Is Psoriasis the Body in Overdrive?

Healthy skin has a developmental cycle of around 28 days. Normally a young keratinocyte gradually changes as it moves through the different layers of the epidermis. It flattens, develops keratin, loses its nucleus and eventually becomes part of the protective outer layer of skin.

In psoriasis this cycle is dramatically accelerated to just four or five days, so the maturation process is incomplete. The cells reach the surface before they are fully ready. The result is the thickened skin and characteristic silvery-white scale that we associate with psoriasis.

Skin Deep

The accelerated skin cycle presents an interesting mind/body question. If the cells are being hurried through their development before they have had time to mature, could there sometimes be some kind of underlying rushed or hurried mindset? The American psychologist Ted A. Grossbart, PhD, author of Skin Deep: A Mind/Body Program for Healthy Skin thinks there might be.

“Fast, Fast, Fast”

Grossbart's discussion of psoriasis becomes especially interesting when he turns to the accelerated skin cycle. He describes noticing a group of people with psoriasis who seemed to live at an extraordinary pace. His memorable description is “Fast, fast, fast.” They were often capable, intelligent and energetic people, but Grossbart felt that some were living not simply in high gear but in something closer to overdrive. They were continually working, achieving, organising, travelling or remaining busy. Although their individual histories were very different, there seemed to be a common difficulty with slowing down.

Grossbart then makes the fascinating connection with the skin itself. Psoriatic cells are also moving too quickly. They arrive at the surface without having had enough time to complete normal maturation, while the rapid production of new cells contributes to the continual accumulation and shedding of scale. Grossbart wondered whether the skin could, in some patients, be doing something remarkably similar to what the person was doing psychologically. He was careful to say that the medical connection was unclear. Nevertheless, he found the parallel useful when working therapeutically with some of his patients.

What Happens When We Slow Down?

Grossbart's deeper question was not simply whether a person should become less busy. He wanted to know why the person needed to keep moving. Sometimes constant activity protects us from something uncomfortable that becomes more noticeable when life becomes quiet. It may be anxiety, uncertainty, vulnerability, anger, grief or a need to remain in control. Different people will have entirely different stories. Grossbart therefore did not describe one universal psoriasis personality. Instead, he encouraged people to become curious about what might happen psychologically if they stopped running quite so fast.

This gives the accelerated skin cycle a particularly powerful metaphor. A healthy skin cell has time to be born, develop, mature and eventually be released. In psoriasis the process becomes hurried. New cells arrive before the previous cycle has been properly completed. Psychologically, we might ask whether something similar ever happens in life. Are we moving from one problem to the next without processing what has happened? Are we continually producing, responding or adapting without sufficient time for integration? Is there somewhere in life where there is too much speed and not enough maturation?

I would treat these as questions rather than explanations. Someone can have psoriasis and live a peaceful, unhurried life. Another person's psoriasis may be strongly affected by stress. Someone else may notice particular emotional triggers only during certain periods. The danger with mind/body theories is turning an interesting observation into a rigid formula. Saying “psoriasis means you are living too fast” is no more satisfactory than saying every headache means the same thing. The value lies in investigating the individual person and seeing whether the idea has any relevance to their particular circumstances.

Looking at Psoriasis Through Heilkunst

This individual approach fits naturally with the way I practise Heilkunst. I would never assume that the accelerated skin cycle alone explains why a particular person has psoriasis, nor would I begin by searching for a psychological conflict. I prefer to look at the whole picture. Diet and nutrition may be relevant. Stress may be relevant. Sleep, digestion, general health, environment, skin care and individual sensitivities may all provide clues. For one person the psychological element may be important; for another it may have very little importance at all.

Heilkunst means the art of healing, and I think of this work rather like detective work. We start with what is obvious and gradually explore what is less obvious. Grossbart's observation gives us another potentially useful clue. When I see psoriasis, I can look not only at the visible plaques but at what the skin is actually doing: growing, moving and renewing itself at extraordinary speed. From there a simple question emerges. Is anything else in this person's life also moving too quickly? Sometimes the answer will be no. Sometimes that question may open an entirely new door.

Perhaps that is the most useful lesson to take from Skin Deep. Psoriasis does not need to be reduced either to biology or psychology. The skin is biological, neurological, immunological and deeply connected with our experience of ourselves and the world around us. Understanding its accelerated cycle gives us an excellent physiological starting point. Grossbart then invites us to look one step further and ask whether the body's unusual tempo has any parallel in the person's life. Not as a diagnosis, and not as blame, but simply as another part of understanding the whole person.