you mean, doctor. I understand very well. For example, you know who I’m working for now as a secretary, you know what his character is, so I don’t find a place for myself when he’s silent, doesn’t say anything, only frowns, and it seems to me that on me. I can't take that long, it's very hard. It’s easier for me when he yells at me, when he scolds me, it’s better for me, I’ll go to my place and cry, and then he will definitely leave, regret it. We drink tea together, I make him, we dine together. And at home, it happens, well, it's not clear why, I start to bully, well, I try not to touch my young man, but more to pester my brother.

- Well, it's understandable, - I nod approvingly with a smile, - my brother, probably, quickly forgives.

- Well, yes, and after all, I understand what I am doing, how I do it, that this is all wrong, it’s not good that I have to stop, but I can’t, I provoke someone … And then they start to attack me, but I find it funny always after and fun. But I regret my husband more and try not to touch him so much.

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An apologetic smile froze on her face.

- You understand what you are doing, you realize exactly how, perhaps even in details, step by step, but you can hardly guess why, right? You want something, something pushes, and this desire, it is strong and does not depend on you, and nothing can be done with it, right?

- Yes, that's right. I can get distracted by something, but sooner or later then again … It doesn't depend on me,”she nodded happily.

- Tatyana, tell me, are your headaches connected somehow with emotions?

- Yes, probably, yes, I'm afraid to laugh, have fun somehow, then almost immediately my head can hurt. But I say, how many years these headaches have not bothered, but the last week …

- Tell us in more detail, then, what were the pains before, how were they provoked, against the background of what could arise?

- Once a week, sometimes I had a headache for half a day or all day. I could vomit, and almost immediately stopped hurting. I got used to pain in high school, in high school. I went to the doctors, but it was useless.

- Were the headaches connected somehow with menstruation? With a change in blood pressure? Have you been at night?

- No, no way. The pressure, perhaps, will slightly increase, already when the head hurts for a long time, lower, and never at night. Mostly in the afternoon.

- Tell me how you got rid of them then?

- So this is the funny thing, you will laugh too!

She perked up.

- It happened six years ago, I got a head injury, well, they even gave me a concussion, they took me to the emergency room, and then after that the headaches stopped, can you imagine, I’m telling anyone, no one believes.

- What are you? This is interesting, listen, I'll take it on board, to my patients with migraines, whom I can't help - I will offer a concussion, at their discretion, maybe they can crack a board, as you think, or maybe they themselves somehow themselves. I can imagine, well, I understand, of course, when you say that, the doctors will smile at best. '' I honestly laugh.

- Yes, you are all laughing, but that's how it was …

- Tell me, what was the blow, what kind of injury?

- Well I say, this is my young man, with whom we now live together, fell on my head on the beach, then we rode a banana on this …

- What are you, Tatyana, this is so romantic.

I can hardly hold back my smile so as not to laugh.

- Then he began to show me signs of attention, we began to meet, and then moved in and live together.

- Did you have anyone before him?

- Not.

- Do you remember that case, well, we sent you to the hospital with an acute pain in the stomach?

- Yes, I was operated on then in gynecology, and then we began to meet. By the way, after the operation it became better. My periods stopped being so painful, but it happened about six months or more after the concussion.

- May I have an intimate question? - it was necessary to try to find out everything that, perhaps, she overlooked.

- Yes of course.

- Sex life is regular, is everything all right?

- Yes, everything is fine, - her answer was excessively quick, faster than, probably, any other question.

- Do you live together now?

“Yes,” she either slightly choked or cleared her throat. - The cough has not yet passed after pneumonia, so I'm suffering, - she added, looking at the floor with embarrassment.

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There was no point in asking further. It was necessary to somehow complete, without torturing further interrogation.

- Look, let's do the following. You will get yourself a notebook, you will measure your blood pressure and write down numbers regularly, whether you have a headache or not. Let's take a 10-point scale to assess the strength of headaches. You will evaluate subjectively, conditionally the most severe pain that you had, let it be 10 points, 0 - no pain. Be sure to write down to yourself in a nutshell against the pressure, as a general state of health, maybe some other circumstances at your discretion. Write it down two or three times a day. You will take these drugs for a month, this one with a strong attack. These injections, if anything, you come here, the nurse in the procedural room will inject you if it hurts badly. And you'll have another MRI of the brain next week. Did you agree?

“Okay, of course,” she nodded, “so why did those headaches come back? Has the concussion action ended?

- Of course not. I have my own assumptions, but for now, probably, I'll keep them to myself. For now, do everything as I say, and have a further examination, we will see you again, you will come, tell me how you are, and see what the result of the treatment will be.

There was a pause. For a while she sat in silence, not in a hurry to leave.

- Now, when you finished speaking, I immediately began to have a headache.

- Well, you probably got it before, only you didn't notice it, it's okay, we will cope with your headache, I have one very effective remedy, I will save it for later, if necessary, for now, let's do it this way.

In conclusion, it will be appropriate to note that another common case of persistent migraine without clinically significant morphological disorders is the case of insufficient implementation of the sound vector. A separate article should be devoted to this.

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