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Counselling for skin conditions 101: What it is and why it works

Written by annakinnaird

August 29, 2023

Psychodermatology is the treatment of skin disorders using psychological techniques such as counselling to address the interaction between mind and skin. It is quite a different mindset to traditional dermatology which is concerned with the physical origins of skin disease and the pharmacological treatment of its symptoms. I practice psychodermatology by offering specialised counselling for skin conditions such as eczema, psoriasis, rosacea, acne and more. In my clients’ experience, the results are astounding.

It’s perhaps helpful to quickly discuss where the psychological sits within the presentation of skin disorder and why therapy or counselling for problematic skin is so powerful. If you suffer from eczema as an example, I will guarantee that you have been told at least once in your life that one of the triggers for eczema is stress. We know this to be true; that certain emotional or psychological states can aggravate the skin, cause a flare up or maintain pain and discomfort. In this way, we are acknowledging the possibility that what is affecting the skin is something that is affecting the mind. And yet, the stress component is rarely treated in a dermatologist’s office.

Conventional treatment for inflammatory skin conditions such as eczema and psoriasis usually consists of suppression; steroidal medications, immunosuppressants, antihistamines, antidepressants etc -drugs that are designed to dial down or switch off inflammatory or allergic responses in the body. In many cases, these treatments are usually affective yet they come with considerable side effects which many people worry about. In many cases however, the skin is not calmed or soothed, it continues to be aggravated, irritated, and painful no matter what medication is thrown at it. At this point it is really helpful to consider that maybe the inflammatory agent isn’t physical but emotional or psychological.  Psychotherapy or counselling for skin conditions offers a completely different approach, it actively opposes suppression and instead seeks to uncover what is bothering us so that it may be processed and integrated. Counselling for skin conditions asks what am I pushing down/away? What am I aggravated or irritated about? What pain am I ignoring or unaware of? What job is my skin doing for my emotional self? These are powerful questions!

How do I know if counselling will help my skin condition? I firmly believe that counselling can always be of enormous benefit for anyone experiencing acute or chronic skin problems. I am fascinated by unusual outbreaks, a strange new skin symptom or changes in skin manageability. In my experience, people who arrive at my practice tend to be seekers. They are often exhausted, overwhelmed, disheartened, depressed, and sometimes scared. They have usually tried exclusion diets, alternative treatments, allergy testing, lifestyle modification and more than one dermatologist, often a lifetime of doing something (all the things) about their skin.  For them and maybe you, counselling can feel like a safe place to land, a place where increasingly being yourself is the medicine.

What can I expect from counselling? Therapy and counselling is quite a basic process which I often refer to as ‘a jolly good listening to’. Clients meet with me weekly at my practice in Wimbledon or online from other locations and we simply start talking through what is going on for you. I take a detailed history of your life as a whole, in order to build an understanding of the context in which your eczema or psoriasis or other skin condition occurs. Together we will consider the psychological stresses in your life now, and in the past and how they relate to the onset or activation of your skin problems. It can be a really creative process whereby we will start thinking of your skin condition symbolically, creatively and imaginatively.

I had suffered from an unexplained red and burning rash on my face for almost 2 years before I ended up in Anna’s office. She asked the usual questions about my skin then asked a very simple question: “What was going on when this first happened?” I remember feeling anxious at the thought of talking about the highly problematic relationship I had been in but I was tired and broken and out it came -and whoosh, there went my red face right there and then. Anna looked at me kindly and said, “I think we might be on to something.” -AE

If you are suffering with troublesome skin, why not book an appointment and come and see me for some counselling. Counselling for skin conditions works and can help you get on with your life. I offer in person counselling in Wimbledon or online from your location, anna@annakinnairdfolkman.com.