Rehabilitation requires methods that will allow for effective support of the psyche of the improved patient. The psychotherapeutic impact enables effective work with the patient during the rehabilitation period. What tool is an effective way to support the rehabilitation process – the traditional Schultz autogenic training or the innovative VR TierOne therapy?
Psyche in rehabilitation
The experience of loss of health and fitness is accompanied by negative emotions. Stress, anxiety and depression occur in the disease. Patients may experience fatigue, lack of willingness and strength to fight for health, aversion to exercise, pessimism and an unfriendly attitude towards the environment. All this complicates the course of required rehabilitation. However, we are not defenceless against these detrimental mental states. A properly designed rehabilitation program should take into account the impact on the level of patient’s psyche, which will make the rehabilitation proceed more efficiently. Relaxation training can be a way to increase the effectiveness of rehabilitation.
The creator of autogenic training is the German physician Johannes Heinrich Schultz. He presented the assumptions of autogenic training in a monograph, back in the 1930s. . Today, it is a method of relaxation generally accepted by the medical community. The autogenicity of training is that the patients learn to influence their own nervous system with the help of self-suggestion in order to relieve tension. Autogenic suggestions direct the entire process to achieve demobilization of the body, and thus a state of relaxation. During the training, attention is directed to individual parts of the body. Autogenic training is divided into 6 stages, which should be mastered in the following order:
- feeling of heaviness in the body,
- feeling of warmth in the body,
- heart rate control,
- breath regulation,
- feeling of heat in the area of the solar plexus,
- a feeling of coldness on the forehead.
It takes 2 weeks to learn each of these stages. Autogenic training should take place in a place that is isolated from the inflow of stimuli from the outside. A quiet and slightly darkened room, where no one will be disturbed, would be optimal. During the exercise, it is helpful to close your eyes (a natural cutting off from visual stimuli), instrumental music or the sounds of nature in the background are also conducive to practice. During training, the patient should adopt a lying or sitting position. The training session takes 15-20 minutes and must be conducted by a trained person. The assumption is, however, that over time the patients will acquire the ability to independently administer the training to themselves. Ultimately, the patients should be both their trainers and trained persons. They are to achieve the ability to sedate themselves. Mastering the training allows you to quickly put your own body into a state of relaxation by means of a sequence of suggestions, which is helpful in stressful situations (this training is popular among athletes, e.g. to reduce excess mental tension before a competition). The results of practicing autogenic training are:
- improved attitude towards life,
- obtaining inner peace,
- stabilization of emotional reactions,
- increase in self-esteem,
- reduction of tiredness and fatigue,
- improving the functioning of memory and attention,
- alleviation of paralyzing anxiety and depression,
- restoring the balance between the subsystems of the autonomic nervous system.
Consequent daily practice is required to achieve the desired effect. Schultz autogenic training requires time to acquire the skills of its proper performance. It takes 12 weeks to master the 6 stages. Some patients may experience discomfort when trying to relax using this method.
VR TierOne therapy
Despite its advantages, autogenic training may not be a sufficient method of treating anxiety-depressive disorders during rehabilitation. Because there are no psychotherapists in rehabilitation teams, autogenic training is usually played to patients in the form of audio recording. For such training to be effective, however, it is not enough to listen, you need your own activity and commitment to the process. There is a new alternative therapy that involves patients to a greater extent and at the same time does not require the presence of a psychotherapist. The virtual VR TierOne therapy uses the assumptions of Ericksonian psychotherapy, it is enriched with breathing exercises and elements of mindfulness training. The therapy constructed in this way is aimed at removing mental barriers that reduce the readiness to benefit from rehabilitation. VR TierOne intervention is not only a way of relaxation, but a method to strengthen the patient’s resources necessary to achieve the rehabilitation objectives. VR TierOne therapy is divided into 8 sessions, which should be used in a fixed order. The therapeutic cycle lasts 2 weeks, it is recommended to use 1 session per day, and each therapeutic session is about 20 minutes. The patient is seated during the session. The VR TierOne medical device is required to perform the therapy. The Virtual Therapeutic Garden of Rebirth creates perfect conditions in which the patients immerse the moment they put their VR headsets on. During each session, the voice-led patient performs tasks in the virtual Garden of Rebirth. The therapy participants are surrounded by a kind verbal message, therapeutic music and a picturesque landscape with which they interact. The result of VR TierOne therapy are:
- improvement of mood and increase in well-being,
- reduction of depression, stress and anxiety symptoms,
- strengthening internal resources,
- positive attitude towards the environment,
- restoring vitality,
- increased focus on “here and now”,
- improvement of cognitive functions,
- reduction of pain sensations,
- acceleration of health recovery,
- physical and mental freedom from stress,
- increasing one’s own efficiency and effectiveness,
- increase in self-acceptance and acceptance of the health situation,
- improving motivation for treatment and participation in rehabilitation.
VR TierOne therapy helps overcome mental crises related to the disease, thanks to which rehabilitation can be undertaken, with the patient actively participating therein. This is a beneficial situation for the patients, desired by the rehabilitation practitioners and expected by their families.
Schultz autogenic training is considered an effective relaxation method, which is why such intervention was used for the control group in research on the effectiveness of innovative VR TierOne therapy as a method supporting respiratory, cardiac and stroke rehabilitation. In the previous research work, no direct comparison was made as to which of these methods was more effective. Both lead to positive changes and bring benefits in maintaining mental health. However, it must be taken into account that a patient with a motivational deficit, who has difficulties in performing the exercises provided for in the rehabilitation program, may also have difficulties in following autogenic training. VR TierOne therapy with high motivational potential seems to be a more interesting and noteworthy method of supporting patients during rehabilitation.