ヨーガと認知行動療法を行った摂食障害合併1型糖尿病の1症例  [in Japanese] Application of Yoga and Cognitive Behavior Therapy for Type 1 Diabetes Mellitus and Eating Disorder: Case Study  [in Japanese]

摂食障害を合併した1型糖尿病患者にヨーガと認知行動療法の併用を試みた.介入当初はアレキシシミア傾向が強く治療への動機づけが不安定であったため,感情の言語化を促しながら,ヨーガを用いて激しい感情と距離が置けるよう援助した.その後に,過食嘔吐の代替行動の形成や問題解決療法など摂食障害によく用いられる技法を導入した.さらに,母親に対して具体的なサポート方法を提案することで母子関係の調整を行い,長期的には1型糖尿病をセルフケアすることに対する患者の自立的態度の育成に貢献できた.

Yoga and Cognitive Behavior Therapy were applied to a patient with type 1 diabetes mellitus and eating disorder. At the beginning of intervention, the patient's motivation towards therapy was uncertain and she was alexithymic. To help the patient identify and express her emotions, thought records were chronicled during sessions. At the same time, yoga was introduced to control her emotions. Behavioral planning enabled the patient to substitute binge-purging with other activities. From the thought records, it was inferred that the patient's lack of confidence in job ability was found to trigger binge eating. Clarification of the areas in which she lacked confidence and then taking small steps to overcome these through the application of cognitive techniques was found to be effective. In addition, her mother's excessive worrying was found to be a major factor in lowering the patient's self-confidence. Therefore, the mother was advised to pay extra attention and give positive feedback in regards to the patient's adaptive behaviors. Our intervention to motivate the patient to actively participate in therapy using cognitive techniques in addition to yoga as a mindfulness technique were found to be effective in controlling eating disorder in a patient with type 1 diabetes mellitus.