The Remarkable Life of the Skin by Monty Lyman

Author:Monty Lyman [Lyman, Monty]
Language: eng
Format: epub
ISBN: 9781473555358
Publisher: Transworld
Published: 2019-07-10T23:00:00+00:00

7

Psychological SkinHow the mind and skin shape each other

‘Strategies of concealment ramify, and self-examination is endless.’

JOHN UPDIKE, SELF-CONSCIOUSNESS. THIS CHAPTER ‘AT WAR WITH MY SKIN’ WAS DEDICATED TO HIS PHYSICAL, MENTAL AND SOCIAL BATTLE WITH PSORIASIS).

The squat Maasai hut perched on the edge of the village, itself alone in an ocean of grassland bordering the Serengeti. I sat cross-legged on the floor directly opposite our host, Remi, who had invited me and Albert, a local doctor, to make use of his encyclopaedic knowledge of Maasai herbal medicine. We discussed the medicinal uses of savannah flora for humans and, more importantly for the locals, cattle.

After we had talked for a while, Remi beckoned into the hut a fourteen-year-old boy who had what his village and family considered to be an ‘incurable skin disease’. The boy was exhibiting a lumpy, violet-coloured rash with blistering across his forehead and both cheeks. The remainder of his body was unaffected. Tense blisters around the eyelids caused him to wince each time he opened his eyes. The condition had erupted some months ago and had been worsening. When Albert asked me to offer a diagnosis I was bemused by the odd pattern on the boy’s face. I glanced at Albert, who also looked flummoxed. A few probing questions, however, revealed that the boy was due soon to be initiated as a moran, a warrior. This entailed a test comprising months of walkabout, far from home. It was apparently not much more pleasant than the old practice of having to spear a lion. As the boy’s history began to unravel, it slowly became clear to us that he was secretly rubbing his face with the leaf of a specific savannah plant whose chemicals were widely known to cause sun-sensitivity and blistering. He was intentionally and successfully mimicking – indeed, creating – a physical skin disease so that he could stay at home to avoid the rite of passage. This condition, where the patient intentionally causes skin damage to simulate disease, is called ‘dermatitis artefacta’. It is a physical manifestation of a psychological problem. As well as feigning illness, dermatitis artefacta can bubble up from many springs of our psyche: from a call for attention following abuse or trauma, to the desire for medical attention in Munchausen syndrome.1 Albert jokingly called the boy’s condition ‘Monday syndrome’ as it often presents in children trying to avoid school. Skin diseases, particularly visible ones, are not simply physical but also psychological.

Skin is the cape of a continent, where we can look out at the blurry boundary where the oceans of mind and body meet. The relatively new field of psycho-dermatology navigates this border between the visible and invisible.2 Interestingly, the brain and the skin develop from the same layer of cells in the embryo – the ectoderm – and these old friends seem to be reunited at various points throughout our lives. The dynamic relationship between skin and mind, once an area of mystery and scepticism, is constantly being confirmed by science.

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