Breast cancer disease and treatment methods not only affect patients’ physical functions, but also bring significant impact on patients’ psychological and social consciousness. In terms of psychological and social consciousness, how to overcome psychological crisis, overcome fear, depression and anxiety, and successfully complete various treatments; how to establish good relationship with family members, receive family support, and regain normal family life order; how to strive to return to society, establish good interpersonal relationships, regain work and realize their own value.
This series of problems deserve the attention of medical workers. Numerous studies have shown that the occurrence of breast cancer is related to psychosomatic factors, such as stressful negative life events, especially the inability to obtain or use social support when experiencing stressful negative life events, which causes disorders in the organism and induces the occurrence of breast cancer.
Similarly, during the whole process of diagnosis, treatment, recovery and follow-up of breast cancer, positive psychological intervention can improve the negative emotions, increase patients’ compliance with treatment, reduce somatic symptoms such as pain and nausea and vomiting caused by chemotherapy, and even improve patients’ immune function, inhibit the development of cancer and effectively improve the quality of life in breast cancer. Zuo Wenshu, Breast Disease Center, Affiliated Hospital of Shandong Academy of Medical Sciences
In ancient society, the concept of psychology was abstract and had many sayings, so people often regarded it as mysterious metaphysics. In biomedicine, psychological factors and psychological principles are rarely mentioned except in psychiatry. Especially when it comes to political and philosophical concepts often psychology is considered as idealism and undesirable. In fact, this is a misconception. The development of modern science has removed this divide.
In the 20th century, with the development of science and technology, scientific psychology arose. The psyche can already be studied by experimental means, and the psyche can be decomposed and quantified. Psychology in the sociological sphere mainly studies the occurrence, development and development of the human mind and psychology, ethics and morality of society, interpersonal relationships and the reflection of human behavior; psychology in the medical sphere, especially neurophysiological psychology, mainly studies the higher physiological activities of the nerve centers of the brain.
For the multiplicity and multidimensionality of thinking, deepening and complexity of mental activities, increased psychological pressure, a large number of psychological problems and psychological topics presented in front of the medical urgent need to solve. Therefore, how to stabilize the mind, how to diagnose and treat psychological diseases and protect mental health as well as carry out mental health work, how to recognize the nature of psychological materialization and human potential and potentiality, how to further explore, study and discuss this series of issues that were rarely paid attention to, but now have become an important subject of modern medicine.
1.Transformation of medical model
1.1 Biomedical model
The most fundamental feature of the concept of biomedical model is that it requires biological evidence for any disease, that is, it requires that any disease can be found in the form of organs, tissues and cells with detectable morphological changes or physiological and biochemical abnormalities. From the requirement of biomedical concept, having a disease means having a lesion, and having a lesion will have corresponding positive indicators to be found, and it can be confirmed by X-ray, ECG, ultrasound, CT and endoscopy, or it can be tested and measured in various laboratories to measure various abnormal data.
In terms of etiology, biomedicine has studied most biological etiologies such as bacteria, viruses and spirochetes, as well as physical, chemical and mechanical etiologies foreign to the environment. Biomedicine rarely considers the place of psycho-emotional and mental states in etiology, and some even reject the concept of psychogenic causes. For social factors, they are also basically not considered to constitute an etiology except for psychiatric disorders. Problems of biomedicine.
① Neglect the whole person and the human psyche;
② Emphasis on microscopic research, ignoring the macroscopic whole;
(3) Over-reliance on instruments and neglect of one’s own senses.
1.2 Psychological medicine model
1.2.1 Basic concept and content The basic concept and content of psychological medicine model can be summarized as the word “human”, that is, biomedicine focuses on “disease” and psychological medicine focuses on “human”. The most important difference between psychological medicine and biomedicine is the introduction of two major factors, psychological and social. The main features of the concept of psychological medicine model are
(1) The concept of “person”, psychological medicine focuses on the whole person as a unified body and mind and the social entity as a unified body and mind;
(2) The concept of “psychogenic” etiology;
③The concept of comprehensive health.
The concept of health in psychological medicine includes the following complete elements.
(1) The biological organism is intact;
(2) Mental health;
(3) Harmony with society. Among them, the last two are more important. According to psychological medicine, psychological disorders are the most important unhealthy, and social maladjustment is the biggest cause of psychological disorders. The above is only one aspect of psychological medicine that emphasizes its importance, but does not deny the role of biological factors; biological factors are still the basic factors of disease, so the full name of the new medical model is the biological-social-psychological medical model.
1.2.2 Basis for the emergence of psychological medicine model
(1) Increased psychological load: The progress of modern society, the civilization of society and the huge creation and accumulation of material wealth also bring huge psychological and social pressure to people. Thus, psychological and social become important factors affecting people’s health and become the cause of psychological diseases.
(2) Changes in disease spectrum and disease spectrum parity: Modern high science and technology have made unprecedented achievements in the prevention and treatment of biological and somatic diseases, and general infectious and contagious diseases have been significantly reduced, with a significant decrease in mortality. However, on the other hand, cardiovascular diseases, tumors, and psychological and psychiatric disorders, which are clearly associated with psychosocial factors, are on the rise. As a result, profound and fundamental changes have occurred in the disease spectrum and disease spectrum parity of the entire population.
(3) Increased hypochondria: Due to the existence of objectively high incidence of tumors and the lack of knowledge about mental mental health and lack of adequate medical knowledge, there is a large number of hypochondria in the population, suspicion of tumors, cardiovascular diseases and physical unhealthiness. This skepticism of patients also requires answers and treatment from doctors.
(4) Medical concept renewal: In the 1970s, when Engel formally proposed the concept of a new medical model, it was soon responded to by people. By the 1980s, almost all fields of medicine began to shift (either verbally or in action) to the new medical model in a comprehensive manner. Undoubtedly, the 1990s and the 21st century will be the era of the new medical model.
It emphasizes and values the role of psychological factors, the role of social environment and life events, the importance of patient’s initiative and motivation, and the importance of discovering the human potential medicine. Through the study of psychophysiological mediation mechanism and the study of brain potential and its mechanism, psychological medicine will further interconnect with the newly emerged human science and promote the development of medicine in a deeper direction.
2.Introduction to psychological problems and psychotherapy Among the “healthy people”, many of them are not enough to be diagnosed as psychological diseases, but they actually have some psychological problems. Psychological problems refer to psychological problems, is the prelude to disease, but has not yet appeared in the system of symptoms. The further development and aggravation of psychological problems is a psychological disorder.
Patients with psychological disorders are completely clear in spirit and consciousness, their behavior is basically normal, their appearance is good at first glance, and they do not cause harm to society, family, units and others. Therefore, family members, colleagues and close friends, and even doctors are often neglected and do not take it seriously, so that the symptoms accumulate over time and deepen. Psychologists must be proficient in clinical practice, and clinicians must be familiar with psychology; they must start from the psychological aspect, find out where the symptoms lie, and provide guidance, while at the same time treating the physiological dysfunction and relieving the physical discomfort; they must give patient explanation and guidance on the discriminatory relationship between psychology and physiology, in order to eliminate tension and anxiety and stabilize the psychological state.
Psychotherapy is both technical, but more art is needed, psychotherapy must be improvised and “improvised” creation and play; prevention and treatment must be synchronized; step by step, not afraid of repetition, hold the balance, psychological problems and psychological disorders can be completely cured.
2.1 Principles and requirements of psychotherapy
2.1.1 The concept of psychotherapy The difference between patients with psychological disorders and patients with somatic disorders is that the former are mainly manifested by psychological dysfunction, and the physical pain is concomitant and secondary. In the latter, the opposite is true. The main goal of treatment of somatic disorders is to eliminate the lesions of the body, and the psychological worries and anxiety will disappear naturally; the treatment of psychological disorders is mainly aimed at relieving the psychological pain.
The elimination of physical lesions is based on physical and chemical drugs and surgery as the main means and methods of treatment; the release of psychological pain (or psychological trauma) mainly relies on “heart medicine” psychological guidance, spiritual comfort and correction of cognitive biases (including behavioral training if necessary). The “heart medicine” is the doctor’s demonstration of language, speech, expression and behavior. Regardless of how many different approaches and theories of psychotherapy have been developed throughout history, how many definitions and interpretations have been given to psychotherapy and how psychotherapy has been divided into broad and narrow definitions, it must ultimately be implemented through the doctor’s words.
The patient begins to receive treatment through the doctor’s language (including suggestion). The doctor’s language requires not only theory and knowledge, the ability to reason logically, but also the art and cultivation of language. Different patients use different language.
2.1.2 The art of psychotherapy The key step in psychotherapy is to see whether the patient can accept the doctor’s treatment. Without the establishment of a mutually acceptable and good doctor-patient relationship, there is no way to talk about psychotherapy. The key to patient acceptance lies not in the patient, but in the doctor, in the art and skill of conversation and in the warm and sincere attitude of the doctor when receiving the patient in the first consultation.
The treatment of psychological disorders must be two-way, never like the treatment of physical diseases, the patient is in a passive “can only listen” situation, the doctor must sometimes listen more, patient and sincere listening. If the patient is silent or even resentful during the consultation, he or she must be patiently helped and guided; if the patient is able to carry on a dialogue, but does not actively or only passively answer, he or she should wait patiently and actively enlighten.