There will be psychology everywhere in life, such as looking in the mirror. In fact, some people are afraid to look in the mirror, so what is the psychological mechanism behind not looking in the mirror?

Medical records:

Xiao Wang's parents accompanied him to the clinic to see me for the first time last summer. It was very hot, but Xiao Wang wore a hat, sunglasses and a mask. Even when talking about his illness, he still refused to take it off. He is very talkative. From his mouth, I learned that when I was in the third grade, I felt that the people around me and the environment were unreal because of the pressure of study. I feel strange and ugly when I see myself in the mirror. I can't accept myself in the mirror, and even accidentally see my own image on the glass, my mood will get worse. When chatting with classmates, I feel that they look at themselves strangely, as if they are commenting on their looks, and they will become nervous when interacting with others. Everything others say and do will affect themselves and feel very painful. There is an impulse to cut people with a knife and jump from a height.

Have you ever been to several hospitals to see a doctor who was diagnosed? Obsessive compulsive disorder? Neurasthenia? 、? Social phobia? And so on. I have taken a variety of antidepressants and antipsychotics intermittently, but I can't stick to them because of the poor effect. I often feel that my brain is empty and I have a headache, so I can't continue my study. After serving in the army, daily training can still cope. Dare not look in the mirror, firmly believe that you are the ugliest person in the world. If I want plastic surgery, I can only feel better if I wrap myself up. I learned from his parents that Xiao Wang has another brother, who has been excellent since childhood and has been praised everywhere. On the other hand, Xiao Wang is very naughty and often criticized. After junior high school, his character became obviously introverted. According to the above symptoms, what is the diagnosis? Neurotic disorder? .

Work experience:

The etiology and pathogenesis of neurotic disorder are complex, and it is difficult to express it with a single theoretical model. The incidence is often related to social and psychological factors. Before getting sick, many people have a certain susceptibility quality and personality foundation, and the symptoms are mainly brain dysfunction symptoms, emotional symptoms, obsessive-compulsive symptoms, hypochondriac symptoms, various physical discomfort and so on. The pain of the disease is obvious, but the social function is relatively complete, the behavior is generally kept within the scope allowed by social norms, the desire for treatment is urgent, and the course of the disease is prolonged.

Xiao Wang felt inferior in front of his brother from an early age. He tried to get his parents' attention by being naughty, but it backfired and made him feel useless. On the contrary, after his illness, his parents accompanied him to many hospitals. They always rented a house next to the army to take care of him, making up for the attention he didn't get when he was a child.

Key points of treatment and nursing:

Psychotherapy: ① Cognitive therapy. This therapy can improve patients' understanding of their own cognitive errors and improper thinking. ② Behavioral therapy. Such as relaxation training, coping with anxiety symptoms caused by not correctly understanding self-body image. Including qigong, yoga, biofeedback and other training. ③ Morita therapy. It is often beneficial to eliminate symptoms by shifting patients' attention from themselves to the outside world and eliminating patients' excessive worries about their feelings.

Drug therapy: ① Anti-anxiety drugs: benzodiazepines can quickly improve acute symptoms. ② antidepressants: SSRIs and SNRIs have better effects. ③ Antipsychotics: Antidepressants are ineffective, but atypical antipsychotics can really improve the effect. (4) Adjuvant treatment of emotional stabilizers: sodium valproate, for example, is mostly used for adjuvant treatment of neurotic disorder.

Nursing points: ① Medical staff should talk with patience, sympathy and acceptance when dealing with patients' pain, understand the authenticity of their experiences, conduct psychological evaluation on patients, support and encourage patients to properly control their emotions and continuously improve their tolerance.

② Explain relevant professional knowledge to patients and correct their wrong cognition; Help patients establish self-confidence, discover the advantages of patients in time, and give praise. ③ Strengthen the education of family members, especially parents. As the most important source of social support before adulthood, parents' attitudes and behaviors towards their children will affect the formation and development of their self-esteem and cognitive style. If children can often feel their parents' understanding, support and care, and are often praised, it will help children to establish a positive self-expression evaluation of their own ability, appearance and social acceptance, help children build self-esteem and self-confidence, and form an extroverted, emotionally stable, enterprising and adaptable personality.

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