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

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

Beginning Reasons for the development of acne

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

At the beginning of the article, we talked about the fact that in psychosomatics there are no identical reasons for the development of a particular disease. Each time we feel almost all spheres of life, and only by the totality of symptoms, including the client's reaction and behavior, we assume which of the directions can lead us to the solution of the psychosomatic problem. In working with acne, this can be very clearly tracked by psychotherapists who have at least once worked with the so-called multiple acne, where it would seem that all existing causes mix and act simultaneously. In this case, it is important to restore the sequence of the onset of symptoms in order to understand the most significant psychological components, since, in addition to physical discomfort, this disease leaves complex scars that are often not amenable to surgical correction.

acne conglobata (multiple or piled up)

As already mentioned, this form of the disease manifests itself in the fact that acne unites deep under the skin, forming sore crimson bumps. In this case, the peculiarity is that acne immediately indicates a variety of different causes, and unlike other forms of acne, this is accompanied by a large amount of pus and scars (scars). Psychologically, such people often "swallow" insults, humiliation, mistreatment, neglect, for some reason, believing that they deserve it. At the same time, the presence of those very scars subconsciously demonstrates to the outside world "being experienced", which, depending on the psychological changes in the treatment process, tells others either "do not hit me, I am so beaten" or "my strength is in my overcoming." However, often multiple acne can be triggered by the very nature of the client (see seborrhea at the beginning).

For example, a client with a constitutional predisposition to excessive production of "fat", against the background of hormonal imbalance, periodically begins to appear acne. For several years, she copes with cosmetic skin care, but when she moves to another city, water, food, work, social circle, etc. change, over time, multiple acne develops. In the process of psychotherapy, sex-role identification, moving as a stress factor, etc., disappear from the psychosomatic versions being worked out, and constitutional traits and depression come to the fore. A tolerant, diplomatic, kind-hearted person who has always put other people's interests before his own is exhausted and turns into a passively aggressive person. On the one hand, she wants to be left alone, since there is no resource, on the other hand, she constantly feels guilty after refusing something to people. So acne helps her to distance herself from contacts with other people, at the same time it does not solve the problem of lack of interest in life - the disease becomes more complicated, the cosmetic defect intensifies, depression worsens. In this case, despite the multiplicity of factors, the main work is to develop a mental resource and revise the basic settings for manifesting oneself in society, related to character and upbringing.

- inverse acne

Like the previous ones, they belong to the late severe forms, and the peculiarity is that there is a secondary inflammation of the sweat glands. In the psychosomatic aspect, there can also be combined reasons here, however, localization (groin, chest, navel, armpits) often gives an additional direction - psychological problems in the intimate sphere. At the same time, it is necessary to understand whether sexual deviations (including fantasies) are a resolving factor in the onset of acne, or vice versa, acne contributed to the decrease and disappearance of intimacy in the client. The connection of inverse acne with obesity and impaired carbohydrate metabolism may also indicate a constitutional predisposition, i.e. on specific character traits, upbringing and destructive family attitudes, including regarding the "sinfulness of the sexual."

For example, a young modern pretty girl seeks help because she can mask acne on her face with makeup, but pimples in her armpits do not give her the opportunity to wear normal clothes, and even more so to undress. In the course of psychotherapy, it turns out that since childhood, her grandmother, who raised her at a certain age, forced her to wear "modest" clothes that did not evoke, did not attract attention, describing in all colors the essence of the depravity of her vulgar peers. Also, the emphasis of education was in the development of such qualities as servility, obedience, suppression of their interests and desires in front of the interests of society, etc. Since at school she was constantly mocked at these memories, she displaces them.

accompanying illnesses

Often, acne can be considered as a reaction to gastrointestinal diseases, diabetes mellitus, etc. In this case, we consider the main disease, not acne. In this context, I want to note the so-called. liver weakness … Since the treatment of advanced forms of acne is accompanied by the intake of a large number of antibiotics, it often happens that the liver "cannot cope" and the client is forced to interrupt the treatment leaving everything as it is. In the psychosomatic aspect, this is combined with fears of change, with unwillingness or internal unwillingness to act, make decisions and take responsibility for their actions. The client considers his resource insufficient, is unsure of his plans. Thus, it is psychotherapy that becomes a kind of preparation of the client for the main treatment.

itching

In psychotherapy, diseases accompanied by itching are associated with auto-aggression - with anger directed at oneself for one's desires and subsequent punishment (scratching to wounds) over and over again. However, in the case of acne, itching is more often associated with the process of wound healing, which allows you to pay attention to how unconsciously a person resists recovery and positive changes. So the question of using the body to solve specific problems (an unconscious secondary benefit) comes to the fore.

pain

Severe pain often accompanies phlegmatic and conglobatic acne (when acne unites deep under the skin, creating large red or purple bumps) and indicates deep psychological trauma associated with upbringing or a specific traumatic event (betrayal, grief, loneliness, injustice, etc.) … Such acne is often associated with somatized depression, other health problems, and coexist with thoughts of a lack of prospects in life and self-deprecation … It is important for people with this kind of problems to know that the complex work of a competent doctor and psychotherapist (specialist in psychosomatics) helps the client not only to reduce the cosmetic defect, but also to gain confidence in himself and in the future. When ready for global changes and establishing trusting relationships, the client gets the opportunity to start life from a new leaf and "create himself anew." However, this process is not fast.

At the same time, almost all clients indicate that "sore pimples" force them to act (whether to take treatment in complex forms, or to stop tearing themselves in the lungs). At the exit of their depressed state, such clients are usually active and persistent in working on themselves, which may indicate pain as a subconscious impetus for qualitative changes.

weakening of immunity

In some cases, abuse of the sun and solarium, bath, frequent washing, disinfection, etc., lead to a decrease in local immunity, which from a physiological point of view contributes to the development of acne, from a psychological point of view, it is more often associated with neurotic experiences in the form of obsessive-compulsive disorder, anxiety disorders, dysmorphobia, etc. In this case, we strive to understand what it means for the client to take excessive care of his body? Why doesn't the client trust his body? What situation is he really trying to control? etc.

However, there is also a reverse situation with demodicosis, when clients stop washing, swimming, you can try to find out why this helps them? Often this is due to the rejection of intimacy.

localization

Based on client cases, the acne prone site may also be associated with the focus of the psychological problem. However, I will immediately make a reservation that there is no universal reason and each story must be considered separately. Nevertheless, with rosacea, which are more common in adult women, the lesion often spreads to the eyes, which is more often associated with a subjective sensation. hopelessness (especially when grieving, losing a loved one, divorce, dismissal, etc.). The concentration of blackheads on the face is more correlated with the problems of the client's perception of himself as a person, while blackheads on the chest and back are more often associated with the problems of perception of his body, sexuality, possibly experienced humiliation (running like a chicken, dressing like a stuffed animal, "flippers" have grown and etc.), especially for adolescents, whose body, due to drastic physical changes in adolescence, may look disproportionate (too long arms and legs, on the contrary, the growth is low, and the head is like that of an adult man, etc.). Acne contributing to hair loss is more common among clients who do not see prospects in life, believe that their resource is exhausted.

For example, one client with multiple acne regarding problems related to employment said so "Look at my face, who can I be in this life with such a face !?"

cosmetic defect

The most difficult problem of acne psychosomatics is related to the fact that it is the presence of a cosmetic defect that causes various secondary psychosomatic disorders in the client - depression, obsession and phobias … Which in turn affects all spheres of the client's life - study / work, relationships, etc. Sometimes it is depression, social isolation and obsessive actions that lead a person to a psychotherapist or psychiatrist. The more significant the client's reaction to a cosmetic defect, the more often it makes sense for him to consult a doctor for medication in support of psychotherapy. At the same time, in order to choose the tactics of psychotherapy, it is important to distinguish between secondary depression (a response to a cosmetic defect) from somatized depression (a manifestation of acne as a sublimation of psychological problems (see seborrhea at the beginning)). In each case, the issues of the prospects for cosmetic correction are considered separately.

For example, developing acne gradually discouraged the client from participating in various school and social events, after which he significantly narrowed his circle of contacts, chose the profession of a programmer and eventually switched to remote work. I turned to a psychotherapist with a feeling of hopelessness, lack of prospects and inability to control myself during treatment (see reactions in the next part), after consulting a psychiatrist, in a difficult psychological state - depression and panic reactions to the need to interact with people, go out into the city, meet with customers, etc. Psychosomatic psychotherapy was carried out in conjunction with a psychiatrist and a dermatologist.

The final article is about the meaning of the client's reactions to acne, the behavior associated with it and the options for psychological and psychotherapeutic assistance