Oral Herpes (cold sores, fever blisters)
Oral herpes produces sores and blisters around the mouth that are harmless to
healthy people, but you need to know how to avoid passing them on. Studies show
that half the people in the country have active outbreaks of oral herpes at some
time, and 70 to 90 percent have antibodies suggesting that they have been
exposed and harbor the virus with or without symptoms.
Like other herpes viruses, the agent that causes cold sores retreats to hide in
nerve cells after the initial attack. Heat?sunlight or fever, for example?can
trigger recurrences along with emotional turmoil. Flu like symptoms may precede
or accompany the first or later attacks. Acylovir (Zovirax) cream and pills are
very helpful. Although no medical treatment can absolutely prevent oral herpes
recurrences, the condition is almost always self-limiting. For the majority of
people, recurrences grow shorter and less frequent as the body becomes more
adept in dealing with the virus.
The emotional responsiveness of oral herpes has been documented for decades.
More than fifty years ago, researchers at the University of Vienna used hypnosis
to both alleviate and experimentally produce recurrences.
One more recent experimental study tried to pin down which emotional factors
were most influential. They found that general measures of personality and
people's circumstances over time were less predictive. Personality traits,
social support, and overall coping ability were much less likely determinants
than specific events of the week before the outbreak. Stressful life events and
the daily and weekly variations in anxiety were the key. Relationship and work
problems were the two most common specific triggers.
In the kind of study that will make your physician's ears open wider, an Ohio
State University group measured antibodies to Herpes simplex type I (HSV-1) in
the blood of medical students and documented a clear link between exam stress
and loneliness and a decreased ability to keep the virus in check.
In general, anything that promotes well-being and relaxation, such as the
appropriate exercises here, may reduce the emotional pressures that trigger
outbreaks. Get to know your personal triggers with the Time Line exercise,
perhaps using a detailed log of events and recurrences.
That disorder has become less common over the years, but it has taken on a newly
sinister meaning in the minds of many because of the hysteria surrounding
genital herpes, which is caused by the same or a similar virus. Some people with
oral herpes are sadly beginning to share the sense of badness and contamination
that can afflict people with genital herpes. It helps to become aware of the
needs, fears, and undone emotional tasks that may make you particularly
vulnerable to feelings of shame, guilt, and dirtiness.
This form of herpes is usually transmitted sexually and infects an estimated 26
to 40 million people in the United States. Sores and blisters appear on the
thighs, buttocks, or the genitals. Like cold sores, these lesions always
disappear spontaneously, but some people are troubled by recurrent episodes. The
initial episode is nearly always the most severe. Much used to be made of the
distinction between HSV-1 (more common above the waist) and HSV-2 (more common
below). At this point, about 15 percent of genital herpes is caused by HSV-1.
Statistically, these infections are less severe, but the treatment is identical
and this distinction has little practical implication for an individual.
Medical treatment has two parts. Analgesics, baths, or lotions reduce discomfort.
Acyclovir (Zovirax) can shorten the duration and intensity of the initial
infection and eliminate or reduce recurrences. Acyclovir is effective only while
it is taken. The period for which it can be prescribed has been extended as its
safety has been documented for longer periods of time. For recurrences,
Acyclovir is usually reserved for severe cases. Herpes vaccines are now being
Emotions are a substantial factor: stress triggers a major part of herpes
recurrences (85 percent and 87 percent in two studies). Genital herpes also has
a particular ability to create emotional turmoil in people who contract
Herpes Zoster (Shingles)
(Griesemer Index: 36 percent; Incubation period: days)
The chicken pox virus (one of the family of herpes viruses) doesn't die after an
episode of that childhood disease but retires to latency in nerve cells.
Reactivated later in life, the same virus can cause the skin eruptions called
shingles, which can be accompanied and followed by severe pain. Medical therapy
for shingles (which accounts for 5 to 10 percent of all skin infections) aims at
healing lesions and relieving pain. The use of steroids may reduce the incidence
of postherpetic pain, especially in older patients. Oral Acyclovir (Zovirax) is
now used commonly to reduce healing time acute pain.
The factors that reactivate the virus are complex, but depression of the immune-system
function plays a role. The immune system responds to depression and emotional
trauma; stress and emotional turmoil are important in triggering and
exacerbating shingles. Obermeyer cites a Czechoslovakian paper that noted a high
incidence of herpes zoster following psychic trauma, supporting my own
For an unfortunate minority, the pain of shingles, postherpetic neuralgia,
lingers after the skin lesions clear up. Medical treatments for this often
excruciating condition include tricylic antidepressants such as amitriptyline (Elavil),
the anti epileptic drug Tegretol, Percocet, and injections of corticosteroids.
Acyclovir does not appear to be helpful with the lingering pain. TENS (transcutaneous
electrical nerve stimulation) applies an electrical current to block pain.
The pain of shingles can be excruciating, and hypnotherapy has proved itself
most helpful here as in other painful conditions. Scott reports the case of a
fifty-six-year-old man who went through years of drug therapy for shingles pain,
nearly to the point of addiction, without lasting relief. Hypnotherapy to reduce
pain directly was unsuccessful. In a dramatic use of the "making the
symptom worse" technique , the therapist had his patient focus relentlessly
on the pain, imagining it worse and worse until the merest brush of cotton on
skin was unbearable. Under trance, the suggestion was made that the reverse was
equally possible. After the second hypnotic session, the patient could resume
his golf games; at a reinforcement session eight months later, he suffered only
slight pain, he was a changed man.
Three case reports from the University of Virginia Medical Center also suggest
that treating this pain hypnotically can be useful. One patient began treatment
with pain so severe that she was unable to sleep or go outside (the breezes on
her face would trigger attacks). She remained pain-free through the two-year
follow-up after four sessions of hypnotic and self-hypnotic work. The other two
patients received some benefit, but failure to follow through with the hypnosis
made them much less successful.
(Griesemer Index: 68 percent; Incubation period: minutes)
These raised, red, swollen spots on the skin affect 20 percent of the population
some time. They often itch, sting, or prickle. Hives can be caused by a complex
of physical and psychological factors: in children, allergy with possible
emotional underpinnings is most common; in adults emotional factors alone.
Hives often go away on their own. Conventional treatments include allergen
avoidance, topical corticosteroids, and antihistamines. In severe cases,
systematic corticosteroids, such as prednisone may be prescribed.
Medical reports describe one man who broke out in hives minutes after he'd been
defrauded in a business deal! In a particularly interesting case of "pseudoallergy,"
a married woman ate lobster with her lover during the course of a guilt-ridden
affair. Thereafter, she developed hives whenever she ate lobster. Experimenters
have experimentally produced hives by suggesting to subjects under hypnosis that
they'd eaten food or come in contact with materials to which they were sensitive.
Investigators such as Gloria Werth of the George Washington University Medical
School emphasize the role of insoluble emotional dilemmas in recurrent hives.
One patient, for example, was miserable in his job but was reluctant to leave
the city where his children lived with his former wife to seek another position.
A young woman was resolved to remain a virgin until marriage but found it hard
to withstand her boyfriend's sexual importunities. An unmarried mother developed
hives feeling trapped between her own aspirations and her responsibility to her
child. A child felt forced to choose between warring parents. If you suffer from
recurrent hives, look for similar "hives dilemmas" in your own life.
Graham and Wolf of New York Hospital-Cornell Medical Center found a pervasive "hives
attitude" among sufferers; they felt they'd been wronged or injured by a
close family member but couldn't retaliate or run away. Their skin showed
physical signs of the emotional beating they'd taken.
As a group, hives sufferers seem to have difficulty expressing anger; they may
not permit themselves hostile or aggressive feelings or fantasies. Their need
for love is often intense and can be traced back to a lack of parental,
particularly maternal, love in childhood.
Hypnotherapy has proved effective for chronic hives. In one study, eighteen of
twenty-seven patients had a complete or near complete recovery; eight others
improved. Short-term psychotherapy, behavior therapy, and relaxation have also
given good results. In my own experience, a combination of psychotherapy with
specific hypnotic techniques, the approach used in this book, has proved most
Hyperhidrosis (Profuse Sweating)
(Griesemer Index: 100 percent; Incubation period: seconds)
This increase in perspiration is usually in response to stressful or
embarrassing situations. Since sweating is part of the fight-or-flight response
and a bodily expression of anxiety, the emotional nature of this symptom is
beyond question. However, profuse sweating can also be the symptom of a central
nervous system disorder, so a good medical workup is essential. Conventional
treatment includes local treatment with aluminum salts. Systemic anticholinergic
drugs and surgery can have serious complications.
Hyperhidrosis, whether confined to the palms and soles of the feet or more
generalized, is distressing and embarrassing in itself. It can easily initiate a
vicious cycle of "avalanching," in which fear of sweating triggers the
unwanted response. If frequent and severe enough, it may promote secondary skin
symptoms, including rashes, blisters, and infections.
Considering the major role of emotions in hyperhidrosis and its emotional impact,
relatively little has been written about psychological therapies for this
condition. Many of the techniques described here can offer help for
hyperhidrosis, particularly relaxation and self-hypnosis imaging techniques to
reduce anxiety surrounding social and sexual encounters. The quick response to
triggering events, characteristic of this disorder, should facilitate your
diagnostic work and help you monitor your progress.
Ichthyosis (Fish Skin Disease)
In this hereditary condition, areas of the skin become dry and scaly,
sometimes accompanied by severe itching. Doctors usually suggest environmental
changes to keep the skin from drying out (emollient lotions, temperature and
humidity control) and may prescribe steroid creams or vitamin A medications.
Ichthyosis is congenital, with no indication that emotions play a role in its
origin, yet hypnosis has produced striking improvements.
Good hypnotic subjects enjoyed the most impressive results. One, a fifty-five-year-old
man who imagined himself in a warm, comfortable imaginary ideal environment,
achieved 45 percent improvement on parts of his body within one month despite
the cold weather that typically made his symptoms worse.48 Where ichthyosis is
widespread, therapists have successfully directed suggestions to one body part
at a time. Generally, hypnosis and self-hypnosis help patients attain a more
optimistic, active role in their treatment; in view of the importance of life-style
in moderating symptoms, this can be critical.
To treat this skin inflammation that appears in body folds, doctors
often advise environmental changes that promote dryness, including light,
absorbent, natural-fiber clothing. Steroids and soothing lotions are helpful.
I haven't found any reports about psychological techniques in intertrigo itself.
Hyperhidrosis can be a key aggravating factor, however, and when it is,
techniques that reduce the anxiety that causes excess perspiration may be
(Griesemer Index: 82 percent; Incubation period: days)
Scaling pustules erupt on the genitalia and mucus membranes, often with severe
itching. This condition, whose cause is unknown but may be viral or
immunological, typically affects those aged thirty to sixty. Medical treatment
uses topical and systemic steroids.
Chronic or triggering stress plays a role in this symptom, according to reports,
but no specific emotional tasks seem to be prominent. The onset of lichen planus
often follows anxiety over work: a reserved, stolid farmer developed the
disorder after a period of intense worry about an impending foreclosure; an
adolescent after a change in work and personal relationships.
Hypnotherapy proved quite effective in one clinical trial: four of eight
patients were cured and three of the others experienced distinct improvement.
There are two forms of lupus: a chronic discoid form that
affects the skin only and a severe systemic form that affects the whole body.
The characteristic rash, raised, red eruptions on the face, ears, and scalp
followed by scaling and scarring?gives lupus its name, which suggests something
gnawed by a wolf. Its cause is unknown, but the disease apparently involves the
immune system and is at least in part hereditary. Medical treatment includes
application of creams to isolated lesions and oral drugs, such as steroids and
chloroquine, for more widespread and severe disease.
Discoid lupus rarely becomes the severe systemic form and is rarely fatal, but
it can be quite disfiguring. It is a capricious disease, getting better and
coming back spontaneously. Some doctors have noted the role of emotional stress
in aggravating and triggering episodes; there's a clear link between chronic
physical and emotional exhaustion and the onset of symptoms.
If you have lupus, you may find the Time Line useful in identifying events and
stresses that aggravate your illness. For physical relaxation, try self-hypnosis.
Any of my techniques that help you deal with turmoil may prove a useful adjunct
to medical treatment; exercises that explore emotional weak spots may help you
handle the impact of the disease and its disfigurement.
This is a wartlike tumor caused by a virus. It may become inflamed and
resemble a boil. Appearing on the genitals, it is a sexually transmitted disease.
It is usually removed easily with cryotherapy (freezing), scraping, or
Suggestion and psychological techniques may be effective here, as they are with
warts. An Italian paper by Arone Di Bertolino reports success with psychological
techniques with children. I've had good results with one patient with
Disease Directory Part Four
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