Ancient physicians noted the special place of the mental component in the origin of skin diseases. Hippocrates, formulating his idea of the nature of human essence in the form of four basic character traits, noted the same formative mechanisms for skin diseases.
At the end of the eighteenth century, Falkoner first tried to link the activity of the skin process with the disruption of innervation of the affected skin areas, introducing the psychosomatic approach to dermatology. In 1933, the German dermatologist W. Sack in his work "Mental Health and Skin" first proposed to take the skin condition as one of the indicators of the individual's mental state. In 1968, the American psychoanalyst Franz Alexander proved that the skin has the property of a specific organ predisposition to react to stress, and therefore the pathological skin process includes not only the local focus, but also the patient's mind.
Stress is the main cause of psychogenic dermatoses and dermatitis in many people. Patients often talk about a "vicious circle": stress leads to itching and aggravates the disease, which causes even more stress. In addition to the temporal dependence between the effects of emotional stress and the manifestations of skin pathology, there is often a clear parallelism between the severity, prevalence, activity of the course, duration of the disease and the intensity of psychoemotional disorders. The same pathological processes that manifest themselves at the neuropsychological level as irritability, fatigue, depression, anxiety, etc. only manifest themselves at the skin level as rashes.
Neurodermatitis (atypical dermatitis) is one of the most common psychosomatic diseases affecting 1-1.5% of the population, mostly women. The disease is manifested by severe itching with predominantly affected face, neck, joints of the arms and legs, elbows, knees, hands, and feet. It has a persistent, chronic and recurrent course, which is often accompanied by neurotic disorders, reduced or lost ability to work, social maladjustment and a deterioration in the quality of life of patients.
Psoriasis is a non-infectious, chronic autoimmune, inflammatory disease, which is characterized by excessive skin cell proliferation, which is manifested by severe flaking, redness, and itching. The disease can affect large areas of the skin, up to total damage, is difficult to treat and causes severe discomfort to the patient. The skin with psoriasis is itchy and covered with scales.
Eczema (atopic dermatitis) is manifested by patches of dry skin that can become itchy, red, and inflamed. These areas often appear in the creases of the elbows and knees, as well as on the face, neck, and wrists. Scratching these areas can make itching worse and cause the skin to ooze a clear liquid.
The onset of the disease is often associated with conflicts in partnerships, relationships with mothers, separation or, conversely, the appearance of people who are emotionally attractive to patients, etc. An important factor, especially in itchy dermatoses accompanied by self-combing, is the suppression of aggressive and sexual tendencies when it is impossible to control one's own emotional aspirations. Combing in such dermatitis is an unconscious way to cope with aggression. At the same time, combing is not always explained by the presence of itching, but becomes a kind of motor discharge of emotional tension.
Patients with dermatitis and dermatoses often experience repressed impulses of hostility towards their families, feelings of inadequacy, depression, nervousness and anxiety, and patients themselves usually notice the negative impact of the feelings and experiences they experience on their condition.
The skin can be seen as a covering layer that performs a protective function. It perceives incoming external and internal stimuli and, if necessary, transforms or reflects them, and therefore can take on a certain symbolic meaning: on the one hand, it protects a person from external influences and factors, and on the other hand, it serves as a means of contact and communication. As a result, when a patient's relationship with his or her own boundaries is disturbed, either dependence on other people, attachment to them and a desire for subordination arise, or rather rigid, impenetrable boundaries are formed that prevent deep contact with the external environment and significant people. In both cases, the development of the disease can begin at the somatic level.
In particular, it is believed that the "scales" on the skin with psoriasis are the body's defense reaction to an uncomfortable environment, protecting a person with low self-esteem and fear of social contact. Therefore, psoriasis often affects people prone to social phobia (fear of people).
That is why psychotherapy should be included in the treatment of dermatoses and dermatitis.
Transcranial electrical brain stimulation (TENS) is also a good non-drug treatment. It is widely used to eliminate pain of various origins due to its analgesic effect, and also has a positive effect on the processes of repair and improvement of the psychophysiological status of a person, reduces anxiety and depression.
Ketamine infusion treatment is a promising method of treating inflammation and psychoemotional imbalance associated with skin diseases. Guided by the principles of integrative, holistic medicine, combining psychotherapy with ketamine infusions, transcranial electrical stimulation, Neurohelp brain rehabilitation, body-oriented therapy, and art therapy, it is possible to achieve a significant improvement in the health of patients.
