Quick QuizRather than dividing illness into "emotional" or "psychosomatic" and "physical, " I think of emotions as a factor in all skin problems. Emotional difficulties may be the sole cause of few symptoms but they play a role, major or minor, in the flare-ups of many, perhaps most. Emotional factors sometimes cause, and frequently can reduce or intensify, itching and pain even when the physical disease itself remains unchanged. All skin problems have emotional impact, regardless of cause.
How important is the emotional factor in your illness? The more of these questions you answer yes, the more significant the factor.
1. Do your symptoms get worse--or better--with emotional turmoil?
2. Is your condition more stubborn, severe, or recurrent than your doctor expects?
3. Are usually effective treatments not working for you?
4. Do most treatments work but not for long?
5. Is each disappearing symptom quickly replaced with another?
6. Do your symptoms get better or worse in a very erratic, seemingly nonsensical way?
7. Do you see striking ups and downs in your symptoms with changes in your social environment: vacations, hospitalizations, business trips, or the comings of family members or bosses?
8. Do people find you strikingly stoic, unruffled, or computer like in the face of stressful life events?
9. Is your level of distress and concern about the problem strikingly high or conspicuously absent?
10. Is your skin worse in the morning, suggesting that you rub or scratch unintentionally at night?
11. Do you have trouble following your health care provider's instructions?
12. Do you do things you know will hurt your skin, such as squeezing pimples or overexposing yourself to sunlight?
13. Do you feel excessively dependent on your dermatologist or excessively angry with him or her? (Even if the faults are real, are you overreacting?)
14. Does it seem that others notice improvements in your skin before you do? Is it hard for you to acknowledge when your skin has improved?
The more of these questions you answered positively, the more likely a candidate you are for the Skin Deep program, but even if most or all of these questions don't apply to you, this psychological approach will offer three important kinds of help:
1. Exercises to help you focus on the hidden role of your emotions in the disease itself. Are they causing, triggering, or heightening outbreaks? You'll learn to know yourself and use this knowledge to make your skin better.
2. Techniques to reduce itching, scratching, burning, and pain,regardless of their source.
3. A systematic method to reduce the emotional impact of your illness so you can cope better and suffer less while your skin improves.