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Psyche and skin are connected, and in this relationship, mental stressors can aggravate and even give rise to skin pathologies. On the other hand, mental techniques such as hypnosis, focused meditation and autogenic training can activate the mind’s contribution to the skin’s well-being. This paper introduces some fundamental concepts in psychodermatology.
The fact that the skin and the mind are intimately connected may seem counter-intuitive at first glance. How can the brain, let alone the mind, have serious influence on the largest of the bodily organs, the skin? They seem to be so far apart, conceptually and anatomically. Yet, if we look at core concepts emerging from twentieth century medicine, a central one teaches that all organ systems in the body are interdependent, all working as one multiconnected entity. And, in this equation, the mind, as a locus of life’s power, remains a determining force.
Psychoneuroimmunology and psychodermatology, relatively new appellations, define this concept as it pertains to the skin, and open links between psyche and emotions, skin disease, and skin health. Embryonically, the skin and the nervous system are closely linked, as shown by the fact that certain emotional states can commonly be expressed through skin blanching, flushing or blushing.
Strong emotions can impact on skin’s well-being. Stress, in all its manifestations, is well appreciated to worsen all manner of skin problems. Appeasing the mental stressors that impact on skin harmony therefore can assist the modulation of psychosomatic skin conditions, and stimulating relaxation and wellness can encourage dermatological harmony so that the skin can flaunt its optimal radiance.
Mind-body and dermatology
A number of common clinical scenarios involving plastic and cosmetic interventions are associated with post-operative discomfort, various degrees of painful sensations, and sometimes, a most annoying symptom, itching. These challenging neurological signals not only decrease quality of life, but also can inhibit healing through behavioral acting out – itching, for example, being inimical to proper tissue repair. Medicaments used to control these symptoms carry side effects of their own and often depress alertness. A reduction of these symptoms, preferably with mind control techniques - and therefore the minimal use of pharmacology - can be of marked therapeutic assistance.
Several skin conditions are well appreciated to resonate with the individual’s mental climate. Among them, are acne, eczema, allergic dermatitis, lichen planus, alopecia areata, and verrucae. Other conditions sensitive to psychological pressures and possessing recognized immunological components include herpes, psoriasis, dermatomyositis, scleroderma, fribromyalgia and lupus.
Reconstructive and cosmetic surgery commonly involves some form of anesthesia, whether local, sedative, or general. Medical hypnosis has for decades been recognized as a valuable pain modulator, if not a pain eliminator. In modern dermatological procedures - whether in the context of hypnosis or not - pre-operative suggestions for comfort, relaxation, well-being and peacefulness can beneficially shape the perception of the intervention. A patient who has been trained in self-hypnosis can often experience the self-administered hypnotic suggestions literally “kicking in” during the procedure as the unconscious mind, in timer mode, automatically follows its programming. Procedures become patently tolerable, and in some cases, actually welcomed. Hypnosis can also be utilized during the procedure itself, aimed to tranquilize physiological responses such as respiration, blood pressure and heart rate. Post-procedure, mental techniques clearly speed dermatological recovery.
Therapeutic mental techniques that impact on skin health
There are states of experiencing self that allow the mind to have more direct and impactful positive influence relative to the workings of the body’s organ systems. Techniques to bring them about can routinely be applied to enhance therapeutic objectives in client care. Among them:
Hypnosis and self-hypnosis
Hypnosis - and self-hypnosis, which represents a learned skill in the auto-induction of hypnosis - are two of the techniques capable of enhancing this mind to body access. In self-hypnosis a more conscious portion of the mind gives suggestions, affirmations and directives to another, more unconscious part. The dedicated repetition of these affirmations, in a context of contemplative relaxation, enhances the formation and expansion of corresponding neural brain networks.
In hypnosis and self-hypnosis, via the opening up of channels of neurological communications, the mind can be guided to amplify its connectivity to skin physiology. Subjects in the deeper ranges of hypnosis report being able to experience their skins in a more immediate and vivid way and, importantly, to be able to voluntarily modulate several of its untoward signals such as discomfort, pain, and peripheral neural protests such as itching.
A recognized use of hypnosis concerns the resolution of wounds derived from plastic and cosmetic surgical interventions. Hypnosis is well known for its capacity to stimulate circulation and to soften inflammatory response. And, in its ability to enhance blood flow to skin tissues, hypnosis allows for more oxygen to be delivered to wounds, conjointly facilitating the delivery of essential immune factors and providing for the more rapid elimination of wound toxins.
The same capacity for circulatory enhancement via hypnosis can be utilized in the context of skin’s convalescent care. The objective here is to enhance those dimensions of skin health that express themselves through sensations of skin freshness, brightness of color, and feelings of radiance and glow.
If we add one ingredient to the relaxation state of self-hypnosis, we have meditation. That ingredient is focused mindfulness. Meditative techniques can achieve comparable benefits to those noted in hypnosis and self-hypnosis. In meditation geared for skin repair, the patient is asked to channel awareness to a specific bodily area, imbuing that area with any and all sensations evoking organ health. These sensations may incorporate the visualization of colors, the conjuring of warmth or coolness, or even the creation of elaborate mental scenery containing images evoking the power and beauty of nature’s forces.
This self-healing modality developed by Swiss and German psychiatrists in the last century offers specific programs of self-development that lead to advances comparable to those achieved in hypnosis and meditation. In the beginning stages of this training, mentally creating sensations of heaviness and warmth in the arms, the legs, and finally in the visceral self, progressively leads to abilities for heightened self-control. Autogenic training can be adapted to the activation of skin metabolism and physiological response, with all its attendant health benefits.
Hypnotherapy in the skin-convalescent patient
Short-term hypnotherapy in the skin-convalescent can address self-image and self-esteem considerations, thus strengthening the client’s relationship to body image and self-concept, and encouraging more realistic expectations of surgical and cosmetic procedures. Indeed, a common and sometimes contrarian experience for the plastic surgery patient is disappointment with the treatment process because of pre-conceived fantasied (and unattainable) results about its outcome.
Mind-body techniques are increasingly utilized and appreciated in disciplines having to do with skin repair, convalescence after surgery, and skin health, This paper touches on hypnosis, self-hypnosis, meditation, and autogenic training as modalities capable of enhancing skin’s balance and well being, and promoting patient comfort. What is more, these techniques can be applied to activating the skin’s potential to express its more intangible qualities such as radiance and glow.
Gérard V. Sunnen M.D.
200 East 33rd St.
New York, NY 10016
(Ret.) Associate Clinical Professor of Psychiatry, Bellevue-NYU Medical Center, New York.