IPNOSI E DISTURBO BIPOLARE

 In Quando usare l'ipnosi

Per disturbo bipolare si intendono significativi cambiamenti sia nell’umore, sia nell’attività, sia nell’energia del paziente. Infatti, i disturbi dello spettro bipolare consistono in una affezione psicopatologica che colpisce la sfera affettiva, cognitiva, comportamentale e relazionale di una persona in una maniera che risulta disfunzionale, ovvero sufficientemente forte da rendere il disagio complesso sotto una molteplicità di profili, che vanno dalla sfera personale e soggettiva a quella relazionale e socio lavorativa. Quando si parla di disturbi dello spettro bipolare si intende mettere a fuoco le sindromi caratterizzate dall’alternanza tra due condizioni cosiddette contro-polari dell’attività psichica umana: l’eccitazione, da cui deriva lo stato euforico; la depressione ovvero uno stato di malessere clinicamente significativo, accompagnato da prostrazione, scoraggiamento, e spesso associato a bassa autostima e perdita di interesse o piacere nelle attività quotidiane (anedonia). Per quanto riguarda l’epidemiologia del disturbo, esso ha un’incidenza pressoché pari tra i due sessi, anche se è lievemente maggiore per il sesso femminile con una stima pari all’1,8% della popolazione. Il disturbo bipolare risulta caratterizzato da uno specifico quadro clinico che vede alterati i fisiologici stati dell’umore legati alla tristezza e alla felicità. Questi due stati contro-polari dell’umore ciclicamente si alternano e, rispettivamente, la tristezza si trasforma in depressione, la felicità in euforia. Le alterazioni più significative dell’umore generalmente si avvicendano a periodi di apparente normalità, detti periodi intercritici. I più significativi benefici psicoterapeutici possono essere ottenuti proprio nelle fasi intercritiche, proprio grazie alla remissione totale dei sintomi che si verifica nella maggior parte dei pazienti. Anche nel caso dei disturbi dello spettro bipolare, l’ipnosi può rappresentare una tecnica terapeutica molto potente. Nonostante si tratti di disturbi consistenti in sindromi di interesse psichiatrico, per cui c’è sempre bisogno di una compensazione farmacologica, intraprendere una psicoterapia tra i due episodi, quello depressivo e quello maniacale, è una scelta di grande efficacia. La psicoterapia offre al paziente il sostegno e l’ascolto e dovrebbe considerare di includere:

1. un aspetto cognitivo-informativo, attraverso il quale approfondire le caratteristiche del disturbo bipolare;
2. il monitoraggio del tono dell’umore, che consente al soggetto di capire quando ci sono cambiamenti significativi in atto;
3. e, per finire, strategie per la gestione dell’umore, che si configurano come uno strumento elettivo per governare al meglio i cambiamenti.

L’ipnosi rappresenta uno strumento in grado di realizzare col paziente l’ars maieutica, ovvero di rendere al paziente la possibilità di partorire la sua verità, in accordo col metodo socratico. È questo il procedimento attraverso cui è possibile sostenere il soggetto a ricercare dentro di sé la verità, attraverso un percorso di esplorazione il più possibile autonomo. La ricostruzione biografica e l’attivazione delle memorie del paziente possono rappresentare per molti un esperienza di grande beneficio. Nel caso delle sindromi dello spettro bipolare, l’ipnosi non equivale a una soluzione tout court, essenzialmente perché ogni paziente esprime le sue peculiarità ed è importante non tanto parlare oggettivamente del disturbo bipolare ma inquadrare la soggettività di ogni essere umano oltre che il significato del sintomo nella sua specificità. Di grande utilità risulta, tuttavia, l’impiego dell’ipnosi nei periodi intercritici e nelle fasi depressive. Le tecniche ipnotiche possono essere usate con successo per bilanciare i livelli chimici nel cervello e portarli a un livello coerente con quelli del soggetto sano. Nello stato di ipnosi si possono stabilire obiettivi e dare suggerimenti motivazionali per aiutare il paziente a svolgere i diversi compiti quotidiani, in grado di restituirgli dignità e autoefficacia. Inoltre, nello stato di trance possono essere date indicazioni perché il soggetto riposi bene e migliori le abitudini alimentari, due bisogni fondamentali che risultano spesso compromessi dagli esiti del disturbo bipolare. Attraverso un adeguato impiego dell’ipnosi, i pazienti hanno la possibilità di sperimentare stati d’animo, pensieri ed emozioni positive indipendenti dalle stagioni e dalle condizioni esterne. Infine, incrementare la fiducia e la stima di sé può aiutare il paziente a formare un concetto positivo della propria identità grazie al quale risulta possibile attivare le risorse interne e sviluppare delle prospettive di vita positive e realistiche.

Dott.ssa Maria Novella Grimaldi
Dottoressa Maria Novella Grimaldi Da circa 20anni esperta di ipnosi strategica, ipnoterapia ericksoniana, ipnosi dinamica e regressiva. Laureata in Psicologia a indirizzo applicativo presso l’Università degli Studi di Roma “La Sapienza” e specializzata in Approccio Breve e Strategico. Da anni utilizzo quotidianamente questo approccio insieme all’ipnosi, durante il percorso terapeutico l’attenzione non viene posta sul passato ma sul presente e sul futuro. Questo tipo di intervento si avvale di tecniche specifiche tra cui ricordo il Training Autogeno, la desensibilizzazione sistematica, l’ipnosi etc. Oltre ad usare le tecniche di rilassamento e l’ipnosi in ambito clinico conduco presso l’Istituto per lo Studio Delle Psicoterapie corsi, riservati a medici e psicologi, per conduttori di Training Autogeno, Tecniche Ipnotiche e R.A.T. Mail: marianovellagrimaldi@gmail.com
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