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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.

Genital Herpes 

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 developed.

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 it.

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 observations.

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.

Hives (Urticaria)

(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 effective.

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 helpful.

Lichen Planus

(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.

Lupus Erythematosus 

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.

Molluscum Contagiosum 

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 electrodesiccation.

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 genital molluscum.

Disease Directory Part Four

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