Greed can cause depression in people

Skin diseases: interaction between skin and psyche


Stress, depression, fears or social deficits influence psychosomatic psychoses. Therefore, psychotherapy can also be used
help to improve skin symptoms.

The skin is popularly referred to as the “mirror of the soul”. Phrases like “it gets under your skin”, “that doesn't itch me” or “this is something to get out of your skin” point to the close connection between skin and psyche. The skin, the largest human organ, can represent feelings. To do this, she uses her own language. For example, fear triggers goose bumps, shame makes you blush, fear makes us sweat. These reactions of the skin to violent emotions are explained by Prof. Dr. med. Uwe Gieler from the Clinic for Psychosomatics and Psychotherapy at the University of Giessen said: "The skin and the central nervous system have the same developmental origin - both are formed in humans from the same dispositions."
But the language of the skin organ is often not understood. This is exactly what is urgently needed. Because skin diseases are very common and are increasing more and more. In the past few decades, some skin diseases such as psoriasis and neurodermatitis (atopic dermatitis) have already become widespread diseases. About eight percent of the population suffer from it. Skin diseases and allergies are becoming more and more common, especially in children. Every fourth child is affected by neurodermatitis.
Skin diseases such as neurodermatitis, psoriasis, acne, herpes, contact eczema and hives are referred to as "psychosomatic dermatoses" because they are somatic but can be influenced psychologically. They are mostly genetically predisposed. But whether and when the disease breaks out, how it manifests itself and how long it lasts, many other factors decide, including chemicals, mechanical skin irritation and the psyche.
It is still not scientifically clear whether psychological problems are the cause or the result of skin diseases. But that's not all that important. "It is much more important to recognize the interaction between psyche and skin," says Munich psychologist Lothar Niepoth: "For the therapist, it is crucial to determine which feelings, behaviors and events have an effect on the disease and worsen or improve it. "
Not high expectations
The therapy of skin diseases such as neurodermatitis or psoriasis is very limited. It is mainly based on relieving symptoms and preventing the disease from worsening. In most therapies, the focus is not on the physical or psychological causes, but on the physical symptoms. Since psychosomatic dermatoses have a psychological component, the question arises whether something cannot also be achieved through psychotherapeutic methods.
This is an interesting and legitimate question, but expectations should not be too high. Most psychosomatic dermatoses are incurable. To date, neither a conventional medical nor a psychotherapeutic procedure has been discovered that has led to complete remissions. Nevertheless, it makes sense to also consider and treat the psychological side of skin diseases. This is shown, for example, by a study by the Hannover Medical School. There, the effects of stress on neurodermatitis and psoriasis were examined. "Psychological stress creates strong immunological reactions," say the study directors Dr. Gerhard Schmid-Ott from the Department of Psychosomatics and Psychotherapy and Prof. Dr. Werfel from the Dermatological Clinic and Polyclinic. In their experimental studies, the two researchers showed that in atopic dermatitis sufferers under acute stress, both the number of white blood cells (lymphocytes) and the number of immune messenger substances (cytokines), which are essentially responsible for the inflammation in this skin disease, greatly increased.
But stress is not the only psychological factor influencing skin diseases. Social deficits, depression and anxiety also play an important role. Patients who have problems asserting themselves against other people or rejecting unpopular tasks always experience flare-ups when such a demarcation fails. The noticeable deformations that go along with some diseases are a great burden for those affected. Many no longer dare to show their skin. When those affected hear hurtful remarks or are appraised with looks, their self-esteem is over. They withdraw. Little by little, their social isolation increases and their fear of rejection and stigmatization can escalate into social phobia. In addition, those affected only think about their skin problem and feel ashamed of it. Skin sufferers particularly suffer from the fact that the course of the disease is unpredictable and uncontrollable. You feel helpless and develop anxious expectations. These psychological reactions lead to internal tensions that can keep the disease going longer.
Each skin disease also has its own characteristics. For example, atopic dermatitis is often accompanied by excruciating, unbearable itching. Those affected react by scratching - usually until the skin starts to bleed. Repeated scratching can lead to inflammation, disfigurement and coarsening of the skin (lichenification). In addition, scratching only provides short-term relief and then triggers itching again itself. Itching attacks usually occur shortly before falling asleep, in the case of boredom or anger, in the event of mental tension and in waiting situations. Often the itching is felt when the transition from tension to rest. Scratching without itching is an expression of emotional states and is known as "tension scratching". "Nocturnal scratching" occurs when the person concerned is no longer consciously under control while sleeping.
Medical knowledge required
In psychotherapy, the psychological problems associated with the skin disease are primarily addressed. This is intended to indirectly improve the condition of the skin. With the help of relaxation processes and cognitive strategies, those affected learn to relieve tension, improve their self-esteem and accept their bodies. Through competence training and role-plays, those affected can be helped to reduce their social deficits. Cognitive restructuring helps those affected to no longer fixate themselves so strongly on the skin condition and to no longer dramatize it. Further components of the therapy are stress management, self-suggestion, self-confidence training, the development of coping strategies and the search for alternative behaviors to scratching. In addition, patients must be given detailed information about their illness. Therapists who treat skin diseases must therefore not only have psychotherapeutic, but also medical knowledge. You should also pay attention to compliance to create a trusting relationship. These therapeutic measures should make it easier to deal with the skin disease and reduce the suffering of those affected.
Psychodermatologists and psychoimmunologists do not yet know much about the connections and interrelationships between psyche and skin. However, it has now been shown that behavioral therapy programs help improve the main symptoms. There are currently some research programs that integrate psychotherapeutic interventions, for example the training and therapy program (ISBP) for young atopic dermatitis sufferers, which was developed by Prof. Pieter-Jan Coenraads, University Hospital Groningen, or the Neurodermatitis Training Working Group (AGNES). Pediatricians, dermatologists, psychotherapeutic doctors, psychologists, ecotrophologists, educators, economists, social workers and nursing staff are involved in the interdisciplinary model project. Medical knowledge, nutrition and psychological content are equally at the center of the counseling program. Marion Sonnenmoser

Niepoth L: Chronic skin diseases. Weinheim: Psychologie Verlags Union 1998.
Gieler U, Bosse KA: Mental factors in skin diseases. Bern: Hans Huber 1996.
Dargatz T: Stress - scourge for the skin. Die Welt (December 2, 2001).
Detig-Kohler C: Up close. In the psychoanalytic dialogue with skin diseases. Giessen: Psychosozial-Verlag 2002.
Stangier U: Skin Diseases and Body Dysmorphic Disorder. Göttingen: Hogrefe 2002.

Information on the Internet: (German Association for Neurodermatitis) (German Psoriasis Association) (German Allergy and Asthma Association)
Skin diseases: interaction between skin and psyche

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