Psychotherapy support

As you discuss the stresses in your life with your psychotherapist or your support
group members, you may learn first-hand what dermatologists have known for a
while— often several weeks elapse between the time of the stress and the
worsening of the psoriasis. You may have thought that there was no connection
between life’s little dramas and the state of your skin. But, when you come to see
the cycle’s pattern, it will be easier for you to break the cycle. For example, if
you discover that having a fight with your parent, child, spouse or work
supervisor always results in a bad psoriatic outbreak, you may have an extra
incentive to find a more amicable way to settle your differences. If nothing else,
recognizing exactly how and when stress affects your psoriasis will help you to
find the relaxation techniques that help minimize the flare-ups if you employ
them soon enough after the stress trigger.
Some of the techniques that may work for you include self-hypnosis,
meditation and yoga. Major metropolitan centres have classes in all of these
disciplines, and some psoriasis centres have support groups that can train you in
these stress reduction techniques as well.
If these stress reduction strategies are not sufficient, you may want to consult a
psychiatrist. Unlike psychologists, psychiatrists are licensed to prescribe drugs,
and there are many new drug therapies available that are designed to reduce
stress and depression. However, let me stress that these drugs must be used
under the continued guidance of a psychiatrist, because there are sometimes side-
effects to be weighed against the benefits of the drug. Some of the medicines now
available include fluoxetine (Prozac) and its relatives, which are antianxiety,
antipanic and antidepressant drugs, and buspirone (Buspar), also an
antidepressant. Your doctor or psychiatrist can tell you more about specific drugs
and their respective pros and cons.
In the years I have been treating psoriasis, I have found that the patients who
have been most successful in dealing with psoriasis, and by successful I mean in
their attitudes as well as in their physical condition, share several characteristics.
First, they have made peace with their psoriasis. This doesn’t mean that they
have given up on seeking treatments that work for them. On the contrary, it
means that they have said to themselves, ‘I have psoriasis. I will not be ashamed
of it or limited by it, either socially or professionally. Since I cannot change it, I
will accept it and continue to treat it as best I can’.
This leads us to the second main characteristic: the most successful patients
are persistent in their treatments. It can become quite discouraging for patients to
live through so many new psoriatic eruptions, especially after relishing the
freedom of being clear for a few weeks or months. Unfortunately, this is often
the nature of psoriasis. The patients who cope best are those who know to expect
that new outbreaks may occur and are willing to try new treatments, creams,
shampoos and whatever else may be required.
As you continue to read this book and to live with psoriasis, remember that
you may not be able to control your skin, but you can control your attitude
towards it. Accepting psoriasis as a fact of life will free up your emotional
energy for more productive endeavours and should alleviate some of the stress
associated with psoriasis.