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psychophysiology
skin correlations and metaphors
psychospiritual approaches

definition

"The smallest skin lesion concerns the whole personality." The skin can bear a multiplicity of psychic meanings and an intimate link exists between the soul and the skin (hot flushed cheeks; pale, cold, damp foreheads; sweaty palms and tingling, prickling, goose bumps; the flushing out of secrets through the Galvanic Skin Response test). The specific skin problem of neurodermatitis is suggestive of the mark of a wounded 'puer aeternus' (the archetype of the eternal youth), the "windhover spirit who cannot fly and therefore cannot fulfill his fate." The puer chooses the skin because the skin is the most visible of the organs and the puer demands that he and his wounds be seen. However, the puer does not necessarily desire others to see the rash, but wants to see for himself, out in the open, what is wrong with him. It is an expression of his wounded spirit consciousness, with which he is not identified. (Severson, p. 129-51)

• "Skin disorders and the mind" - F.A. Whitlock: Too often it is assumed that manifestations of emotional disturbance in the course of a skin condition require that the patient should by treated by psychological techniques. Nothing in fact could be further from the truth. The etiology of psychosomatic disorders is multiple, and excessive concentration on one etiologic variable to the exclusion of others does the patient no great benefit. The judicious combinations of dermatological and psychological treatment seems to be ideal. To put the matter more succinctly, 'Have faith in the Lord but use sulphur for the itch.' (Locke, 1986, p. 200)

• "The emotional factor in skin diseases" - B.E. Christensen: Successful therapy in psychogenic and related dermatoses often depends on the harmonious relation between patient and practitioner. (Locke, 1986, p. 183)

• "Psychosomatic factors in dermatology" - H. Krafchik: Every patient who consults his doctor is in a state of fear. He is thereby rendered more susceptible to suggestion, and the correct attitude of the doctor can profoundly affect his autonomic nervous system through his emotions, and thereby almost every chemical reaction throughout his body may be modified. Reassurance and a frequent and intimate discussion with the patient will often produce an unbelievable feeling of well-being and strength in a patient and contribute much to the resolution of skin eruptions produced by emotional upsets. (Locke, 1986, p. 190)

• "Psychoanalytic observation on skin disorders" - B. Mittelman: The conflicting trends that were found to be correlated with skin disorders were longing for affection and care, the fear of abandonment and attack, feelings of helplessness, hostility, aggression, wounded self-esteem, guilt, self-depreciation and self-debasement, and erotization of the skin. The fantasy content was that of obtaining love and care through warmth and cutaneous contact. Broad emotional needs and drives (such as the need for love and care, hostility, erotic strivings, anxiety and guilt) were vital in the dynamics of skin pathology. These same broad needs led to anxiety attacks and depressive reactions. (Locke, 1986, p. 193)

• "Depression and skin disease" - K. Preston: If depression is looked for carefully in all cases of psychosomatic skin disorders, its true incidence will be realized. (Locke, 1986, p. 194)

• "Emotional factors in skin disease" - B.F. Russell: Inherent personality difficulties and unsatisfactory interpersonal relationships are the basis on which psychogenic dermatoses develop. The majority fall within the designation 'frictional dermatoses,' being manually produced or aggravated. Such individuals tend to vent their aggression on themselves. (Locke, 1986, p. 194)

• "Dermatologic hypochondriasis: a form of schizophrenia" - S.H. Zaidens: Dermatologic hypochondriasis is an acute recurrent anxiety state occurring in 11 latent schizophrenic patients. It may be precipitated by acne vulgaris, hypertrichosis, seborrheic dermatitis, or other cutaneous changes. (Locke, 1986, p. 202)

• "Psychodynamics of chronic allergic eczema and chronic urticaria"
E. Schneider: That psychological factors are of importance is mostly accepted by most investigators of these dermatoses. However, when it comes to the specific psychic factor or factors involved, there is hardly any agreement at all. As one reviews the literature, there is scarcely a conflict experienced by man that has not in some way been implicated. (Locke, 1986, p. 195)

•"Psychological aspects of atopic dermatitis" - B. Kuypers, E. Wittkower:
Mind and emotions play a definite role in the course of eczema. 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)

• "Psychological components in chronic urticaria" - B.K. Kraft: Patients presented all found it difficult to express anger (common to many psychosomatic conditions). Specific to urticaria is failure to recognize hostile feelings to any significant extent, even though subjects felt trapped, hurt, frustrated, and helpless.
Study showed that in most cases the patients had been intensely annoyed just before the urticaria eruption, but had not shown this to their surroundings, and had greatly resented their own annoyance. All of this is connected with their infantile personality structure. (Locke, 1986, pp. 79-80)

• Patients with psoriasis and chronic urticaria were exposed to stressful life situations before the disease onset and suffered from psychological distress (anxiety, depression, inadequacy) significantly more than those with fungal infections. (Locke, 1983, p. 134)

• "Compulsive scratching; a descriptive model" - Boddeker, K.:
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)

• "Pruritus and scratching" - A. Dunbar: Pruritus and scratching may be looked upon as a substitute for the sexual act or masturbation. The patient utilizes chronic dermatitis and scratching to discharge tension associated with psychological conflicts. The skin becomes 'erotized' as an 'organ of expression' of hostile, masochistic, and exhibitionistic trends. Repressed genital sexuality has been displaced to the skin with scratching occasionally representing a masturbatory equivalent. (Locke, 1986, p. 154, 170)

• "The psyche and the skin" - E.T. Bernstein: No one would question the close physiologic relationship between the psyche and the skin. Detailed case studies seem to confirm the importance of psychogenic factors in some of the dermatoses. It has therefore been postulated that therapy cannot be totally effective unless some form of psychotherapy is used in conjunction with more conventional forms of treatment. The psychotherapy needed for these patients is not beyond the scope of the general practitioner. (Locke, 1986, p. 184)

see:
body reveals: the spirit
converting a symptom to a signal
process paradigm
process interview: cutaneous system
search for god


footnotes