When an Itch Is More Than Skin Deep
In my practice I found that the cause of a chronically itchy skin (pruritus) is most often physical. Perhaps dry skin, something in the diet, bedding, an allergy, or other medical cause.
However, sometimes the cause is not to found in the physical. Then we need to look beyond the skin itself, and into the mind.
The Skin Is Both a Boundary and a Meeting Place
Dethlefsen and Dahlke, in The Healing Power of Illness, describe the skin as existing between the two poles of separation and contact.
On the one hand, it forms a physical boundary between ourselves and the outside world, protecting us from our environment.
On the other, it is one our main ways of making contact with that environment. We touch and are touched through the skin. We experience warmth, cold, pleasure, discomfort and physical closeness through it.
There is also an obvious connection between the skin and our emotional state.
We blush when embarrassed. We may become pale with shock. We sweat when nervous. We get goosebumps when frightened or deeply moved. Dethlefsen and Dahlke point to these familiar reactions as examples of psychological processes becoming visible through the skin.
What Is Irritating You?
The psychological interpretation of itching becomes particularly interesting when we look at the language we naturally use. We say:
Something is bugging me.
That really irritates me.
He gets under my skin.
I'm itching to do something.
These expressions existed long before anyone tried to develop a psychological theory of pruritus.
Dethlefsen and Dahlke focus strongly on this language. They describe itching as a form of stimulation. Something can stimulate us pleasantly or unpleasantly. We can be excited, irritated, fascinated, provoked, attracted or angered. All are forms of being stirred by something.
From this perspective, an itch can become an interesting question:
Is something in my life demanding my attention?
That does not mean that an emotional problem has caused the itch. Nor should we search for psychological meanings before considering ordinary physical explanations.
But when itching persists and the obvious causes have been explored, the question may be worth asking.
Scratching Beneath the Surface
Dethlefsen and Dahlke take the metaphor one step further.
When something itches, we scratch.
Scratching is almost a miniature form of digging. They suggest that, symbolically, the person with pruritus may be trying to get beneath the surface and discover what is irritating, exciting, angering or disturbing them.
Is there anything that has been getting under my skin lately?
The difference is important.
One imposes an interpretation.
The other begins an investigation.
A Student I Treated
I once treated a lady from Indian who came to me with a persistent acne.
I began where I normally begin: with the more straightforward possibilities. We looked at her diet and other possible physical or environmental influences.
After three month nothing had changed. Then she spoke the stress around her university examinations., the problem appeared to be connected with the considerable stress she was experiencing around her university examinations.
Questions Worth Exploring
"Linguistically, the general idea of itching and scratching has a purely psychological meaning:
I'm itching to do it, we say, or again, I was tickled pink.' Now itching and tickling are both forms of stimulation, and the verb to stimulate covers a whole spectrum of experience ranging from simple charm, delight, fascination and attraction, through common-or-garden tickling, teasing, provocation and/or irrita-tion, to outright excitement, thrill and arousal. While it is true that many of these words have possible sexual connotations, we should not let sheer sexuality blind us to all their other meanings and possible references - many of which may appear at first sight to be contradictory. We can "irritate' people in an aggressive way, and yet at the same time we may describe the mood of a delightful evening as 'stimulating'. If something 'excites a fascination' for us, it arouses something in us - be it sexuality, aggression, affection or love. Thus, is it not possible to attach any single, clear valuation to the idea of stimulation. For us it is ambivalent. None of us can be certain whether we shall find any given stimulus delightful or be irritated by it. All that can be said is that a stimulus stimulates us. Even the Latin word prurigo means not only 'itching but also "lasciviousness' and lust', while the corresponding verb prurire means "to itch'.
A physical itch shows that something is biting' us or 'bugging' us on the psychological level. Yet evidently we have ignored it or refused to notice it on that level, or else it would have had no need to somatise itself as an itch in the first place.
Behind the itching stands some powerful emotion, some inner fire, some burning issue that wants to come out into the open and be discovered. That is why it itches and so makes us scratch. Scratching is a mild form of scraping and digging. Just as we scrape and dig the earth in order to find something buried and bring it to light, so pruritus patients scratch the surface of their Skin in order symbolically to find what is bugging them, biting them, needling them or exciting them. Once they have found out what is making them so edgy they feel less itchy. And so itching always warns us of something that is biting us' or 'needling us'. It informs us of something that, far from leaving us cold' is burning us up inside: a glowing passion, a fiery enthusiasm, a burning love or even a flaming anger. No wonder, then, that itching so often goes with Skin eruptions, red spots and in-flamed 'places'. The challenge is to keep scratching around in our consciousness until we have found what is really biting us. It promises to be a truly stimulating experience!
In the event of skin-problems and eruptions, the following are the questions to ask yourself:
Dethlefsen and Dahlke finish their chapter of skin problems with questions concerning boundaries, contact, intimacy, what may be trying to come into awareness, and what is quite literally “getting under my skin.”
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Am I limiting myself too much?
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How easy am I finding it to make contact with other people?
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Is there a repressed desire for intimacy behind my tendency to reject others
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What is it that is trying to burst through the barriers so as to come to light? (sexuality? instinctiveness? passion? aggression? enthusiasm?)
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What is it that is really 'getting under my skin?”
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Have I condemned myself to solitary confinement?
