By: Mordy Tiefenbrunn, M.S.W.
“I can’t wear that...” “I’d love to go out for ice cream, but I just can’t bear the thought of everyone looking at me like that..." "I need to cover my face, I'm all spotted”, “There’s no way anyone could possibly find me attractive like this...”
For anybody, these are things that may be thought or felt every now and then. For people with Psoriasis, these thoughts and subsequent feelings could be and often are a daily struggle. Waking up in the morning and looking in the mirror, people who have Psoriasis are forced to struggle with the painful reminder that they have a condition that makes them look different, or they may even feel that they are simply difficult to look at. Having Psoriasis is also uncomfortable and even painful, the spots can be itchy, raw, sore, etc, and can leave someone with simply no patience or desire to do anything. It causes people to need to take days off from work to recuperate, cancel dates or appointments, which can lead to feeling shame, inferior, or embarrassment.
Nobody wants to feel this way! However, it is widely known in the world of psychology that there is a deep interwoven connection between our thoughts, emotions, and subsequent behaviors. In the case of a psoriasis fighter, an example of this relationship could be something along the lines of “Who could possibly want to be friends with someone who looks like this?” (negative thought), which would cause that person to feel sad, depressed, lonely, etc (emotions), thereby making him/her closed off from other people and avoid social encounters, dress in a way to avoid attention, or the like. (behavior) When someone has negative thoughts about their body and self-image, it impacts the way they feel and act and in a profound way, and it can be very easy to fall into these thoughts when dealing with psoriasis sores and spots all over their skin.
The Cognitive-Behavioral Therapy method deals heavily with working on compartmentalizing this triad so that when these thoughts come into one’s head, they can catch them and re-route them so that their emotions are not affected. Taking our example from above, our friend with Psoriasis can say to himself something like “there are many people in the world who do not base friendships off of purely external factors such as looks or a skin blemish”. Alternatively, they could say to themselves “there is nothing wrong with how I look, my Psoriasis does not change who I am as a person.”
A study in 2014 (Shah & Bewley, 2014) talks about a woman who sought out psychological treatment from a dermatology psychologist specialist because she felt she wore her psoriasis as a “badge of shame”, which came about through her painful body self-image. As a young girl, she had been raped by a family member, after which point her psoriasis began. The study goes on to say that she had been in and out of therapies for years, including CBT therapy, but no one had ever really dealt with the feelings of shame and wishing for belonging she held towards her sisters and desire to be included. The study concludes that there is much work to be done in the field of dermatological psychology, and people with psoriasis really need a much more holistic intervention approach when being treated.
Having painful thoughts about one’s psoriasis that affect self-esteem, body image, and overall confidence in one’s abilities and overall functioning is normal. Our goal here at 7Chairs is to help our new friends overcome these thoughts and feelings so that they once again can live the happy, confident, and capable lives that they deserve.
**Shah, R., & Bewley, A. (2014). Psoriasis: the badge of shame’. A case report of a psychological intervention to reduce and potentially clear chronic skin disease. Clinical and Experimental Dermatology, 39(5), 600–603. https://doi.org/10.1111/ced.12339