{"id":330,"date":"2012-05-28T20:00:18","date_gmt":"2012-05-28T16:30:18","guid":{"rendered":"http:\/\/www.dohsa-hou.com\/?p=330"},"modified":"2014-02-18T21:54:09","modified_gmt":"2014-02-18T18:24:09","slug":"naruse","status":"publish","type":"post","link":"https:\/\/www.dohsa-hou.com\/?p=330","title":{"rendered":"THE CLINICAL DOHSA-HOU FOR"},"content":{"rendered":"

Gosaku\u00a0 Naruse, PhD<\/strong><\/p>\n

\u00a0International Institute for Clinical Dohsalogy<\/strong><\/p>\n

1.\u00a0 What is “clinical dohsa-hou” ?<\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 A) The\u3000so called “clinical dousa-hou” is an endemic original
\ntherapeutic or training method for clinical psychology which has rapidly developed in recent three decades (1966) and still now being widely evolve for the field of clinical psychology in Japan. Its\u00a0distinctive feature is\u00a0 to utilize\u00a0 the DOHSA as the major tool not only for psychotherapeutic treatment but also in fields of psychological help in general, for instance sports, education or mental health. And verbal activity which has been\u00a0 the major tool for traditional psychotherapy and traditional complementary medicine in Japan is here used as only supplemental means.
\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 B) The dohsa means a psychological process of self-striving by\u00a0\u00a0 the owner of his body to realize a body-movement which is intended by himself. It is a psychic activity of the goal-directed striving to realize the pattern\u00a0 of body movement coincides with the intended pattern of motion by himself. It is the owner’s self controlling activity of his own body-movement which is schematized like as a process as follows<\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0 < Intention >—–< striving >——< body movement >.
\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 C) In the therapeutic session of dohsa-hou, client is asked to\u00a0\u00a0 realize a pattern of body movement as an imposed motor task by therapist. When client accepts and agrees to therapist and therapy, he strives to perform the task as his own intension. In such case, the essential of dohsa activity is a process of striving to realize the motor pattern which is given to client as the therapeutic task. Thus the role of therapist is to help his client’s process of task striving to perform the imposed pattern of dohsa. That is, the true purpose of dohsa-hou is to work upon client’s\u00a0 mind for therapeutic approach through the motor activity of body as a clinical tool. By his striving, client has a specific new chance for experiencing to attend and concentrate to make realaction on his own body through the co-operating work with his therapist for the same goal. Thus, the major goal of dohsa-hou is to make the patient to activate his body and mind, facilitate his sensitivity of body movement and stabilize his ability of self control for his own motor action, and also to get an experience of co-operating work with his therapist.<\/p>\n

\uff12. Characteristics of motor disability by cerebral palsied child<\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 A) Clinical study of dohsa-hou made its first step in 1966 when\u00a0 the author found a fact that some cerebral palsied young men with heavy motor disability of arm were able to raise successfully up their arm\u00a0\u00a0\u00a0\u00a0 through\u00a0 their own striving by hypnotic suggestion of possibility of arm movement under light trance. Since then, experimental and clinical studies were widely attempted by the author (1966, 1967, 1968a, 1968b)\u3000and his colleagues to make such a question clear what is the true nature of motor disability by cerebral palsied person. Every kind of techniques including traditional orthopedic methods and neurological training like as the so-called Bobath’s\u00a0 method (1976) or Bojta’s\u00a0 one had been examined. In spite of a general belief that\u00a0 cerebral palsied person is not able to move his body by himself, the autor’s studies had\u00a0 uncovered that was miss understanding. Widely demonstrated fact is that even if he is possible to move his body by himself because of the full physical equipments for the motion, when he strives to move his arm, the pattern of body movement\u00a0 as the result\u00a0 of striving goes far wrong from his intended pattern by his all means. Such a discrepancy inbetween intended pattern and realized one comes up from a fact that he has no suitable\u00a0 experience or means on\u00a0 how to strive for the movement of his\u00a0 own body according\u00a0 to his intention.
\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 B) The results of study for a quarter century(1975, 1988, 1995) \u00a0By the author and his collaborators suggested that as the best way for amelioration of motor disability by those person, it was necessary to stand on\u00a0 psychological view point and method rather than physical or physiological one, because of the fact that the basic difficulty by
\nthose persons was psychological process of dohsa as to soft mechanism “how to move his body according to his intention”, even if their
\nphysical or physiological conditions like as muscle-skeletal or neuro-muscular system as to a hard mechanism were well equipped and prepared for body movement.
\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 C) Thus, a systematic technique of dohsa-hou\u00a0 has been developed for amelioration\u00a0 by helping, training, or therapy for palsied client to get master how to strive himself to perform intended pattern of movement, and it has demonstrated a very successful effect of amelioration for these person, and at present, the most part of schools and institutions for cerebral palsied over the all of this country are applying the dohsa-hou for their amelioration of motor difficulty.<\/p>\n

3. Development of therapeutic (training) method of dohsa-hou<\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 A) Therapeutic method of dohsa-hou had begun with muscle relaxation for the purpose to eliminate the unsuitably strong muscle
\ntension which disturbed the intended pattern of body movement. Relaxation training following to Jacobson’ principle\u00a0 of self-operations control\u00a0 by “progressive relaxation” were applied\u00a0 at first with hypnosis and afterward without hypnosis for ten years(1924, 1934). According as such unsuitable muscle tension began to release through the progression of training, many\u00a0 clients not so heavy became\u00a0 to get their body move easier or successfully corresponding to his intention.
\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 B) Since for the other many clients who have never experienced to move his body corresponding to his intention therapeutic training by\u00a0\u00a0 such simple relaxation showed not always so sufficient effect, it became necessary to be designed a new training method by which client had to\u00a0 strive more active for making a motor pattern of appointed part of body securing relaxation of the other parts of body by himself corresponding to his intended pattern. Here, client is asked to move his body as the major goal, and to put to relax as the secondary goal. That is, striving to move a part of body (for instance bending his arm at elbow) client\u00a0 has to relax or inhibit muscle tension of the indifferent or harmful\u00a0 parts (arm and especially elbow, shoulder, wrist or even hand).\u00a0 Through those experiencing of the task striving, feeling of body, moving-sensation of body part, striving to make a motor pattern in accordance with the intended one, confirmation of motor pattern as the result of striving so on, client\u00a0 usually shows rapid improvement in his motor ability.
\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 C) It is an extremely impressive moment for therapist to see client’s unique behavior who gets the body trunk upright by himself without support by therapist at the first time in his life in which he has\u00a0 lived lying\u00a0 down on the bed or floor because of their difficulty of
\ngetting up. Since such a moment, his looks, manners and all of behaviors are rapidly altered, and becomes look like more light heart, active and stoutly. It seems to mean that he met gravity at the first time in life and became to be able to stand his upper body upright vertically by himself on the earth corresponding with the gravity. Standing upright is\u00a0\u00a0 not only a necessary tool for locomotion of body but also may give him\u00a0living energy of human being for having active behaviour on everyday life. This is why\u00a0 training of self-standing upright has been taken as the most important task in dohsa-hou for cerebral palsied, .
\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 D) On the way of study\u00a0 on training of stand-upright, the author and colleagues\u00a0 became aware of the fact that client makes up gradually the central axis of body which\u00a0 plays the basic role to induce the axis of\u00a0 his existing ego. Such a body-axis seems to integrate his all parts of body organizing as a whole and to take the role of a central basement for not only when he tries to accept and perceive the outer world\u00a0 but also when\u00a0 he strives to act upon the environment through his own body. As a matter of fact, since he became to be able to stand by himself, his ability of discrimination on the upper and lower, far and near,\u00a0 right and left sides so on in his environment showed remarkable advancement.
\nAt present, the central task for motor training is the so-called “Tate”-system in which the major goal of therapy is to get\u00a0 client’s\u00a0 body-axis stand on “tate” (which means vertical) well upon the ground on earth,\u00a0 and to make his axis\u00a0 more clear, secure, soft and flexible in the every day life.<\/p>\n

4. Major patterns of motor difficulty on each body part for “tate”- system training
\n\u00a0<\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Because each body part in “tate”-system motor training for cerebral palsied shows respectively some distinctive features which makes therapeutic approach difficult by its inadequate muscle tensions and in suitable movements of body, therapist has to help client suitably for client’s good management of these difficulties by his self-control for necessary muscle relaxation and purposive\u00a0 pattern of body movements.
\nThese parts of body for control are shown in each part of body is expressed as psychological schema, and their characteristic\u00a0 difficulties for training are shown as follow\uff53:<\/p>\n

\u00a0 1. neck\u00a0 : lean forward\/backward, bend to right\/left side, twist,
\n\u00a0 2. both part of scapula joint in back: bend forward, shrink both joints forward, lift up,
\n\u00a0 3. shoulder: lean forward, humpback, declivity\/acclivity of right \/ left sides, lift up,
\n\u00a0 4. back\u00a0 : lean forward, round back, side bowing to right\/left, twist,
\n\u00a0 5. waist : lean forward\/backward, side bowing to right\/left, twist,
\n\u00a0 6. groin : bend backward\/forward, lean right\/left side, twist,
\n\u00a0 7. knees : bend forward, lean backward, stretch, twist,
\n\u00a0 8. ankles: stretch, bend up, twisted in\/out side,
\n\u00a0 9. feet\u00a0 : heel up, toe up, bend in\/out side of foot up, revolve to in\/out side,
\n\u00a010. shoulder joints: bend in\/out side, stretch straight up\/down\/ side, twist,
\n\u00a011. elbows: bend in\/out side, stretch straight, twist in\/out side,
\n\u00a012: wrist : bend in\/out side, stretch straight, twist in\/out side,
\n\u00a013. hands & fingers: grip, stretch,
\n5\u3002Therapeutic tasks in the “tate”-system training
\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 A) The “tate”-system training is composed of six\u00a0 major tasks\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 which include some supplementary tasks, and related tasks. The six\u00a0\u00a0\u00a0\u00a0\u00a0 of major task are as follows:
\n\u00a0\u00a0 (1) “zai”\u00a0\u00a0\u00a0\u00a0 : sitting body upright on the floor with crossed legs\u00a0<\/p>\n

\u00a0\u00a0 (2)”hiza-tati”: standing by knees on the floor
\n\u00a0\u00a0 (3)”ritui”\u00a0\u00a0\u00a0 : standing straight by legs on the floor as shown
\n\u00a0\u00a0 (4)”hokou”\u00a0\u00a0\u00a0 : walking and gait,
\n\u00a0\u00a0 (5)”shisei”\u00a0\u00a0 : posture in standing posture,
\n\u3000 (6)”taijiku”\u00a0 : (body axis) free and skillful manipulation of body\u00a0 axis and related\u00a0 motor patern in everyday life.
\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 B) For the client who has been living lie down on bed or floor
\nsince his birth, training is applied in order from (1) “zai” via (2) “hizatati”, (3) “ritui” , (4) “hokou” , (5) “shisei to (6) body axis.<\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 C) For the client who is able to stand and\/or walk, training is
\napplied according to his awkward or difficult pattern of motion: that is , (1) \u201dzai\u201d is for client who is not stable to maintain firmly stand
\nstraight his upper body, (2) \u201dhizatati\u201d is for one\u00a0 who is not sure to maintain his waist straight on vertical, (3) \u201dritui\u201d is for one who is not easy to stand by legs and foot straight on the floor,\uff08\uff14\uff09”hokou” is for one who is unstable to maintain body balance\u00a0 against the earth
\nproclaim shifting on both sides of leg and moving his body forward according to walking, (5) “shisei” is for one who shows characteristic\u00a0 distortion in front view and also side view\u00a0 not only on the standing posture but also on the sitting and standing by knees, and (6) “taijiku” is for one whose body axis is not stable, immature, not flexible, clumsy, or\u00a0 not free when he is going to make some usual daily pattern of motor\u00a0behavior.<\/p>\n

6. Procedure in training session<\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 A) Decision of major task and supplementary tasks in therapeutic session,
\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 B) Relaxation by “omakase” : to get client entrust\u00a0 therapist with\u00a0 his whole body and mind through sufficient relaxation,
\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 C) Making postural pattern of body: to make most suitable posture for training corresponding to major task by therapist’s hands\/body for help,
\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 D) Putting client’s heart and soul into his body: to get client stand independently on his body with his own striving and
\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 responsibility trusting to his body and unconscious activity,
\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 E) Making body axis: to get\u00a0 client stand straight up, stamp down, make a firm step\u00a0 on the earth,
\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 F) Making joint on axis: to get client make one or some\u00a0 flexible points on the body axis,
\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 G) Making flexible axis of body: to get client manipulate freely and well balanced body axis on the earth integrating his all parts of body and his mind into a whole activity.
\n\u00a07. Essentials of therapeutic\u00a0experiences by palsied client in motor training of dohsa-hou<\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 A) Therapeutic purpose of dohsa-hou for therapist is to help his client to get valuable experiences in therapeutic sessions for the sake of modification of manner of experience in his everyday life not only\u00a0\u00a0 on the motor actions, but also a lot and various kinds of feeling in\u00a0\u00a0\u00a0 dohsa-process, getting client to attend on to his own body and movement, to recognize to his parts of body again, to grasp his body map more clear, to feel of himself striving for dohsa activity, etc.
\n\u00a0\u00a0\u00a0\u00a0 \u3000B) The manner of striving to realize or perform a motor pattern given by therapist as a therapeutic task has to be altered by client himself through taking a new and necessary manner of striving and at the same time giving up the old and harmful manner. Because of such a harmful striving is generally done without awareness, it may be necessary for therapist to get his client be aware of his own striving. Although such a striving may be experienced by client with awareness in the first half of therapeutic process, therapist has to help his client to be able to strive successfully to realize the task without awareness in the later half.
\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 C) For realization of intended pattern of motor task client has to carry out suitable management and control in every moment of dohsa\u00a0\u00a0 process integrating two kinds of activity into a whole: one is his own striving to bring the\u00a0 pattern of body movement as like the feed forward information, and the other is recognition of real body movement as the effect of his own striving like as the feed back one.
\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 D) It is the beginning and also the most important condition in\u00a0 the dohsa therapy that client has to leave his body and mind to his
\ntherapist entrusting his treatment with like as hypnotic rapport. Under such a condition of rapport client is able properly to accept even
\nsomething subtle signs for communication from his therapist, and also he is possible to leave his body to himself at the same time leaving his non-conscious activity and mind to himself. Therefore it is very much important job for therapist to help his client to make such a therapeutic relationship like as hypnotic rapport.<\/p>\n

REFFERENCES <\/strong><\/p>\n

-Jacobson, E.(1938). Progressive Relaxation. Chicago:The University Press
\n-Jacobson, E.(1964). Anxiety and Tension Control. Philadelphia: \u00a0\u00a0 J.B. Lipincot
\n-Naruse, G. (1966). Nohsei-mahi shya no shinrigakuteki rehabilitation. -I:\u00a0\u00a0\u00a0\u00a0 shikan-koudou ni tuite. (Psychological rehabilitation of cerebral\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 palsy. -I: on relaxation behaviour). Archives of Educational
\n–\u00a0\u00a0\u00a0 psychology,\u00a0 Faculty of Education, Kyushu University, 11, 2, 33-46.
\n-Naruse, G.(1967). Nohsei-mahi shya no shinrigakuteki rehabilitation
\n–\u00a0\u00a0 II: Tan’i dousa ni tuite. (Psychological rehabilitation for cerebral\u00a0\u00a0\u00a0 palsy II: On unit pattern\u00a0 at joint motion). Archives of Educational psychology, Faculty of Educatuon, Kyushyu\u00a0 University, 12, 2, 43-64.
\nNaruse ,G.(1973). Shinri Rehabilitation. (Psychological Rehabiritation).\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Tokyo: Seisin
\n-Naruse, G.(1975). Psychological treatment of motor difficulty for \u00a0\u00a0 cerebral palsied children. The Journal of Rehabilitation Psychology,\u00a0\u00a0\u00a0 III. 1-10.
\n-Naruse, G.(1976). A comparative syudy of the psychologica treatment to\u00a0Bobath’s method. The Journal of Rehabilitation Psychology, IV. 1-7.
\n-Naruse, G.(1976). Examination and treatment of standing posture ofcerebral palsied children.\u00a0 The Journal of Rehabilitation Psychology,\u00a0\u00a0 IV. 8-14.
\n-Naruse,G.(Ed.),(1984). Shougaiji no tameno dohsahou. (Dohsa-hou for\u00a0Disabled Children). Tokyo: Tokyo Shyoseki.
\n-Naruse, G.(1985). Dohsa-Kunren no Riron. (Theoretical Study of Dohsa -Training). Tokyo: Seisin Shobou.
\n-Naruse, G.(1992). Recent development of Dousa-hou in Japan. The Journal\u00a0 of Rehabilitation Psychology, XVII, XVII, XIX, 1-6.
\n-Naruse, G.(1995). Rinshou Dohsagaku kiso. (Theoretical Basis of the \u00a0Clinical Dohsalogy). Tokyo: Gakuenshya.<\/p>\n","protected":false},"excerpt":{"rendered":"

Gosaku\u00a0 Naruse, PhD \u00a0International Institute for Clinical Dohsalogy 1.\u00a0 What is “clinical dohsa-hou” ? \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 A) The\u3000so called “clinical dousa-hou” is an endemic original therapeutic or training method for clinical psychology which has rapidly developed in recent three decades (1966) … \u0627\u062f\u0627\u0645\u0647\u200c\u06cc \u062e\u0648\u0627\u0646\u062f\u0646→<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[23],"tags":[],"_links":{"self":[{"href":"https:\/\/www.dohsa-hou.com\/index.php?rest_route=\/wp\/v2\/posts\/330"}],"collection":[{"href":"https:\/\/www.dohsa-hou.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.dohsa-hou.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.dohsa-hou.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.dohsa-hou.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=330"}],"version-history":[{"count":6,"href":"https:\/\/www.dohsa-hou.com\/index.php?rest_route=\/wp\/v2\/posts\/330\/revisions"}],"predecessor-version":[{"id":727,"href":"https:\/\/www.dohsa-hou.com\/index.php?rest_route=\/wp\/v2\/posts\/330\/revisions\/727"}],"wp:attachment":[{"href":"https:\/\/www.dohsa-hou.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=330"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.dohsa-hou.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=330"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.dohsa-hou.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=330"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}