Thursday, 22 March 2007

Skin complaints

Wart removal, with its long history of bizarre cures, has been the target of considerable interest from psychosomatic researchers, requiring as it does the occurrence of a change in the patient's resistance to a virus. While warts resist all manner of treatments, hypnosis has long been observed to be effective:
Noll RB., Hypnotherapy of a child with warts, J Dev Behav Pediatr. 1988 Apr;9(2):89-91.

Spanos NP, Stenstrom RJ, Johnston JC, Hypnosis, placebo, and suggestion in the treatment of warts, Psychosom Med. 1988 May-Jun;50(3): 245-60.

Spanos NP, Williams V, Gwynn MI., Effects of hypnotic, placebo, and salicylic acid treatments on wart regression, Psychosom Med. 1990 Jan-Feb;52(1): 109-14.

Phoenix SL., Psychotherapeutic intervention for numerous and large viral warts with adjunctive hypnosis: a case study, Am J Clin Hypn. 2007 Jan;49(3): 211-8.
But it's not just warts which are amenable to this kind of treatment. Skin complaints in general provide a fertile ground for psychological interventions. University of South Florida's professor of Medicine Philip D. Shenefelt concludes in Hypnosis in Dermatology, Arch Dermatol. 2000;136:393-399, that
A wide spectrum of dermatologic disorders may be improved or cured using hypnosis as an alternative or complementary therapy, including acne excoriée, alopecia areata, atopic dermatitis, congenital ichthyosiform erythroderma, dyshidrotic dermatitis, erythromelalgia, furuncles, glossodynia, herpes simplex, hyperhidrosis, ichthyosis vulgaris, lichen planus, neurodermatitis, nummular dermatitis, postherpetic neuralgia, pruritus, psoriasis, rosacea, trichotillomania, urticaria, verruca vulgaris, and vitiligo.
The question then arises as to whether there is something special about the skin, or whether changes there are simply more noticeable. That there's something peculiarly visual about skin complaints can be seen by turning to the relevant section of a medical textbook where one is often greeted by a plethora of florid pictures.

Shenefelt opts for the former explanation with a developmental physiological argument in Complementary psychocutaneous therapies in dermatology, Dermatol Clin. 2005 Oct;23(4): 723-34
The skin and the nervous system develop side by side in the fetus and remain intimately interconnected and interactive throughout life. Because of the skin-nervous system interactions, there is a significant psychosomatic or behavioral component to many dermatologic conditions. This permits complementary nonpharmacologic psychotherapeutic interventions, such as acupuncture, aromatherapy, biofeedback, cognitive-behavioral therapy, hypnosis, placebo, and suggestion, to have positive impacts on many dermatologic diseases.
This account is compatible with the skin being privileged as the site of others' touch and gaze. We report a case in our book where it is precisely the visibility of the skin that's at stake. A woman's belief that she caused her son's death leads to a series of disorders, shuffled about by her hypnotherapist, including a number of skin complaints, which involve both a punishment and a need to be seen to be punished.

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