Biosuggestive therapy as an effective method for correction and treatment of psychosomatic disorders

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Lesya Ukrainka Volyn National University

Biosuggestive therapy as an effective method for correction and treatment of psychosomatic disorders

Viktor Koshyrets, Kateryna Shkarlatiuk

The purpose of the article is to describe and analyze the effectiveness of Oleksandr Strazhnyi's biosuggestive therapy, the author's method for the correction and treatment of psychosomatic disorders.

Methods. The study examines the method of biosuggestive therapy (MBST) - aimed to remove psychosomatic disorders and restore psychological comfort and well-being of a personality. It includes a combination of verbal and non-verbal suggestion techniques in a light trance state. The method involves the implementation of the following techniques: individual conversation, group conversation (in case of group therapy) and conducting a biosuggestive session.

Results. MBST has proven to be one of the most effective psychotherapeutic tools for correcting health disorders using a session consisting of verbal and nonverbal suggestive structures. In the course of the session, the painful nervous processes responsible for the perception of poor health fade away and the neural connections containing the image of well-being are strengthened. As a result, the body's hidden reserves are activated and self-regulation processes are launched.

In this way, biosuggestive psychotherapy begins to work according to the laws of a conditioned reflex, that is, a habitual action in response to one or another sensory stimulus. A reflex is fixed with each repeated session and is attached in a long-term memory. Over time, the suggestive blocks voiced by a psychotherapist reprogram a human body to new positive settings. MBST sessions relieve heightened sensitivity to emotional and physical pain.

Conclusions. The technique of micro-breaks lies in the basis of biosuggestive psychotherapy. The sudden break of the pattern lies in the fact that a psychotherapist begins the conversation without adjustment, immediately by going beyond the pattern. For this, you can use a positive statement, a positive emotion etc. The meaning of a psychologist's work is to switch sharply a person's attention from emotional trauma, mental or physical pain, to the good, that is, a negative factor to a positive one. The practice of combining the MBST sessions with other therapeutic techniques is also used.

Keywords: biosuggestive therapy, psychotherapeutic technique, MBST therapeutic effect, audio session music, micro-breaks technique, biosuggestive session, therapeutic touch.

Коширець В., Шкарлатюк К. Біосугестивна терапія як ефективний метод корекції та лікування психосоматичних розладів

Мета статті - описати та проаналізувати ефективність біосугестивної терапії Олександра Стражного, авторського методу для корекції та лікування психосоматичних порушень.

Методи. У дослідженні розглядається метод біосугестивної терапії (МБСТ) - спрямований на позбавлення людини від психосоматичних розладів, відновлення психологічного комфорту та гарного самопочуття. Він включає поєднання прийомів вербального і невербального навіювання в стані легкого трансу. Метод передбачає релізацію наступних прийомів: індивідуальну розмову, групову бесіду (у разі групової терапії) та проведення біосугестивного сеансу.

Результати. МБСТ продемонстрував себе як один із найбільш ефективних психотерапевтичних інструментів для корекції порушень здоров'я за допомогою сеансу, що складається з вербальних та невербальних сугестивних конструкцій. У процесі сеансу згасають болючі нервові процеси відповідальні за уявлення про нездоров'я та посилюються нейронні зв'язки, що містять образ хорошого самопочуття. В результаті активізуються приховані резерви організму та включаються процеси саморегуляції.

Таким чином, біосугестивна психотерапія починає працювати за законами умовного рефлексу, тобто звичної дії у відповідь на той чи інший сенсорний подразник. Рефлекс закріплюється з кожним повторним сеансом і фіксується у довгостроковій пам'яті. З часом сугестивні блоки, які озвучуються психотерапевтом перепрограмовують організм людини на нові позитивні налаштування. Сеанси МБСТ знімають підвищену чутливість до емоційного та фізичного болю.

Висновки. В основі біосугестивної психотерапії застосовується техніка мікророзривів. Раптовий розрив шаблону полягає в тому, що психотерапевт починає розмову без підстроювання, одразу з виходу за межі шаблону. Для цього можна використати, позитивне твердження, позитивну емоцію тощо. Сенс роботи психолога - у різкому переключенні уваги людини з емоційної травми, душевного чи фізичного болю, - на хороше, тобто негативний фактор - на позитивний. Існує також практика поєднання сеансів МБСТ з іншими терапевтичними техніками.

Ключові слова: біосугестивна терапія, психотерапевтична техніка, терапевтичний ефект, аудіосеансна музика, техніка мікророзривів, сеанс біосугестії, терапевтичний дотик.

Introduction

The method of biosuggestive therapy is simple and at the same time effective psychotherapeutic technique aimed to remove psychosomatic disorders and restore psychological comfort and wellbeing. Psychosomatic disorders are the most common health disorders as every specialist who practices in the field of psychological or physical ailments faces them (Kaplan, Sadock, 1991). The method of biosuggestive therapy (MBST) combines verbal and non-verbal suggestion of a peson in a sate of light trance. Not only suggestion is used, but other techniques: therapeutic touch of a therapist to a client, voice setting, group induction etc. The author of this method, psychotherapist Oleksandr Strazhnyi, states that sessions of biosuggestive therapy are necessary for people who have certain psychosomatic disorders - health disorders not caused by serious organic diseases. A psychologist can correct not only a client's psyche, but also body manifestations of chronic fatigue, depression, stress etc.

Psychologists, who have mastered the method of biosuggestive therapy, indicate that while working with their clients, they also receive a therapeutic effect on their body during a session. The principle is as follows: human brain does not distinguish where it gets audio information from - conversation, lecture, TV, radio etc. (Greenson, 1986). The suggestive phrases of the recorded audio MBST session, which a psychologist hears during his work, affect both a cliennt and a thearapist. Contacts between a therapist's palm and a client are used during a session of biosuggestive therapy. These contacts perform on open areas of a skin (forehead, back, neck, knees) and through clothing (chest, abdomen). During a physical contact, production of oxytocin, which reduces internal tension, occurs both in a patient and in a therapist (Erikson, Rossi, Rossi, 1976). Accordingly, the level of tension, anxiety, worry, etc. decreases in both of them.

Methods

MBST session is an electromagnetic treatment (correction) program recorded on an electronic medium. MBST can also be used remotely, without direct presence of a therapist. A course of treatment (correction) using the method of biosuggestive therapy usually requires 810 psychotherapy sessions. The session can be individual or group. The stucture of every session consists of three parts:

1. Individual conversation.

From session to session, it is aimed to reorient the emphasis of a client's perception of own situation and all connected with this painful attitudes. For instance, a client's belief «I have a very big problem» we replace by «There is a way out in any situation». Alternatively, a viewpoint «I am a sick person» we rebuilt to «Why not to become a healthy person». The concept of «No one can help me» is changed to «We have been able to help many people with the same problems, and most likely we will be able to help you».

2. Group discussion (in situation of group therapy).

The aim of this discussion is to have positive influence on new group members by those clients who have already passed several sessions and felt improvement.

3. Biosuggestive session.

Session begins when participants comfortably seat in the chairs and a therapist turns on the audio recording, with the help of which he conducts a treatment session. Total session time lasts aproximately 45 minutes; pure session time goes up to 20 minutes. Every session is held according to the canons of classical suggestive therapy with three modifications. During the biosuggestion session a psychotherapist does not seek to introduce a client into a state of hypnosis, a light trance is enough. The voice of a psychotherapist is accompanied by the background music heard in the audio record. During the session, a therapist performs therapeutic touches to a client in a certain rhythm. It should be noted, that combination of above-mentioned three factors was not previously used in psychotherapy.

Results and discussion

We can judge a lot about the effectiveness or ineffectiveness of this or that method, but objective conclusions can be drawn only after its verification with strict adherence to the rules of scientific research. Such verification of MBST was carried out at the Department of Psychiatry of Medical Psychology and Narcology of the Donetsk Medical University in Kramatorsk) (Osokina et al., 2017; Osokina et al., 2017а). Official recommendation of MBST usage for psychosomatic disorders treatment of civilians and military personnel was given by the crisis center for medical and psychological assistance of Kostiuk Kyiv Institute of Psychology of the National Academy of Pedagogical Sciences of Ukraine. League of psychiatrists, psychologists, narcologists and psychotherapists of Ukraine in Donetsk region as well as the department of military psychology of Military Institute of Taras Shevchenko Kyiv National University of the Ministry of Defense of Ukraine also gave such recommendations (Strazhnyy, 2019).

Certainly, the best option for any positive therapeutic effect is complete recovery from disease. This means that all disease symptoms have disappeared, a client feels well and objective examination methods do not reveal any abnormalities. Blood pressure is normal, endoscopic examination records disappearance of gastric ulcers, ultrasound diagnostics does not find previously recorded violations etc. The best option is relatively common, but still there are many health disorders that cannot be completely eliminated.

Oleksandr Strazhnyi has conducted statistics to prove the effectiveness of his method. Since it is not possible to monitor clients five years after MBST, it is unreal to distinguish between remission (a symptom-free period of disease) and complete recovery. In this regard, when talking about real results, the term «recovery» is not appropriate, and study orientation aims at: a) disappearance of signs of disease (symptoms), b) improvement of well-being, c) condition without changes. There is no «deterioration» column in the statistical data. This is because deterioration of health state of clients after biosuggestive therapy is unobserved.

The conducted data were analyzed according to the clients' outpatient cards. The course of treatment consisted of eight sessions. In total, the cards of 3,000 clients aged from 7 to 90 were analyzed. People aged from 35 to 65 years prevailed. Women made up about two-thirds, men - one- third. Treatment was usually carried out in one session two times a week (Strazhnyy, 2019).

The statistics reflect the results one month after the start of treatment. Despite the subjectivity, everything possible was made to get closer to the real assessment of the results of the MBST therapeutic effect. Positive results in psychotherapeutic practice may be associated with the fact that clients simply do not want to upset the specialist and admit the ineffectiveness of the treatment. Therefore, the presented analysis is based not only on the words of customers. If clients said they felt better, but it was obvious that not all symptoms had disappeared, the data were fixed in the «improvement» column, not in the «disappearance of symptoms» column. In order not to give the impression that MBST can replace surgery or chemotherapy, cancer statistics were deliberately not included.

The obtained results proved that most clients begin to feel the effect of biosuggestive therapy already after the first or second session, and to achieve the maximum possible result, 8 sessions are needed. Not every person can be completely freed from this or that psychosomatic illness, and not all clients respond to therapy to the same extent. However, in cases of incurable organic disorders, it is often possible with the help of MBST to achieve remission (symptoms-free period) for several months, sometimes even several years. A person usually has several symptoms at the same time. Some disorders may remain after treatment, while others may disappear. In this case, biosuggestive therapy helps, albeit partially.

Currently, psychosomatics is an interdisciplinary scientific field and is a subject of research in medicine, physiology, psychology, sociology and in psychotherapy. Despite the fact that the word «psychosomatics» is very often used in scientific literature, currently there is no single definition of this term. In general, its meaning follows from the words that make it up (soul and body). As a scientific direction, it aims to describe the interrelation between psyche and body, studies how psychological factors affect the functions of body and cause diseases. Psychosomatic disorders are mental and physical ailments that arise because of negative impact of various external and internal psychological factors and they are manifested in the form of certain physical symptoms (Koshyrets, 2022). The emergence and development of psychosomatic disorders is influenced by the entire range of social and biological factors. The list of psychosomatic diseases is quite extensive: bronchial asthma, hypertension, neurodermatitis, rheumatoid arthritis, stomach and duodenal ulcers, diabetes, coronary heart disease, oncological diseases etc. It should be noted that psychosomatic disorders have tendency to imitate one or another pathology, which cannot be detected by instrumental or laboratory methods.

The author of MBST Oleksandr Strazhnyi suggests conditionally dividing psychosomatic disorders into mainly psychological disorders and mainly physical manifestations:

1. Mainly psychological disorders - asthenia, chronic fatigue, lack of energy; internal tension, stress, anxiety, feeling of fear; imbalance, anxiety, irritability; mood deterioration, indifference, loss of life meaning; memory impairment, impaired concentration, sleep disturbance.

2. Mainly physical manifestations - headaches, vertigo, tendency to high or low blood pressure, unpleasant heart sensations, functional heart rhythm disorders, vegetative crises; dyspnea, neurasthenic cough, unpleasant abdomen sensations, stomach spasm, intestinal spasm, reflux, bile duct dysfunction, decreased or increased appetite, constipation; functional disorders of kidneys, ureter and bladder, constant or migrating pains in spine and joints, allergy, diathesis, bronchial asthma, functional disorders of menstrual cycle, «neurotic» ovaritis inflammation, inability to become pregnant in absence of hormonal or organic disorders; sexual disorders (anorgasmia, women libido weakening; potency decrease and men premature ejaculation), other diseases not detected during medical examination.

The basis of MBST is correction of health disorders using a session consisting of verbal and non-verbal suggestive structures. MBST session is an electromagnetic wave audio program that affects neurons of a brain, which is transmitted to a person who listens to it, and brings beneficial changes to body. The therapeutic program of the MBST session consists of the following suggestive verbal constructions: «You are calm», «You are resting», «Your heart is working normally», «Your breathing is calm» etc. During the session, painful nervous processes responsible for the perception of poor health fade away. Neural connections containing the image of well-being are strengthened. As a result, body's hidden reserves are activated and self-regulation processes are activated. Initially, the information received by the brain is transmitted by neural circuits and fixed in short-term memory, which should be constantly reinforced. That is why MBST spesialists repet sessions, preferably several times (7-9). In this way, biosuggestive psychotherapy begins to work according to the laws of a conditioned reflex, that is, a habitual action in response to one or another sensory stimulus. The reflex is fixed with each repeated session in long-term memory. Over time, the suggestive blocks voiced by the psychotherapists reprogram the human body to new positive settings. In case of psychosomatic disorders, the neural system of emotional and physical sufferings causes psychogenic pain (rejection, hopeless loss, etc.) and somatic pain (morbid sensations in certain organs) (Ellis, 1962). In other words, if it «hurts» psychologically, it also «hurts» physically. MBST sessions relieve heightened sensitivity to emotional and physical pain.

The word affects a person in different ways, causing certain biochemical reactions in the body. Aggressive and hostile phrases activate release of adrenaline from the adrenal glands. A person focuses, concentrates, and strengthens protection against danger. Regrets and offensive phrases multiply monoamine oxidase in the body, the family of enzymes that destroys the mediator of good health - serotonin. Therefore, there is a bad mood, anxiety, worry, bitterness, insomnia etc. Cheerful and pleasant phrases increase the level of endorphins in the body, which contributes to the good mood, euphoria, pain reduction, normalization of blood pressure, feeling of peace, balance, and optimism (Koshyrets, 2022).

The positive algorithm of biosuggestive influence used during the session is aimed at activating the body's neuroendorphin system. It brings pleasure to a person and activates the processes of self-regulation. According to Oleksandr Strazhnyi, suggestion affects both the subconscious (unconscious) component of psyche and conscious perception of a word (rational analysis). Any person accepts not what someone tries to «impose», but what is ready to be accepted (what corresponds to own feelings, beliefs, ideals, norms etc). The following factors should be taken into account in the process of biosuggestive psychotherapy to the suggestion process work effectively:

1. Authoritative personality.

2. A person sympathizes with a certain person when language is clear and understandable.

3. Congruence of a suggestor.

4. Messages are confirmed by additional information, figures, and statistics.

5. A listener feels that a speaker himself believes in what he says,

6. Information is obtained from various sources.

7. A person himself is ready to believe what he is told.

People of different talents, different training and different experience work in psychotherapy. However, regardless of this, a client will believe and trust a psychotherapist who is an authoritative person, is sympathetic and his language is clear and understandable. If a client feels that a psychotherapist himself believes in what he says, a client himself wants to believe in what he is told. If a psychotherapist radiates comfort, if a client feels that we really want to help him and especially if positive changes in his own condition are already noticeable - in this case, a therapist's charisma «has worked» properly. It is necessary to note, that a specialist «does not treat», but a client's organism «treats itself». Moreover, a psychotherapist's task is to «launch» the processes of self-regulation.

Conclusions

The principle of MBST is to replace a neurotic pattern with a pattern of good well-being. That is, the negative template is replaced by another, positive one. A psychosomatic disorder develops imperceptibly. At first, nothing bothers a person, and then there is a feeling that something is wrong with health; then a person has more and more frequent symptoms that indicate the beginning of the disease, and, in the end, a person absolutely believes that he is sick. The MBST works as follows: a person first imagines himself to be healthy, and then feels it. The pattern of illness is replaced by the pattern of recovery, and then, due to the inclusion of self-regulation mechanisms, the pattern of recovery turns into the real recovery. MBST session acts as a catalyst for the body's internal resources: when after the first few sessions it could be possible to create the desired pattern, the body itself will complete the process of getting rid of somatic neurosis.

Any person is able to get rid of, for example, aggression, anxiety, fear, as well as minor somatic symptoms without the help of a doctor or psychologist. However, without outside help, a person will not be able to get rid of neurotic patterns that have been forming for years. Psychosomatic symptoms become habitual and are very difficult to get rid of, but possible.

Most often, every person perceives everything that happens in life according to own formed pattern (formed stereotype). In case when the patterns do not coincide with each other, there is an attempt to destroy the interlocutor's pasttern and put his own in its place. And if the pattern is destructive and causes neurosis, then it is necessary to apply and adjust psychotherapy. Breaking the neurotic pattern, whether purposefully or accidentally, helps a person to destroy the old painful pattern and replace it with a new healthy one.

The micro-breaks technique is used in biosuggestive psychotherapy. It lies in the fact that something unexpected should happen during the session. If you interrupt any stereotyped action of a person, that will confuse and cause a temporary altered state (light trance) and incline a person to take someone else's words as his own or as an instruction for action. We perform the neurotic patterns breaking techniques in order to prevent the possibility of critical assessment of information in usual way or scheme.

There is gradual and sudden neurotic pattern break. The first consists of the following five steps: 1. Seizing the initiative. 2. Adjustment. 3. Fixing the adjustment. 4. Output through positive. 5. Key phrase.

The sudden pattern break lies in the fact that a psychotherapist begins a conversation without adjustment, immediately going beyond the pattern.

For this, you can use a positive statement, a positive emotion etc. The point is to switch sharply a person's attention from emotional trauma, mental or physical pain, and switch the bad focus to the good, and any negative factor to positive.

Biosuggestive sessions can be conducted both individually and in a group format (8-10 participants). In this case, the result of psychotherapy is even better. The process of psychotherapy itself must be clearly organized and adjusted accordingly. Before the start of the session, you should make sure that nothing and no one interferes, gadgets are turned off, the location is convenient, the light is comfortable, the volume of the session record must be adjusted appropriately etc. The positive effect of the therapy will be better if other group members induce it, that is, share their good impressions of the previous sessions and results. Then other participants are «infected» with the state of trust, mutual understanding and hope, which increases their suggestibility. Therefore, the suggester can be not only a psychotherapist, but also the therapeutic group itself (Kellerman, 1979).

During the session, the members of the therapeutic group can feel a pleasant heaviness, calmness, relaxation, lightness, carelessness. However, it is important to perceive the session naturally and casually. Immediately after the session, a client may feel a surge of strength, vigor, freshness, and good mood. Moreover, the most important thing is that all what bothered a person disappears: pain, unpleasant sensations, discomfort etc. After the first session, you may feel a little tired, lethargic or want to sleep or lie down. This is a good prognostic sign, and if the body reacted to the session in this way, then it needs rest and relax.

The one who felt tired on the first day after the session, the next day, to his or her surprise, felt an increase of energy and improvement in wellbeing. Sometimes a slight aggravation appears after the first session. But it is temporary and precedes gradual recovery. The extensive experience of sessions shows that in the vast majority of cases this aggravation is observed only after the first session. And the following sessions show that the body begins to recover. With each subsequent session, one feels more and more fresh energy, surge of strength, good mood and improvement in well-being. There is one general rule - immediately after each session, the participants do not talk about anything bad. After all, negative phrases and associations block the production of endorphins in the body, which cause positive changes.

In MBST audio session, the rules of clear pronunciation of phrases are observed, accents are placed on one or another word, and a game with voice intonation is performed. At the beginning of the session, a psychotherapist's voice should sound natural and relaxed, as if he is simply talk to the client - without artistry, without embellishments, without directiveness. Just neutral and calm attitude to what happens. A psychotherapist just talks, does not teach anything, does not impose anything. Thanks to this, a listener does not have the desire to resist. Gradually, the neutrality leaves and a therapist's voice begins to sound more confident, calmer, as if «lulling». Phrases become clearer, and after some period begin to take the form of necessary settings (beliefs). The main rule is that there should be no dry reading of the text.

The text of the audio session is compiled in such a way that it can be applied to anyone, regardless of age, disorders and health complaints. Well-thought-out construction of sentences, rhythm of speech calculated in seconds, its volume, intonation, accents on certain words - all this makes the audio session the effective practical tool of therapy. The therapeutic effect also largely depends on the state of a specialist during the session. During the MBST session, a psychotherapist should feel comfortable. The audio record of the session is perceived much better than a live voice of a psychotherapist. Moreover, this allows to significant increasing of the treatment effectiveness.

A teherapeutic touch is important component of the biosuggestive process. Therapeutic techniques that use a touch have been used since ancient times. Some consider the body as a diagnostic tool, when a person's condition is assessed by the tension of various muscle groups, others treat the body as an object of therapy. However, the use of physical touch in work with clients is a controversial issue in psychotherapy. While some experts see touch as a form of non-verbal communication that can have therapeutic value, others believe it is a pathway to abuse and risk of injury. There is no clear definition of an acceptable and ethical way of touch in relevant documents and recognized by all schools and associations of body psychotherapy.

A touch as integral component of biosuggestive psychotherapy should be normal: neither strong nor weak. A touch must be clear, real and unambiguous. With a vague touch, the feeling of contact is lost; with «unintelligible» touch, we can mislead a person. A touch should not convey any other message than «a touch happened». Therapists need to be especially attentive and sensitive so as not to retraumatize with a careless touch. Friendly touches have a pronounced calming effect. Soft and calm touch increases the production of oxytocin, a hormone that is produced in the posterior part of the pituitary gland. Oxytocin increases the level of serotonin and dopamine: serotonin reduces the level of anxiety, tension, depression, and dopamine improves concentration (Thaler R, Sunstein C., 2009). In addition to increasing the level of oxytocin in the body, touch also reduces the production of cortisol - «stress hormone» - in the cortex of the adrenal glands.

Suggestive phrases cause a healing effect if a person hears them being in a light trance. Sessions of biosuggestive therapy are composed in such a way that a person who hears them enters this state. To achieve the therapeutic effect during suggestion, trance is desirable, but it does not necessarily have to be deep. If a client falls into deep trance, this does not mean that he is a «weak person» who easily obeys someone's will. During biosuggestion sessions, no one manipulates or bends to own will. Professionals put a person into a trance for the sole purpose of treatment. However, even if a participant reaches a state of deep trance during the session, a psychotherapist only helps him.

Audio session music has a positive effect on a person's emotions, feelings, mood and physiological processes in the body. Through the auditory analyzer in the cerebral cortex, its harmony spreads to the subcortical centers, the spinal cord and reaches the internal organs through the autonomic nervous system. Music affects any person, regardless of age, education, erudition. Rhythmic music activates certain areas of the brain involved in movement, concentration, learning and memory. It helps to perform routine work better.

Calm music stimulates the body's production of dopamine, which improves mood, reduces anxiety, and affects satisfaction, joy and motivation. Calm music also lowers high blood pressure, reduces the frequency, intensity and duration of headaches, epileptic seizures and helps to fall asleep quickly. Upbeat music strengthens the immune system. It can create a positive emotional response that affects the secretion of hormones that strengthens immunity. Melodious music reduces painful sensations. Pleasant music promotes the production of hormones that reduces stress. Listening to pleasant music, a person treats people more kindly. The degree of own selfishness decreases. When listening to any music, both hemispheres of the brain function symmetrically.

Rhythm is of the particular importance. When the background music sounds, a person, even without listening to it, begins to react in time with his foot or shake his head. This happens unconsciously. The autonomic, nervous, cardiovascular and respiratory systems also react unconsciously to the musical rhythm. Rhythm is an important component of life. Daily biorhythms, emotional, physical, intellectual - these are periods of decline and rise, which are also characteristic of the activity of internal organs, hormonal and nervous systems. Music, normalizing the rhythmicity of biological processes occurring in the body, optimally distributes energy, promotes harmony and well-being.

We use classical and light music in MBST sessions. MBST session provides for setting up a client to work on himself, where he usually encounters his own laziness and reluctance to change something in his life. To achieve the effective result of MBST, you can use written tasks with structuring of the entire therapy session, noting problematic points, minimum tasks and maximum achievement of the desired positive changes. The practice of combining the MBST sessions with other therapeutic techniques is also used.

biosuggestive therapy psychosomatic

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https://uvnpn.com.ua/upload/iblock/022/022fcd3e3721c430f11fabf4541afa35.pdf

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