Essay 8 Psoriasis

8/8/2019 Essay 8 Psoriasis

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Introduction. Why have I chose psoriasis?

What I know about psoriasis

What is psoriasis?

Key facts about the condition

*(Annexe 1. Types of Psoriasis)

Psoriasis and emotionsOur skin feels our emotions

Psoriasiss psychological symptoms

*(Annexe 2- Initial Questionnaire)

*(Annexe 3- Medical Treatments)

How hypnotherapy helps

Relaxation

Visualization

Distraction

Pain relief

* (Annexe 4- Symptoms, objectives and hypnosis techniques)

Conclusion

Bibliography

*(Annexe 5- Scripts)

H-6 Herena Caridad Hernandez Ortega 1


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1) Why I have chose psoriasis.

The main reason to choose psoriasis as condition for the essay is, because it

is directly related to one of my case studies and I already did some

previous research about it.

I will be helping a friend that suffers psoriasis to understand better how

important is to think in a positive way, that it is essential to feel happy

to be happy and

There is a very high percentage of people with skin conditions in the UK,

especially of eczema, dermatitis and psoriasis, this fact got me

thinking that as therapist at some point we should choose what I

would call speciality, a subject that we have researched and

developed and have some experience treating. There are two

subjects that I am interested in, the first is quite obvious, skin

conditions, principally psoriasis and dermatitis, and the second one, is

pain control, I firmly believe that hypnosis it is a wonderful, veryeffective tool to deal with physical (and psychological) pain, a much

more natural way of dealing with pain with much less

contraindications than the use of painkillers or drugs.

2) What I know about Psoriasis.

What is Psoriasis?

Psoriasis is a common skin condition and affects 2-3% of the population of the

United Kingdom. It is basically when the skin is growing at a faster speed, skin

cells take about 21 to 28 days to replace themselves, with psoriasis this

happens every 2 to 6 days. This results in an accumulation of skin cells in the

form of a psoriatic plaque. This process is the same on different parts of the

body wherever it occurs. The appearance of psoriasis depends on where theplaques are found. (Types of psoriasis, Annexe-1)



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Around 30% of people with psoriasis have a family history of the condition,

and certain genes have been identified as being linked to psoriasis. However,

many genes are involved and even if the right combination of genes has been

inherited, psoriasis may not appear.

Key facts about the condition

- Psoriasis is not contagious

- Psoriasis normally comes and goes, but it is consider a chronic

condition

- Psoriasis affects males and females equally and can appear at any

age, but it is most common age of onset is 20 to 30 years old.

- Causes are unknown. Trigger factor include infection, skin injury

and stress.

- There is evidence that psoriasis can be triggered by streptococcaltonsillitis (especially in children).

- Psoriatic plaques are patches of inflamed skin covered by silver

coloured scales. Scales flake off exposing the red skin beneath

- Inflamed plaques are much more thicker than normal skin

- The most common affected areas are knees, elbows and scalp

(The face is not commonly affected).

- One in ten people with psoriasis develop psoriatic arthritis.

- People with psoriasis often feel stigmatized, flawed, guilty,

ashamed and secretive.

- Psoriasis an also have a psychological impact on patients with

many suffering from depression.



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- Sunlight can aggravate the condition (about 3%of cases) as well as

relieve it.

- The treatments of maniac depression with lithium can worse

psoriasis.

Psoriasis has been linked to:

Physical stress: exercise, hard labour, birth.

Chemical stress: environmental pollution, such asexposure to pesticides and cleaning solvents, andthe personal use of chemicals, such as drugs,alcohol, caffeine, and nicotine.

Nutritional stress: vitamin and mineraldeficiencies, protein or fat excesses or deficiencies,food allergies.

Traumatic stress: infection, injury, burns, surgery,extreme temperatures.

Mental stress: high responsibility, long hours,perfectionism, anxiety, and worry.

Emotional stress: anger, fear, frustration, sadness,betrayal, bereavement.

Psycho-spiritual stress: relationship, financial orcareer pressures; issues of life goals, spiritualalignment, and general state of unhappiness.



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3) Psoriasis and emotions

Our skin feels our emotions.

The skin is a complex organ, and a very sensitive one. It is susceptible to the

environment to protect us and allow us to function properly

To sense and respond to the outside world, the skin contains many millions of

nerve endings that are connected to the body's control centre - the brain.

Thanks to these links with the nervous system, our skin reveals manyemotions;

It turns pale and clammy when we experience anxiety

It blush when we are embarrassed

It glows when we are happy

It produces goose bumps when we are fearful

Like other organs of the body, such as the heart when is subject to stress, the

skin, in a sense, has an emotional life of its own filled with the feelings a

person has avoid, in an attempt to protect themselves. Our skin feels for us.

It can't talk in words but its emotional language may be expressed by the

appearance of a rash, eczema or an outbreak of psoriasis.

When stress occurs in our lives, and we experience emotional difficulties,

these emotional states can make psoriasis much more likely. This is the same

principle which governs the fight and flight response. When we perceive real

or imagined danger, our bodies go into high alert.



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As I learn more about the skin, the emotions and the brain, the key discovery

seems to be the body's ability to turn intensely experienced ideas and

fantasies into physical realities.

It was important to me understand that we dont always feel emotions in the

way we may think that we do. At times the efforts to not express or feel

emotion can cause the body to show those emotions in other ways. The

efforts to protect ourselves from feelings can cause more trouble than the

feelings themselves, as our mind and body find other ways of express the

very emotions we are trying to mask.

Psychological symptoms

Disturbances in body image and difficulty to function normally socially and in a

working environment

The quality of life may be severely affected by the chronicity and visibility of

psoriasis, as well as by need treatment for life.

There is five dimensions of the stigma associated with psoriasis

Anticipation of rejection

Feelings of being flawed

Sensitivity to the attitudes of society

Guilt and shame

Secretiveness

Depressive symptoms are frequent in cases of severe psoriasis

Depression may modulate itch perception, exacerbate pruritus and lead to

difficulties with initiating and maintaining sleep.

Psoriasis affects sexual functioning. In one study, 30% to 70% of patients

reported a decline in sexual activity. These patients also had a higher

depression scores, greater tendency to seek the approval of others

and greater tendency to drink alcohol.

4) How hypnotherapy can help



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The first thing to achieve success with hypnotherapy is to work with the client

individually and focussing in the issues that they present to us. It is

importantto combine the use of psychotherapy and counselling skills

as part of the therapy (Questionnaire, Annexe 2)

It is fundamental to avoid made any assumptions, being aware of the ethical

issues and professional limitations and always being realistic about

the expectations and goal settings with the client.

Each person is unique and the treatment and the hypnosis techniques for

a client with psoriasis should be based on the client's present

beliefs, behaviour, motivations, and symptoms.

Hypnosis techniques

Relaxation. The person that suffers from psoriasis is normally very aware at

all moments of the condition, in some cases because the skin is

itching, painful or uncomfortable, the simple fact of relaxing physically

is in itself a wonderful experience, but not easy for some patients to

achieve, is then when as a therapist, we have to find the most

appropriate and suitable relaxing techniques. There are many to

choose from, but the most common are normally as well the more

effective, like progressive muscular relaxation, circular breathing or

low breathing, these techniques have an added benefit; the client can

learn them as part ofself-hypnosis and master them like as a daily

routine or when needed to help finding inner-balance and to relief

tension.

- Visualization. After achieving the state of relaxation, the client will

benefit from the process of visualization, being able to recreate positive



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feelings and a sense of well-being and self-confidence, giving the chance

to enjoy a private and safe experience. Becoming calmer and happier in

themselves, reducing the stress levels and anxieties that are so damaging

for the condition and the persons state of mind.

- Distraction. Focusing the mind, via relaxation and with positive imagery

suggestions, it can make changes in blood flow, body temperature, muscle

tension, and the immune function, which makes enormous differences in

the physical processes that produce the psoriatic plaque. Here the goal is

experiential participation by the activation of ideas already within the

patient.

Pain Relief. Depends of the objectives, we can use three procedures:

Transform, alter or displace the pain perception.

Localize exactly the pain and suggest analgesia

Distract the attention from the pain and focus in positive and peaceful imagery

5) Conclusion

Having a skin disease is not just a complaint;it is a way of life day in, day out, from morninguntil night, with no cure Evidence submitted by a woman with psoriasis

Doctors and GPs deal mostly with the physical symptoms and to a certaindegree have in consideration the emotional side of the condition and it is truethey can treat all degrees of psoriasis effectively using products andtreatments. (Annexe -4 Medical Treatments)

But there is no cure, and the treatments have a downside: some topicalcreams are messy and may stain clothing and skin. Phototherapy may requirethe person having 2 to 5 weekly visits to a dermatologist or psoriasis clinic for

several weeks. Many of the systemic medications have serious side effects.



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I think that many people that have psoriasis find that there is not enoughsupport available about the impact of psoriasis at a psychological level andpatients feel very vulnerable and powerless.

In cases when the psoriatic plaque is visible the person may feel upset about

other peoples reaction and behaviour, they can feel rejected, ashamed, guiltyand develop negative feelings and thoughts. Hypnotherapy can do nothingabout how other people react to the visible signs of the condition but can helpthe client to have a different attitude and find positive coping mechanisms todeal with stressful or uncomfortable situations. I will illustrate this with anexample from Miss FL, who suffers severe Erythrodermic psoriasis, and diduse hypnotherapy for anger management and other issues.

She used to get very upset when shopping, the people at the till insteadplacing the change in her hand, as they normally do with other costumers,decided to leave it on the counter, in front of them, to avoid contact.

Miss FL used to get so upset and stressed about going shopping that foralmost a whole year family and friends did the shopping for her. Until sherecently accepted people not necessarily wanted to be mean, there could beother reasons behind the reaction, mainly because people dont know whatpsoriasis is and if it is or not contagious.

She started to go shopping with a different attitude, quite nervous at thebeginning but trying to keep as calm and relaxed as she could. She wasslowly able to concentrate on the shopping list and not in the peoplesreactions around her. And one day spontaneously after the cashier left thechange on the tray, she said; it is only psoriasis and it is not contagious, nexttime I would like you to give me the change normally, please. She related thisto me with a big smile on her face, how the cashier apologized and noddedwith her head in a bit of the shock. She thought it was very easy and it feltgreat to receive the apology, such a simple gesture had an amazing effect onher and give her a whole new perspective in how to deal with similarsituations.

It was very moving, as friend and as a therapist observe this astonishingchanges.



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6) Bibliography

- British Association of Dermatologists. Psoriasis guideline 2006. London

- Understanding Psoriasis. Andrew Warin

- Psoriasis: A Patients Guide. Gail Zimmerman and Lowe

- Understanding Skin Problems: Acne, Eczema and Related Conditions.

Linda Papadopoulos and Carl Walker

Word Count; 2129


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