ერთი შემთხვევა მწვანე სახლის ისტორიიდან (საქართველოს ფსიქიატრიის მოამბე #7)

erTi SemTxveva mwvane saxlis istoriidan

marine tarasaSvili

mwvane saxli, fsiqologiuri momsaxurebis centri mcirewlovani bavSvebisa da maTi mSoblebisaTvis, 2006 wlidan funqcionirebs TbilisSi. Tavdapirvelad is fsiqikuri problemebisa da daavadebebis prevenciis mizniT gaixsna, frangi pediatris, fsiqiatrisa da fsiqoanalitikosis fransuaz doltos mwvane saxlis (LA MAISON VERTE) modelis mixedviT. Tumca Tavidanve mwvane saxls, praqtikulad janmrTel bavSvebTan erTad, autisturi speqtrisa da fsiqozis sxvadasxva formis mqone bavSvebic estumrnen.

didi enTuziazmi, TiToeuli bavSvisa da TiToeuli dedis problemis Rrma analizi, empaTia, Tavisufali saTamaSo garemo – esaa is, rac mwvane saxlSi bavSvebs exmareba mdgomareobis met-nakleb SemsubuqebaSi, zogierT SemTxvevaSi ki, pirdapir rom vTqvaT, gamojanmrTelebaSi.

vfiqrobT, mkiTxvels daainteresebs erTi SemTxveva mwvane saxlis praqtikidan. bavSvi, romlis SemTxvevasac aRvwerT, 2006 wlis Semodgomaze moiyvana dedam CvenTan. mas ukavSirdeba mwvane saxlis pirveliNdidi warmateba da pirveli sixaruli.

4 wlis da 3 Tvis luka dedam autizmis diagnoziT moiyvana. biWunas sevdiani, tanjuli saxe hqonda; ar hqonda Tvalis kontaqti, misi mzera sivrceSi ikargeboda. BbiWi zedac ar uyurebda bavSvebs, arc saTamaSoebs. jdeboda yvelasgan moSorebiT, xSirad gaunZrevlad, tanjuli gamometyvelebiT. moZraobac Taviseburi hqonda, TiTqos wonasworobas kargad ver icavda. hqonda akviatebuli, stereotipuli qcevebi, ar laparakobda, magram erTsa da imave akviatebul frazebs (mag., samSeneblo kompania `aqsis~) xandaxan yviriliT da sakmaod gaurkvevlad wamoiZaxebda xolme. ar asrulebda aranair miTiTebas, awuxebda uZiloba, sistematurad iRviZebda dilis 4 saaTisTvis, 2-3 saaTis ganmavlobaSi ganuwyvetliv tiroda, Wamda cudad, erTsa da imave saWmels, ar icvamda axal tansacmels, iTxovda, rom adgili ar SeecvalaT saxlSi arsebuli nivTebisaTvis da a.S. periodulad gamoixateboda agresia dedisadmi. DSM  IV-is mixedviT, mas aReniSneboda autizmis yvela niSani, ganviTarebis mZime Seferxebebi; socialuri interaqciis da komunikaciis, qceviTi, mentaluri darRvevebi,  aseve stereotipuli interesebi da aqtivobebi.

Sexvedra tradiciulad anamneziT daviwyeT. biWuna iyo axalgazrda mSoblebis pirveli sasurveli Svili. ojaxi cxovrobda mamis mSoblebTan erTad. fexmZimoba iyo normaluri, dedas am periodSi aranairi daavadeba ar gadautania. mSobiaroba iyo fiziologiuri, bavSvi janmrTeli daibada. dedis TqmiT, is or wlamde normalurad viTardeboda, daaxloebiT ori wlidan SeamCnia, rom bavSvi nel-nela icvleboda, xdeboda Wirveuli, ukontaqto, amcirebda sityvaTa marags, aRar interesdeboda saTamaSoebiT da a.S. hqonda disbaqteriozi, sxva daavadeba ar gadautania.

mwvane saxlis ZiriTadi samuSao meTodi – es aris fr. doltos analitikuri midgoma bavSvisa da misi ojaxis wevrebisadmi. autisturi speqtri ganixileba, upirveles yovlisa, rogorc emociuri darRveva. amitom Cven davinteresdiT ojaxis wevrebs Soris arsebuli urTierTobiT.  Cvens SekiTxvaze – xom ar yofila ojaxis wevrebs Soris daZabuloba da Cxubi, luka swrafad wamoxta da dedas pirze xeli aafara. am moulodneli reaqciis Semdeg, ra Tqma unda, aRar davijereT dedis naTqvami, rom saxlSi ar Cxuboben da romc iyos rame kamaTi, biWunas es mainc ar esmis. Cven, doltos meTodikis mixedviT, bavSvs misTvis am aSkarad mniSvnelovan Temaze davelaparakeT. vuTxariT, rom xandaxan didebsac eSlebaT, rom yovelTvis sworad arc isini iqcevian, rom miuxedavad yvelafrisa, luka yvelas uyvars saxlSi da Tu rame usiamovneba xdeba, es misi brali ar aris...…

biWs TiTqos araferi esmoda, magram vicodiT, rom amaze saubari mas sWirdeboda.

amis Semdgom is odnav ufro mSvidad modioda xolme mwvane saxlSi.  paralelurad bavSvi Cveulebriv saxelmwifo baRSi Seiyvanes. ra Tqma      unda, iq is ganmartoebiT ijda amoCemebul adgilas, aravis ekareboda, ar Wamda, zogjer isvelebda kidec, miTiTebebs ar emorCileboda, magram gulisxmieri da momTmeni maswavleblis wyalobiT baRSi pasiuri yofnis SesaZlebloba mieca. biWuna baRSi mxolod ramdenime saaTs rCeboda, Semdeg ki dedas mwvane saxlSi mohyavda yoveldRiurad. aq is ismenda Tavis istorias, mucladyofnis periodidan moyolebuli. dedis da Svilis yvela SiSs, SfoTvas vixsenebdiT, vaanalizebdiT, yvela `araadekvatur~ qcevas xmamaRla, dedisa da bavSvis gasagonad, vxsnidiT da reaqciebs  vakvirdebodiT. vcdilobdiT, lukas da dedamisis mudmiv emociur mxardaWeras. amasTan erTad, Cven vTamaSobdiT da SefarviT vcdilobdiT biWunas saTamaSoebiT dainteresebas. sul male man daiwyo kubikebiT cixe-simagris msgavsi oTxi kedlis aSeneba, romelSic erT patara kubiks ganaTavsebda da Semdeg xmamaRla, nerviulad yviroda: `gaaTavisufleT, uSveleT, viRupebi!..~ Ees iyo perifrazi cnobili multiplikaciuri filmidan: `ficxel, miSvele, viRupebi~, da mivxvdiT, rom biWuna Svelas iTxovda. pasuxsac iRebda: `nu geSinia, Sen ar daiRupebi, aq imitom dadixar, rom dagexmaroT”. es pasuxi mas amSvidebda.

es TamaSi daaxloebiT 5-6 Tves gagrZelda. mdgomareobis gaumjobesebasTan erTad TamaSSi cvlilebebi SeimCneoda. nel-nela man cixe-simagres fanjara da kari gaukeTa. sul ufro da ufro xSirad aRebda am fanjarasa da kars, ufro da ufro xSirad gamohqonda `tyve kubiki” cixe-simagridan. TamaSis es cvlileba mis fsiqikur simSvidesa da ganviTarebas pirdapir asaxavda. roca progresi cxadi da TvalsaCino gaxda, lukam saerTod Sewyvita es TamaSi da imave kubikebiT Cveulebrivi, Tavisi asakis Sesaferisi, TamaSi daiwyo.

mwvane saxlSi mosuli bavSvebis raodenoba izrdeboda. biWunas es ar moswonda, aravis uyurebda, axlos aravisTan midioda. nel-nela gaRizianebisa da eWvianobis gamoxatva daiwyo. es yvelaferi Zalze Zneli iyo samarTavad, magram es iyo misi progresi. Cven misi ganviTarebis stadiebs moTminebiT mivyvebodiT da frTxilad, magram daJinebiT winsvlisken vubiZgebdiT.

erT dRes mwvane saxls ori studenti gogona estumra. isini xaliCaze isxdnen da bavSvebTan mxiarulad TamaSobdnen. luka moSorebiT ijda da SevamCnieT, rom uCumrad maTken aparebda Tvals. moulodnelad biWuna gamoiqca, erT-erT maTgans fexze Semoaskupda da amRerda: `gogov, colad gamomyevi, Segikerav faCaCebsa...”A

es misTvis gambedavi nabiji winsvlis sawindari aRmoCnda. winsvla axla ukve yoveldRiurad ufro da ufro TvalsaCino xdeboda. sityvaTa maragi swrafad ivseboda, gaurkveveli metyveleba warsulSi darCa. mas ukve SeeZlo azrobrivad gamarTuli winadadebis awyoba, mag., wiTeli manqana midis... Seicvala siarulis manera, gamometyveleba, ukve TviTon iTxovda im TamaSs, romelic specialurad misTvis, Tvalis kontaqtis savarjiSod, movigoneT; iTxovda yuradRebas, Seqebas...…Tumca zogadi mdgomareoba Tvisobrivad igive rCeboda. periodulad Zlierdeboda akviatebuli frazebi, qcevebi, uZiloba, Wirveuloba da sxv. misi perioduli regresi pirdapir kavSirSi iyo ojaxSi konfliqtTan an usiamovno SemTxvevebTan sabavSvo baRsa Tu sxvagan.

muSaobidan daaxloebiT 7 TveSi lukam pirvelad gabeda da Tqva:  `me minda...” (manamde is ukve gvelaparakeboda, magram mxolod mesame pirSi).

amis Semdeg winsvla kidev ufro TvalsaCino gaxda, Tumca periodulad isev meordeboda akviatebuli frazebi, qcevebi, uZiloba, nerviuli reaqciebi...…

erTxel biWunam yvela saTamaSo saTiTaod Camoamwkriva magidaze: Tojinebi, kubikebi, manqanebi, burTebi, daTuniebi...…yvelani visxediT da vuyurebdiT... grZeli magida gaavso da ikiTxa:

- deda, ra aris fiqri?

SekiTxva moulodneli iyo da sanam pasuxs movifiqrebdiT, swrafad aur-dauria saTamaSoebi erTmaneTSi da gamoacxada:

- ai, es aris fiqri...

kidev erTxel ganvcvifrdiT biWunas Sinagani gancdebisa da fiqrebis gamoxatvis unariT. qaosi, romelic bavSvma magidaze Seqmna, asaxavda mis fsiqikaSi arsebul qaoss. is jer kidev ver ereoda Tavis gaucnobierebel ltolvebs, grZnobebs, SiSebs, magram mas Cveni sjeroda da Cvenc mis winsvlaSi eWvi ar gvepareboda.

roca zafxuli dadga da biWunas avuxseniT, rom ardadegebze mwvane saxli iketeboda, man moiwyina da ikiTxa:

- aba me ra meSveleba?

Semdeg sezonze mas baRis Secvla mouxda, radgan baRi, sadac adre dadioda, daixura. dedis TqmiT, axalma maswavlebelma masTan kontaqti ver SeZlo. luka mitovebulad grZnobda Tavs da amas isev seriozuli regresi mohyva. Cven ki vagrZelebdiT muSaobas, yvela problemas vuanalizebdiT, vuxsnidiT. deda, romelmac Tavidanve alRo auRo Cvens midgomas, saxlSi Zalian exmareboda. periodulad masTanac calke saubari gvixdeboda, rom bavSvTan muSaobis stimuli da misi gamojanmrTelebis rwmena ar daekarga.Mmamas ki uWirda bavSvTan emociuri kontaqtis damyareba. magram erTxel mama lukasTan erTad magidas miujda da didxans xatavda yvelafer imas, rasac luka sTxovda.  am dros lukam TviTonac moidoma xatva. D manamde, miuxedavad swrafi gonebrivi winsvlisa, wvrili motorika saerTod ganuviTarebeli hqonda, TiTqos Ffanqars xelSi verc iWerda da uceb, mamasTan erTad, Seqmna Tavisi pirveli naxati – didi mze da saxli... amis Semdeg masTan muSaoba fanqrisa da furclis gamoyenebiTac gaxda SesaZlebeli..

  Semdeg wels, roca biWuna 6 wlis gaxda, kerZo skolaSi Sevida, sadac dawyebiT klasebSi sakmaod rTul programas gadiodnen. skolaSi wasvlac nervul daZabulobasTan da Zlier SfoTvasTan iyo dakavSirebuli, magram yvelaferi gadailaxa. skolaSi wasvlis Semdeg CvenTan ukve kviraSi erTxel, SabaTobiT Tu Semoivlida xolme.

axla luka ukve 8 wlisaa da da wels mesameklasSi gadavida. is cocxali, mxiaruli, kontaqturi biWia, kargi gonebrivi ganviTarebiT. metyvelebs absoluturad gamarTulad, nebismier kiTxvas pasuxobs ara marto adekvaturad, aramed gonebamaxviluradac ki. mecadineobs damoukideblad.  meore klasis damTavrebis Semdeg skolaSi konkursi Catarda da lukam pirveli adgili aiRo qarTulsa da maTematikaSi. warsuls Cabarda yvela misi autisturi simptomi. krizisuli periodebi ufro da ufro iSviaTdeba. krizisul periodSic ki aRaravis mouva azrad, rom is autistur speqtrs miakuTvnos.

lukas SemTxveva erT-erTi TvalsaCino magaliTia imisa, rom mcirewlovan bavSvebSi, rac ar unda mZimed mogveCvenos bavSvis mdgomareoba, pesimisturi molodini naadrevia. sistematuri da siRrmiseuli muSaobiT SesaZlebelia mdgomareobis araTu gaumjobeseba, aramed sruli emociuri da mentaluri gamojanmrTeleba. aRsaniSnavia isic, rom lukas ar miuRia aranairi medikamenti, arasdros daucavs kvebiTi dieta, ar gauvlia specialuri swavlebis kursi da, saerTod, masTan Cvens garda aravis umuSavia.

Ees SemTxveva kidev erTxel adasturebs f. doltos bavSvTa fsiqoanalizis Teoriis marTebulebas, romelic xazs usvams autizmis  warmoSobaSi emociuri kontaqtisa da garemosTan adaptaciis unaris darRvevebis gadamwyvet mniSvnelobas da amgvar pacientTa  mkurnalobisas fsiqoanalizuri midgomis wamyvan rols.