-IBIS-1.5.0-
tx
cutaneous system
eczema
psychospiritual approaches
metaphors and correlations
Atopic dermatitis patients have a greater tendency to be in a state of high manifest anxiety, depressed, neurotic, and hypochondriacal than patients with other dermatological diseases and those in the control group. (Locke, 1983, p. 131)
Mind and emotions play a definite role in the course of atopic dermatitis. The evidence does not necessarily imply that emotion causes the disease, but it becomes readily apparent that the state of mind may have a definite and remarkable effect on the course of the disease. The rate of recovery could be improved if due regard were given in the treatment of the patient to emotional factors involved. (Locke, 1986, p. 158, 161)
The psychosomatic histories of 90 patients with disorders of the 'eczema family' were compared with those of 50 controls. Specific situations were seen to precipitate the onset or relapse of eczema: threats to life and existence, threats of loss of an outside source of support or disturbance to inner established patterns, such as blows to self-esteem or conflicts over sex and aggressiveness. (Locke, 1986, p. 160)
Compulsive scratching; a descriptive model: Limited repertoire of social skills in these patients does not provide them with a strategy to master negative emotions. The resulting diffuse tension is temporarily reduced by scratching; this reinforces the tendency to perceive itching. The immediate relief of tension that follows scratching is followed by feelings of dissatisfaction or guilt associated with scratching, which further increases the tension. (Locke, 1986, p. 153)
20 cases of atopic dermatitis fell into two main groups: emotionally labile, tending to hysteria; and rigid, tending to compulsiveness. Patients in the more labile group were afflicted with dermatitis for a much greater portion of their lives than were members of the rigid group. The characteristic family constellation included a strongly hostile-dependent relationship to the mother. The characteristic major conflict was in the sphere of sexual relations. Itching and scratching were manifestations of anger at mother figures or sexual objects. Hostile attitudes were usually conscious, and much anger was expressed in interviews and dreams. Objectively the patients were often timid and shy. They tended to handle their feelings by suppression. Suppressed weeping was a prominent symptom. (Locke, 1986, p. 157)
Therapeutic success appears to bear heavily upon the practitioner's ability to cope with the excessive demands and the well known unresponsiveness of eczema patients. An iatrogenic factor stems from unconscious hostility and some form of rejection from the practitioner. (Locke, 1986, p. 156)
Remissions of atopic eczema occur when frictional dependency ties are severed, compensatory emotional support is gained, and infantile wishes find greater satisfaction in aggressive outlets. (Locke, 1986, p. 156)
Associated with fierce, volcanic anger that cannot find an adequate outlet. (Epstein, p. 95)
Breath-taking antagonism; mental eruptions. (Hay, 1984, p. 162)
Inflammation: fear; inflamed thinking; seeing red; anger and frustration about conditions in one's life. (Hay, 1984, p. 170-1)
Skin problems represent anxiety, fear, being threatened; old, buried stuff. (Hay, 1984, p. 183)
Chinese psychophysiology:
Liver ~ Gan is the home of the Hun (Ethereal Soul); it relates to decisiveness, control, and the principle of emergence; stores and cleanses the Xue (Blood); maintains smooth flow of Qi and Xue (Blood); and reflects emotional harmony and movement.
» Healthy expressions are kindness, spontaneity, and ease of movement.
» Liver Xu (Deficiency) signs include impotence; frigidity; pain in thighs, pelvic region, and throat; ready tendency to "the blahs" (Seem, p. 28); timidity; depression; irritability; vertigo; pruritus; dry skin and/or tendons; asthma; aching at the waist; hernia; and difficulty raising head up and down.
» Liver Wind derives from Liver Yin Xu (Deficiency) and/or Liver Xue Xu (Blood Deficiency) and their subsequent inability to embrace the Yang, and can manifest as joint stiffness, dizziness, tremor, paralysis, convulsions, rashes, itching, and neurological problems.
Gall Bladder ~ Dan is the source of courage and initiative, and is responsible for decision-making as the bodily Minister of Justice; controls circulation of the nourishing and protecting energies [Ying Qi and Wei (Protective) Qi]; expresses itself through the sinews (ligaments and tendons); and opens into the eyes. Its channel purifies Yang energy in the body.
» Healthy expressions are kindness, decisiveness, control, and spirit of initiative.
» Gall Bladder Shi (Excess) signs include tiredness; sighing; irritability; bitter taste in the mouth in the morning; pain in all joints; edematous knees and legs (Seem, p. 29); tinnitus; lateral headache; heaviness in head and stomach; muscular spasms; and limbs slightly cold. Chronically suppressed anger can implode and give rise to Fire in the Liver and Gall Bladder.
» Anger, frustration, and resentment can cause Liver Qi Stagnation which, in turn, can produce Heat which affects the Gall Bladder.
Spleen ~ Pi governs digestion and manifests in the muscle tissues; transforms food into Qi and Xue (Blood); governs the Xue (Blood); resolves Dampness, and relates to the ability to assimilate, stabilize, and feel balanced and centered.
» Healthy expressions are fairness, openness, deep thinking, and reminiscence.
» Spleen Xu (Deficiency) signs include slightness (deficient "form"); abundant elimination; morning fatigue; cold, wet feet (Seem, p. 28); abdomen taut and distended like a drum; craving for sweets; flatulence; nausea; mild edema; memory failure; heavy feeling in legs; easy bruising; pale lips; loose stools; muscular weakness; and, indirectly, obesity.
» The excessive use of the mind in thinking, studying, concentrating, and memorizing over a long period of time tends to weaken the Spleen. This also includes excessive pensiveness and constant brooding. (Maciocia, p. 241) Likewise, inadequate physical exercise, overexposure to external Dampness, and excess consumption of sweet and/or Cold foods will also deplete the Spleen.
Lung ~ Fei governs the Qi; regulates the rhythm of respiration, the pulse, and all bodily processes; is the home of the Po (Corporeal Soul); it relates to strength and sustainability; extends through the skin and controls the pores.
» Healthy expressions are righteousness and courage.
» Weakness, dysfunction, and illness are associated with excessive grief, sadness, worry, and depression. Worry depletes the Lung Qi.
therapies
behavior modification:
Biofeedback: Use of frontalis EMG, relaxation, and imagery training. (Locke, 1986, p. 155)
Biofeedback training for handwarming and relaxation. (Locke, 1986, p. 157)
Compulsive scratching: Suggested treatment techniques include aversive conditioning, relaxation, reinforcement for not scratching, and training in social skills. (Locke, 1986, p. 153)
Intervention: Pediatric treatment for injurious scratching using a combination of time-out for scratching and tangible reinforcement for reductions in the number of body sores. (Locke, 1986, p. 203)
Intervention: Pediatric behavioral treatment, centering on reinforcing desirable
behavior and noncritical communication. (Locke, 1986, p. 205)
imagery:
oil well (Chavez): cleansing
skin deep (Chavez)
star shine (Chavez)
affirmation:
Harmony and peace, love and joy, surround me and dwell in me. I am safe and secure. (Hay, 1984, p. 162)
(Inflammation) My thinking is peaceful, calm, and centered. I am willing to change all patterns of criticism. I love and approve of myself. (Hay, 1984, p. 170-1)
(Skin) I lovingly protect myself with thoughts of joy and peace. The past is forgiven and forgotten. I am free in this moment. (Hay, 1984, p. 183)
theotherapy:
(skin problems) Dionysus, Heracles, Orestes, Pelops (Lemesurier, p. 115)
hypnotherapy:
Hypnosis was started in the form of simple suggestion. Varying degrees of hypnotic trance were obtained, and during the hypnotic state the suggestion was given that the skin condition would resolve and return to normal and the irritation, if present, would disappear. In most of the conditions treated pruritus was a marked feature, and it was certainly found that the anti-pruritic effect of simple hypnosis was often very striking. It was also apparent that the doctor-patient rapport was considerably enhanced. Patients became more willing to speak. (Locke, 1986, p. 188)
Hypnosis followed by use of posthypnotic suggestions: use of fingertip application whenever feeling or noticing the beginning of a rash. Return for hypnotherapeutic reinforcement sessions 3-4 times a year. (Locke, 1986, p. 155)
psychotherapy:
Whatever happens to the skin corresponds to an inner process. The diverse functions of the skin (protection, contact, expression, excretion, respiration, temperature regulation, sexuality, etc.) are associated with a common theme that alternates between the two poles of separation and contact. Something is bursting through our limits, or trying to armor an inner sensitivity. Questions to ask in the event of skin problems:
» What is it that is getting under my skin? What is trying to burst through barriers?
» How easy/difficult is it to make contact with other people? Do I desire intimacy?
» Have I condemned myself to solitary confinement? What is useful about this?
(Dethlefsen, p. 162, 170)
process paradigm: (experientially oriented)
What is the symptom preventing me from doing? What is the symptom making me do? (see process interview: cutaneous system)
related materia medica listings:
the shadow and physical symptoms
skin metaphors and correlations
converting a signal to a symptom
behavior modification techniques
imagery: precautions
imagery: techniques
affirmations: guidelines and precautions
theotherapy
hypnotherapy
process paradigm
footnotes
Reprinted from The Foundations of Chinese Medicine, Maciocia, Giovanni, 1989, by permission of the publisher Churchill Livingstone, a division of Elsevier Limited.