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  • Open Access

Stress-pathological connection between the psyche and skin

  • 1
Annals of General Psychiatry20065 (Suppl 1) :S299

  • Published:


  • Urticaria
  • Bodily Awareness
  • Aesthetic Experience
  • Sensual Contact
  • Declarative Sentence


The psyche and skin are diametrically different categories, which have two worlds: the idealised and material world. But are they really that different when they come from the same parent? The intimacy that exists between them is surprising.

Man is an open biological psychological and social system and a disorder in one part caused by stress (real or imaginary) effects the other parts of the whole system as well as the skin.

The skin supplies limits, communication, aesthetic experience and especially as a receptive organ (highly reactive to emotions) is a mirror to the psychological processes.

On one hand, the man and his persona, resistance and style of reaction which depend on cognitive and effective characteristics, psychological organisation and defensive mechanisms in interaction with biological correlates. On the other hand, the skin with the help of the neural and humeral canal unconditionally communicates with the persona. They are two polarities on a complex psychosomatic web.

This survey is directed to the psychotherapeutic way of treatment of the psyche – equally important method for the treatment of the body, too. The holistic approach to the treatment of patients with skin illnesses can be brought to full restitution. The sentence Wisdom of the organism is not only to be taken as a declarative sentence, but as an ancient key to the human being as a whole. It is integrated into the psychotherapeutic goal. And its goal is to establish self-regulation of the organism with the help of self-awakening of the persona (by correction of the emotional, mental and somatic level). The personal awareness is a contact dimension of the persona, which supplies understanding, recognition, acquiring information with a simultaneous embrace of perception, thought, feelings and reaction.

Materials and methods

In one year's time 32 patients with skin illnesses (urticaria or psychogenetic pruritus) between the ages of 28–50 have been treated with psychotherapy. In the beginning, they have been unsuccessfully treated with antihistamine and corticosteroid. Their main cause was the unexpected and intense stress (real or imaginary lost).

The Gestalt psychotherapy is being used: dialogue, repetition, taking a role, confrontation, staying with something, rhythm of contact and withdrawal, oriented fantasy.


The psychotherapy gave the following results: 1. Acquiring awareness for the importance of the stressful event for the forthcoming life and connection with the skin changes. 2. More successful control of emotions and other possible alternative solutions for problematic situations. 3. Re-establishing self-respect, self-confidence and security.

There is a difference in the use of separate methods, length and imminent manifestations between patients with urticaria and pruritus.

1. Urticaria

longer treatment; greater resistance; slower development of consciousness; difficulties in the contact with other parts; frequent use of confrontation, staying with something, oriented fantasy; an accent on bodily awareness with accompanied verbalisation.

2. Pruritus

no fast treatment effect; lesser resistance, especially in the beginning; an easy contact on all the levels; frequent use of methods: repetition, taking a role, rhythm of contact and withdrawal; an accent on expression of emotions; rapid eruptive reduction of anxiety.


In our therapeutic work, it is emphasized the patient's assuming of control over his body (not to neglect the skin), methods and experiences as well as remaining in a particular sense which is followed by an adequate body changes with a simultaneous recognition and acceptance. The emphasis is on the body language as an expression of emotions. By gaining awareness the simultaneous assimilation of the problem step in together with the increased vitality and, functioning and withdrawing of the skin illnesses.

During our work the following principle was used: Neglecting the mind, awareness and acceptance of our senses, putting an accent on our sensual contact with our inner self, more precisely what the patient feels on his/her skin, in his/her inner organs, muscle tension or movements – Somatic manifestations of the feelings.


The somatic medicament therapy gives therapeutic success. But what if the cause of the somatic illness is from a psychogenetic background? Can the local antihistamine and corticosteroid therapy solve the mental conflicts with the persona? The treated patients are the real evidence of a successful method – psychotherapy.

Authors’ Affiliations

Medical Centre in Kumanovo, Neuropsychiatry Ward, F.Y.R.O.M


© The Author(s) 2006