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Abstract. Stress and anxiety are risk factors for exacerbation of chronic diseases, in particular autoimmune pathology. The article reviews studies that prove the effectiveness of the meditation method as a tool for reducing anxiety and stress, as well as providing an integrated approach to providing quality medical care for chronic autoimmune diseases. Keywords: meditation, psychosomatics, autoimmune diseases, integrated approach Introduction Stress becomes an integral part of life. The development of social networks, the growth of personal activity, stressful stimuli at work, a high level of psycho-emotional experiences against the backdrop of ongoing events in the world and other factors provoke an increase in the burden on a modern person. Along with psycho-emotional experiences, even a healthy person has an increased level of anxiety, there is disquiet, internal tension, which directly affects the state of the body. Sleep is disturbed, an imbalance in the work of the sympathetic and parasympathetic nervous systems gradually increases, neurohumoral regulation of the functioning of organs and systems suffers. Prolonged exposure to stress factors provokes the exacerbation of chronic diseases, the growth of chronic inflammation [1] and, in particular, disruption of the immune system. This provokes an increase in the painful symptoms of an already existing chronic disease and the appearance of new signs due to the stereotype of the development of the disease.

Scientific research of the SCO countries: synergy and integration International Conference Meditation is used as an additional element of a comprehensive approach aimed at reducing levels of anxiety and stress. Regular application of the method shows a positive trend in psychosomatic spectrum diseases, as well as autoimmune chronic pathology. The 2018 Mindfulness Based Therapies for Autoimmune Diseases and Related study [2] singled out the practice of meditation as a new method of psychotherapeutic intervention that improves the mental, and subsequently physical health of a person suffering from an autoimmune disease. Meditation and Mindfulness Today, meditation is a method of psychological assistance for working with a patient of a psychological and psychosomatic profile [3]. The main objective of the method is to teach a person the skills of auto-observation, auto-regulation and auto-programming, which allow, with regular repetition, to master the principles of managing emotional intelligence. The development of emotional intelligence when working in meditation contributes to the introspection of one’s own activity, that is, it develops the skill of awareness. This is a state in which a person focuses on the psycho-emotional experiences of the current moment, abstracting from experiences about the past and future, observing their own sensations, including bodily ones. Neurophysiologists argue that the development of the skill of mindfulness occurs in parallel with positive changes in the neurons of the cerebral cortex [4].

Systematic self-observation contributes to the development of mindfulness, and also helps a person gain stress resistance by relaxing the body and mastering the skill of autoregulation. An increase in resistance to stress leads to a decrease in the level of anxiety and disquiet, the restoration of the psycho-emotional state, which has a positive effect on the quality of life. Meditation and stress Meditation in the MMCC method (Mindfulness Meditation of Conscious Concentration - meditation of open attention and conscious concentration) has a direct positive effect on the psycho-emotional state of a person, increasing his/her resistance to stress and restoring balances in the work of the nervous system [5].

At first, mental processes stabilize, the level of calm attention increases, a person learns to regulate mental activity in such a way as to switch from negative experiences to positive ones. The duration of maintaining calm attention increases after 10-15 days of regular meditative practice, as a rule, at this moment the night rest mode is restored, the process of falling asleep improves. There comes a period of reduction of anxiety and disquiet, the nervous system becomes more resistant to stress factors, the balance between the sympathetic and parasympathetic nervous systems is restored.

A decrease in a long-term level of anxiety is accompanied by adaptive changes in the body [6]. Irritation of the sympathoadrenal centers decreases, the normal function of the pituitary-hypothalamic tract is restored, the level of cortisol in the blood decreases and the level of melatonin increases in parallel. In addition to improving the mental state and stabilizing the emotional background, a person begins to notice the first qualitative changes in physical well-being [7,8]. Stress, early childhood experiences and autoimmune pathology Studies of 2012-2015 on the effect of stress on the course of chronic pathology [9,10] revealed direct relationships between the development of symptoms of depression, multiple sclerosis, autoimmune joint damage and other autoimmune pathologies and stress experienced in early childhood. Negative childhood experience child gained at an early age has a direct impact on the development of chronic diseases in adulthood. Activation of the hypothalamic-pituitary-adrenal axis in response to exposure to a superstrong stress stimulus provokes the release of chemically active substances.

This is a normal reaction to short-term unpredictable stress, but if the child is constantly surrounded by adverse environmental factors, the stress becomes chronic. In this case, activation occurs immediately in two endocrine axes: hypothalamus-pituitary-adrenals and hypothalamus-pituitary-thyroid gland, there is a change in internal regulation, a shift in homeostasis within the body. The child goes through physical and mental changes, and if neurohormonal and neurohumoral changes are physical, then mental processes include a permanent increase in the level of anxiety and fixation of attention on the factors of external aggression. The study “Cumulative childhood stress and autoimmune diseases in adults” of 2009 [11] revealed a direct relationship between negative early childhood experiences and acquired autoimmune diseases in adulthood. According to the results of this study, 80% of the surveyed participants suffering from various autoimmune pathologies (systemic lupus erythematosus, autoimmune thyroiditis, multiple sclerosis, rheumatoid arthritis, etc.) grew up in dysfunctional families, faced the loss of a close relative, or were subjected to physical or mental abuse in childhood [12 ].

Mental and physical changes continue to persist even after the stress factor has been eliminated. The manifestation and exacerbation of a particular chronic disease and the debut of an autoimmune pathology occur at a time when the stress of adolescence and adulthood is superimposed on children’s negative experience. In addition to treating the underlying disease, an integrated approach is required to provide comprehensive care to the patient. 130 Scientific research of the SCO countries: synergy and integration International Conference Meditations as part of a comprehensive approach Reducing the level of anxiety and increasing stress resistance is a key link in an integrated approach for any chronic pathology. Stress as a psychogenic factor contributes to the development of exacerbations, in particular in autoimmune diseases. Meditations show a consistently high level of effectiveness [15] in reducing increased anxiety, eliminating excitement and increasing stress resistance with regular listening in patients with chronic and autoimmune pathologies.

Autoimmune diseases often have a negative impact on a person’s mental health, provoking the development of depression, apathy, and other disorders [14]. Meditation is a method of preventing the development of complications from the psycho-emotional sphere of a person through the management of emotional intelligence. An integrated approach should also be supplemented by individual work with a specialist (psychologist, psychosomatologist or psychotherapist) for the psychocorrection of high levels of emotional, psychological and physical stress resulting from a traumatic event in the past to restore the ability of normal mental and physical functioning in everyday life.

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