Comedones, Acne, Seborrhea. Psychosomatics Of Acne (beginning)

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

The habit of associating acne (pimples) with adolescents significantly removes us from understanding what may actually be behind acne. While most adolescents outgrow the problem of acne, therapists are more likely to be consulted by people of an age who do not experience those "youthful" problems, but suffer severely from acne in one way or another. In this article, which consists of 3 parts, I will try to highlight as many different directions as possible in which, according to psychosomatic theory, it makes sense to study this problem. The general plan can be presented as follows: 1 - description of the problem, possible causes; 2 - main manifestations and related problems; 3 - the client's reaction to the disease and options for correction, both independently and with the help of a psychotherapist.

Some doctors are inclined to write off the psychosomatic aspect of the dependence of the skin on a psychological state on the fact that even in the womb, the nervous system and skin are formed from the same germinal lobe. Psychologists, demonstrating the relationship, often give examples of how the skin reacts to our emotional experiences: when we worry (redness), when we are afraid (excessive sweating, goose bumps), etc. identify and suspect the problem of the work of a particular organ. Thus, the skin is not just a reflection of our experiences, but also a kind of screen for the inner state of a person. generally … We say that the skin is the brightest developer of what actually happens to us inside. It is due to this globalism that psychosomatic diagnostics cannot be generalized on the basis of "skin", and for each specific problem there should be, first of all, an analysis of the physical causes of the disease and only after the search for psychological ones. It is especially important to determine the sequence of manifestation of a psychological problem associated with a skin disease. this affects both the prognosis and the tactics of psychotherapy.

So, what is acne from a psychosomatic point of view?

Basically, acne (pimples) is an inflammation of the sebaceous gland. Normally, it brings to the surface of the body a sufficient amount of "grease" to create protection against germs, prevent drying out, and make it less vulnerable by increasing elasticity. An overabundance of "fat" production may indicate a subconscious desire to even more protection - to a subjective feeling of lack of support, distrust or feeling that there is no one to rely on, etc. It often happens that a parent or a beautician who teaches a child / client effective skin care, thereby also plays a psychotherapeutic role - it reduces anxiety, gives a feeling of that very support and support, significance and acceptance, acts as a person you can rely on and who can be trusted. Conversely, ineffective recommendations like "drink brewer's yeast and sorbents" or "love yourself" exacerbate the situation of distrust and withdrawal - the problem is gaining momentum.

For a mature person "stuck" at the level comedones (black dots - oxidized excess fat) it is recommended to reconsider your attitudes regarding places, people and events that he associates with a sense of security and protection, support and trust, irrational anxiety and fears, etc. Properly selected skin care and structured introspection help to significantly reduce the problem of the formation of comedones, up to complete disposal.

In order to list the varieties of acne, the format of the article will not be enough, so we will take as a basis the thesis "acne" = "disorientation", and the position that in psychotherapeutic work with acne, we primarily pay attention to the issue of competent information, acceptance, creation safety conditions and support. And we are getting ready for the fact that, unconsciously, a client with acne will constantly "test" us in these areas, both a teenager and an older person.

Reasons for the development of acne may be different, and in each specific case a special story is revealed in front of us where psychological reasons can be both primary and secondary. Let's consider the main ones:

mechanical

The very same reason that refers to the formula "not all diseases are from the brain." When a person works in a polluted production, uses low-quality cosmetics or creams, when clothes injure a certain area of the skin (for example, a permanent hat on the forehead or too dense underwear) - the time is clogged from the outside, which prevents the elimination of fat and inflammation occurs. If you do not take timely measures to clean up and eliminate external pollutants, acne develops. Here psychological problems become secondary, and when there is no resolving conflict (see "stress" below), it makes sense to associate them with a reaction to a defect in appearance (see "cosmetic defect" below). When collecting information from the client, it is important to note these reasons in order to distinguish mechanical pollution from seborrhea. Actually, in cases where the client performs competent skin cleaning, he may not need the services of a psychologist at all.

hormonal

Often the development of acne has its origin in hormonal changes in the body. Here the psychological factor is also secondary, but very important. The trick is that these changes are associated with an overabundance of the so-called. androgens - male hormones. The body is looking for its golden mean and is trying to determine how much and what hormone needs to be allocated to this particular person. Depending on how we cope with these changes, the body either finds the best option, or the hormonal disruption is delayed.

Psychologically, we can observe an excess of aggression, uncontrollability, irascibility, hysteria, etc. - something that is associated with the manifestation of uncontrollable strength and influence, sharp emotional outbursts, which is a response to disorientation (subconsciously we feel that something is wrong then, but what exactly, how to behave and what to do about it, we do not understand). At the same time, clients may feel confusion, anxiety, lack of confidence in themselves, their abilities (which can be intensified by the reaction to hormonal changes in the form of deterioration of attention, memory, changes in thinking), etc. In addition to general psychological study, often work with such clients has a gender directionality, i.e. is associated with issues of gender-role identification and often manifests itself after natural hormonal storms during pregnancy, lactation and the postpartum period. Then the analysis includes the correspondence of the client's ideas about her social sexual role to reality.

For example, a client of a muscular type, mom and grandmother, who belong to a completely different constitutional type, were taught from childhood (and she sincerely believed in it) that children are happiness, the meaning of life, and that "she is now so prickly, and when will give birth, everything will change at once - in our family all women are like that. " However, after giving birth, the client falls into depression, because she does not receive the expected "happiness" from everyday life and motherhood, and therefore feels like an abnormal and bankrupt woman, a mother. Against the background of hormonal imbalance, acne develops, which for the client becomes an unconscious projection of the conflict between what she feels like a woman and what she supposedly should feel like a "real" woman. Psychotherapy helps her to reconsider her attitudes, understand herself and accept "her" femininity, and not the femininity imposed by the stereotypes of other people. Postpartum depression and acne subside.

If this happens to a teenager, it is important for him to reflect (introspection) on the subject of gender-role expectations (I am a man or a woman, what does it mean to me, how I should behave, what I feel when I behave this way). In the case when in his environment the role functions are distributed harmoniously (for his perception) and with proper skin care, acne will soon disappear without psychological correction (it will outgrow). If a teenager cannot decide and find his place in sex-role relationships (girls who are like "tomboy", but like a lady; boys who are like "men", but like "mother's son"), he has the likelihood of fixing acne for a long time. Then the role of secondary psychological trauma as a cosmetic defect becomes very important. Self-perception of a person mistakenly begins to build up through a defect in his body (no one is friends with me (they do not take a job) because I am ugly / ugly). In this case, it is important to catch these cognitive errors and teach the client the skills of introspection and critical thinking. The presence of an idol-mentor that is significant for the client (an older adult of the same sex with him (for a teenager, a parent is often an anti-example!)), Through identification with him, helps to quickly and easily go through this path of self-determination.

For example, a client teenage girl during psychotherapy constantly talks about the traits that she likes in her teachers, coaches, mother's friends, etc., while she can hardly say anything about herself. Psychotherapy helps her, through the image of idols, to shift the emphasis from others to herself, to understand her interests, her desires, needs, etc. The embodiment of what she wants, together with competent skin care, helps her get rid of acne.

Also, the so-called late acne may have a hormonal cause (read more on conglobate and inverse forms). This is the same form of non-teenage acne that appears after puberty (or joins existing ones), can be chronic and is more common in men. In the psychological aspect, there is often a crisis of self-identification, problems in relationships with the opposite sex (together with problems of a sexual nature). However, the trend is towards the education of hyper masculinity, especially in families where the father is either absent or nominally present (this is what about "real" men who do not cry, who keep their faces (emotions in themselves), who are sometimes endowed with absolutely illogical " debts "to the family and" supernatural "abilities, etc.). In most cases, men show some kind of infantilism, caused by the fact that they had to grow up early, they were assigned a "male" fate early, and late acne is a kind of external proof that "I am too young to be a" real "man" …

stress

A fairly common reason for the so-called. situational psychosomatics associated with specific people and situations. Acne as a reaction to a stress factor, a specific conflict, interaction with a specific person, etc., can be identified with the help of an introspection diary. In order to solve this problem in psychotherapeutic terms, we are working on the search for a "trigger" (conflict that triggered the development of the disease) and attitudes associated with communication and interaction, changing the response to a stress factor and, accordingly, looking for an alternative (how to solve a psychological conflict without resorting to to the body - acne). In parallel with cosmetic care, we are looking for options to reassess the situation that provoked the imbalance and, if possible, get rid of it.

For example, a client working in a construction team (there is already mechanical pollution), swears and aggravates the conflict with the foreman (trigger) and, as a result, gets acne (stress provokes defense mechanisms = excessive production of fat on clogged pores = inflammation). If the conflict was simple, she could take a break from work, heal, and return without problems. In this case, the conflict is complex, and even after a course of treatment, constant stressful interaction with the boss provoked inflammation. So the client faces a choice - to find a common language with her superiors or to quit.

seborrhea

Most types of acne are based on the so-called. seborrhea, in which not only the adequate production of fat by the body is disrupted, but also its composition changes. We can also suspect seborrhea if the client presents other symptoms of "fatness" - hair quickly grows oily, slow metabolism and a tendency to be overweight, etc. In the world of constitutional theories, we correlate such a person with cyclothymic temperament and body type "picnic ". There are desperate disputes about the reasons for the development of seborrhea. It is associated with stress, metabolic disorders, and heredity. In psychotherapy of psychosomatic diseases, seborrhea is closely associated with a person's character, his attitudes, models of behavior and generic scenarios. More often these are people prone to depression and wave-like moods, people with irrational self-criticism, low self-esteem and a low level of claims (learned formulas for all spheres of life: I am nobody and nothing; not capable of anything; I do everything through …; stupid and stupid; freak; I have nothing to love, etc.), people who do not know how to say "no" and defend their rights, people who live for others and for the good of others, etc. At the same time, they can be tough and aggressive, but this reaction is more comes from despair and is a kind of manifestation of protection (a "well-fed" aggressive teenager with acne is a desperate cry for psychological help, where one of the parents will be required. If we are talking about an adult, then special attention is paid to family attitudes in his therapy). The psychotherapy of such a client cannot be quick and it is based not so much on the search for a resolving conflict (from which the disease began), but on the work on self-perception, self-identification and change of destructive generic attitudes.

For example, the client grew up in a very good family, but from her parents she constantly received the message "not enough" - not kind enough, not beautiful enough, not successful enough, not managing enough, etc. Due to the fact that she experienced such an attitude and the client's mother (who also suffered from acne), no one considered this message "abnormal", on the contrary, it was perceived as a stimulus for development. The problem was reflected precisely in seborrhea due to the fact that there were favorable constitutional features for this.

metabolic disease

Often we are assured that in order to get rid of acne it is necessary to cleanse the whole body. However, in this case, as in the case of seborrhea, it is important for us to distinguish whether the failure is situational or metabolic disorders are dictated by our physiology. The first refers to the so-called. "situational" psychosomatics and is closely related to the stress factor (with the help of analysis it is possible to identify a conflict, after which acne appeared), the second with "true" and the solution to the problem is possible only partially. For example, when we see that rashes are associated with excessive consumption of sweet and starchy foods, such a client more often at the physiological level experiences an increased need to use these products. In this context, we will have to deal not only with acne as such, but also with psychosomatic disorders in the form of eating disorder, obsessive-compulsive disorder and depression. The scope of work is expanding.

- demodicosis

Another common cause of complex forms of acne is the Demodex mite, which lives in the sebaceous glands and, at the first opportunity, begins to parasitize (see below "accompanying symptoms"). When an overly tolerant client appears in front of us, who owes everything and everyone - at work, at home, friends, bosses, etc., who is too polite and courteous, we can safely suspect he has an excess of these very parasites. In this case, a very complex intrapersonal conflict appears on the surface, on the one hand, the person is afraid of being rejected and therefore tries to be good for everyone and give himself to everyone to the maximum, on the other, his appearance provokes others to avoid him (that very rare case of acne when the client is considered contagious). The main task of psychotherapy, in addition to general psychosomatic factors, is to identify the root of dependence on other people, the need for global acceptance and, at the same time, a ban on intimacy, avoidance of other people (see below "reaction to illness").

For example, a client whose mother, after protracted conflicts, betrayal and divorce from his father, unconsciously projected a negative attitude towards the male sex onto his son. He, in turn, unconsciously, with all his behavior, tried to take the role of a full-fledged man in the house in order to become important and necessary. At the same time, he did not know how to correspond to the role of her husband and, in fact, could not replace her husband, so he constantly failed in his attempts to make his mother happy. The client received the resolution of the situation through a long path of introspection, gender-role identification and separation from the mother.

reaction to specific drugs

Sometimes inflammation can be associated with taking certain medications. In this case, the primary problem is most likely, which forces them to accept. For example, taking anabolic steroids (drugs that accelerate muscle growth) can be caused by complexes related exclusively to the appearance, perception of oneself, one's body, one's beauty (and acne is only confirmation and at the same time aggravation of the problem). Or vice versa, taking sedatives, sleeping pills can be caused by general overexertion, chronic fatigue, stress, etc. in conjunction with acne, a person may feel "out of place" that they are not going their own way.

Equally important for diagnosis are the degree of complexity of the damage to the body and manifestations of accompanying symptoms.

The second part describes: the most complex forms of acne diseases, concomitant symptoms and diseases, as a subject of psychosomatic analysis.

And the third, final article on the meaning of the client's reactions to acne, the behavior associated with it and the options for psychological and psychotherapeutic assistance