Skin Deep: A Mind Body Program for Healthy Skin by Dr. Ted A. Grossbart - HTML preview

PLEASE NOTE: This is an HTML preview only and some elements such as links or page numbers may be incorrect.
Download the book in PDF, ePub, Kindle for a complete version.

(29-15)

Sex

Wife seemed strange

Sex now just

sexually

a memory

(39-75)

(39-75)

Other

Beat Fred

Cut back on

Moved to new house

at tennis

socializing

(31-10)

for first

(18-5)

(25-10)

time

Car trouble

Car trouble

Christmas (rough)

Car finally

(12-20)

fixed

Cat ran away “our child”

Mother-in-law running wild

House needs new roof

(29-50)

Below the line, list all the important events of your life just under their

appropriate years. Basically, these include everything that has made you the person

you are.

This definitely means family events, such as the birth of siblings, people moving

in or out of the house, deaths, and a major illness of anyone: parents, brothers,

sisters, grandparents. If your mother or father was absent for a time or if a parent got

a new job or was fired or promoted, include it. Put in even less tangible events, such

as a shift in relationships for instance, if you remember drawing closer to your

brother around the time you were fifteen.

As in the sample Time Line, add important events involving work and school:

starting school, changing schools, honors, dishonors, and graduations. When did you

start and leave each job? List all transfers, promotions, and shifts in duties. If

particular events on the job stick in your mind, such as a fight or especially

supportive relationship developing with a boss or coworker, put it in. Include big

moments in athletics and turning points in friendships. Things that disappointed you

by not happening are as real as things that did happen, so don't forget to put in the

time you didn't make the team.

Sexual events may be particularly important; jot down all the milestones. Going

way back, note when you first discovered the difference between little boys and little

girls, when you first played "doctor," when you first masturbated, or began to

menstruate. Include your first boyfriend or girlfriend, first kiss, petting, intercourse.

Any event that stands out in your sexual life deserves to be noted just because you

remember it: starts and ends of significant relationships, fights, high points, even

orgasms you'll never forget. (Note: here and throughout this exercise, don't skip

topics that make you uncomfortable. These may be the most important. If you wish,

use a code on the Time Line to ensure secrecy.) Childbirth and abortion are

important parts of your sexual history.

Your medical history is highly relevant. Place in its appropriate spot any

significant illnesses you've suffered, or any operations or major medical procedures.

Needless to say, put in everything dermatological.

If there's anything that impresses you with its emotional impact, give it space on

the Time Line, such as pets, family fights, trips and travels, periods when you were

depressed and didn't know why, any significant change or turning point. The rule is:

If it seems important, it is important.

This exercise is not the work of an afternoon. It's a personal research project

that you will have to live with for weeks, perhaps months. In my experience, many

people get impressive results quite quickly – in a few hours, they've gotten down to

basics, perhaps twelve of the most important events of their lives. After that, there's

often a long period where they return to the project from time to time, adding

important events as they come to mind, touching up, filling in, and refining the Time

Line.

Try posting the Time Line on your bedroom or bathroom wall so you can add

details as they occur to you. Once you get your mind on the proper wavelength,

information and memories gradually percolate and drift up to the surface. You'll

probably discover a wealth of material that was in "inactive storage" – accessible to

your memory but not immediately accessible. As you sift through your memory bank,

Find out more at http://www.grossbart.com

the most important things will emerge.

How can you discover what events, what needs, and what fears and emotional

tasks inhabit the deep parts of your mind, where today, yesterday, and infancy sit

side by side? It is here that your Time Line can yield the fullest dividends. Pressing

relentlessly to reconstruct these years that are both dim and distant yet vibrantly

alive, you are seeking to find out what makes you who you really are.

Constructing your Time Line is a lengthy task but one that will reward you with

insights all along the way, and once you've gotten the first ten or so pivotal life events

down, you've made a significant start. As you search for and wait for more details to

bubble up to the surface, relax. You're your own biographer here but you needn't

worry about the scrupulous standards of objective accuracy that bind most

biographers – our goal is psychological reality. If you remember that your mother

was out of town for six months when you were five years old and she tells you that in

fact she took a two-week trip to Baltimore when you were seven, your version is the

"right" one for your purposes. As a small child, you experienced her loss as

prolonged: the distortions of memory are a lie that tells the truth.

Help from relatives may be invaluable when you're trying to reconstruct early

events, which deserve particular attention if your skin problem began when you

were young. Find out what you can about the big moments of those years, tapping the

memories of your parents, older brothers and sisters, and uncles and aunts. If you

were born with a skin problem, find out what was happening in your family during

the preceding year – this may have influenced the prenatal environment in which you

developed.

The Time Line is a wide-angle panorama that portrays your whole life at once.

Later I'll show you how to move in for a close-up of a critical period.

Now let's look at some striking research that will help us get the maximum

benefit from your Time Line.

If you've picked up a magazine or newspaper or turned on the TV news in

recent years, you've no doubt heard all about stress, and the way that emotional

experience can affect your body profoundly enough to make you ill. Studies have

linked diseases, including heart attack, ulcer, and infection, to stress. If (for genetic or

unknown reasons) your skin is your body's weakest link, it is here that emotional

turmoil is likely to take its toll.

What causes stress exactly? There's a general answer, which is useful, and a

more personal, psychological answer, which will be much more useful. According to

psychiatrists Thomas Holmes and Richard Rahe, there are certain events, like many

on your Time Line, that cause stress to everyone. Holmes and Rahe call them "life

changes." They developed a scale that lists major life change events and

approximates how much stress each would cause the average person.

Their Life Event chart, (a sample of which follows) covers the gamut of human

experience. The most stressful change is the death of a spouse, rated 100; divorce is

not far behind at 73. No one would argue the impact of these losses on anyone, but

some other stress sources may surprise you. "Changing to a different line of work" is

often a change for the better. We usually think of "Outstanding personal

achievement" as a cause for celebration. Yet Holmes and Rahe rate it almost as

stressful as "In-law troubles."xxv

Find out more at http://www.grossbart.com

The essential ingredient all these events share is change. Any change, good or

bad, forces your mind – and your body to adapt. If too much is demanded in too little

time, your body's adaptation energy is exhausted. Psychologically, all change involves

loss – a promotion at work, for example, means the loss of familiar duties, roles, and

relationships and loss means emotional and physical wear and tear.

The effects of stress and loss are cumulative. In a series of studies, Holmes and

Rahe asked subjects from different cultures and walks of life to score and total up all

their life changes from the past year. They found (with surprising uniformity,

considering the diversity of the people they studied) that those with a score greater

than 300 in one year had an 80 percent chance of falling ill. When the score fell into

the 200 to 299 range, the odds for illness were 50 percent. People who tallied 150 to

200 points had a 37 percent risk of health problems?xxvi

Can you see such a pattern behind your skin disorder? Examine the section of

your Time Line that extends a year before your symptom developed, note events in

the Holmes-Rahe Life Event chart, and add up your score. Do the same tabulation for

years preceding major flare-ups. You may want to compare these scores with

"normal" one-year periods of your life.

This is just the beginning, however. Holmes and Rahe studied the way people

respond to stressful events on the average. You are unique; what's important – here's

a notion we'll return to time and again – is the meaning of these events in your mind

and their effect on your body.

To take a familiar example, day-to-day irritations, such as parking problems and

fights with the boss, are also stressful. Yet individual reactions differ enormously.

Consider two men in the same traffic jam. One is fuming, tapping his fingers,

constantly rechecking his watch, and ruminating over time lost. The other has

resigned himself to waiting as an unattractive but inevitable feature of city life: he's

using the time to mull over a work-related problem while he listens to music on his

tape deck. On the same highway – perhaps in the same car – one man is under stress,

the other is not.

By the same token, your neighbor's divorce may be very different from your

divorce, and the 73 points assigned to this life change event on the Holmes-Rahe

scale may be inappropriate to both (even though it is accurate for the average).

''Troubles with boss" may have one meaning to a person who has difficulty dealing

with authority and an entirely different one for another who has achieved a

philosophical attitude toward the compromises we must make to earn a living. To the

first, such troubles "cost" far more than the 23 stress points assigned by the Holmes-

Rahe scale; to the second, far less.

To personalize your stress score, go back to your Time Line and reconsider the

years before your skin problem started and worsened significantly. List again the

significant changes that took place. Refer to the Holmes-Rahe chart again, but this

time adjust its point values up or down depending on what each event actually meant

to you.

Are these cumulative scores significantly different from your own first totals?

Can you see a pattern? Some people rate their own reactions consistently less intense

than the average, which raises some useful questions. Are they out of touch with their

feelings? Do they deny or suppress their emotions more than most people? Do you

Find out more at http://www.grossbart.com

rate certain events higher in stress than Holmes and Rahe changes – changes for the

better, such as promotions, for example, or relationship ups and downs? If so, you

may have unearthed a valuable clue to your needs, fears, and emotional tasks.xxvii

The question is: Where does your heightened reaction come from? Why is a

business failure, say, distressing but surmountable for Robert G. but devastating for

Horace T.? At every moment, in every situation, you react with a personality that

comes in part from your genetic heritage but that for the most part has been shaped

and molded by the experiences you've accumulated throughout your life.

To put it simply, your earlier years are not just part history. The emotionally

vibrant events that you never came fully to terms with are live and active in your

here-and-now life, vulnerable and sensitive, an emotional Achilles' heel. All the

losses, frustrations, and confrontations of your life connect like the links of a chain; if

you rattle one, all the others will rattle.

When you feel you're overreacting to an apparently unimportant event, it's

because you're also responding to all the earlier events that the experience brings to

mind – not one link in the chain but a dozen. The heart does not overreact. This will

become clear as you understand the past events that survive, alive and kicking, in the

parts of yourself that escape the laws of time.

Find out more at http://www.grossbart.com

NUMBER OF

SCALE

YOUR

LIFE EVENT

OCCURRENCES

VALUE

SCORE

Death of spouse

100

Divorce

73

Marital separation from mate

65

Detention in jail or other institution

63

Death of a close family member

63

Major personal injury or illness

53

Marriage

50

Being fired at work

47

Marital reconciliation with mate

45

Retirement from work

45

Major change in the health or behavior of

a family member

44

Pregnancy

40

Sexual difficulties

39

Gaining a new family member (e.g.,

through birth, adoption, oldster

moving in, etc.)

39

Major business readjustment (e.g., merger,

reorganization, bankruptcy, etc.)

39

Major change in financial state (e.g., a lot

worse off or a lot better off than usual)

38

Death of a close friend

37

Changing to a different line of work

36

Major change in the number of arguments

with spouse (e.g., either a lot more or a

lot less than usual regarding child

rearing, personal habits, etc.)

35

Taking on a mortgage greater than

$10,000 (e.g., purchasing a house,

business, etc.)

31

Foreclosure on a mortgage or loan

30

Major change in responsibilities at work

(e.g., promotion, demotion, lateral

transfer)

29

Son or daughter leaving home (e.g.,

marriage, attending oallege, etc.)

29

In-law troubles

29

Outstanding personal achievement

28

Wife beginning or ceasing work outside

the home

26

Beginning or ceasing formal schooling

26

Find out more at http://www.grossbart.com

NUMBER OF

SCALE

YOUR

LIFE EVENT

OCCURRENCES

VALUE

SCORE

Major change in living conditions (e.g.,

building a new house, remodeling,

deterioration of house or re hbmhood)

25

Revision of personal habits (dress,

manners, associations etc.)

24

Troubles with boss

23

Major change in working hours or

conditions

20

Change in residence

20

Changing to a new school

20

Major change in usual type and/or

amount of recreation

19

Major change in church activities (e.g., a

lot more or a lot less than usual)

19

Major change in social activities (e.g.,

clubs, dancing, movies, visiting ,etc.)

18

Taking on a mortgage or loan less than

$10,000 (e.g., purchasing a car, TV,

freezer, etc.)

17

Major change in sleeping habits (a lot

more or a lot less sleep, or change in

part of day when you sleep)

16

Major change in number of family get-

togethers (e.g., a lot more or a lot less

than usual)

15

Major change in eating habits (a lot more

or a lot less food intake, or v er y

different meal hours or surroundings)

15

Vacation

13

Christmas

12

Minor violations of the law (e.g., traffic

tickets, jaywalking, disturbing the

peace, etc.)

11

This is your total life change score for the past year

Source: The Schedule of Recent Experience (SRE), © 1976 by Thomas H. Holmes, M.D.

For example, suppose a major skin flare-up appears to have been triggered by

the breakup of a casual relationship, a rejection by someone who didn't mean very

much to you. Why the devastating effect on your skin? An introspective look

backward may reveal that loss and rejection loom large in your life story. Look back

Find out more at http://www.grossbart.com

far enough and you may find a similar loss in the childhood days when you were

most needy and vulnerable – the prolonged absence of a parent or a pronounced

emotional withdrawal – that sensitized you to the losses you would experience ten,

twenty, even forty years later.

To use an analogy, a person who is allergic to bee venom can suffer a violent

reaction, even die, when stung – not the first time but after one or more stings have

created a sensitivity. If such a reaction occurs, it is misleading to say that the "trigger"

was the sting that occurred two minutes earlier, ignoring the earlier ones that made

the person sensitive. To understand this vulnerability, you must look back over the

years; the stings of ten, even twenty years ago are still alive in the antibodies that

circulate in the bloodstream.

In reconstructing the events that inhabit the deep parts of your mind, your Time

Line yields its fullest dividends. Pressing to recapture those early years that are both

dim and distant and vibrantly alive, you are finding out what makes you who you

really are. As you fill out your Time Line with all the significant events that have

remained in your memory, be alert for motifs and patterns. Many of these events

have stuck with you because they are connected to your wishes and fears. Your Time

Line, then, is a map of emotional hotspots; the prominence of events having to do

with anger or rejection or loss or guilt may lead to a new understanding of emotional

tasks that keep your skin disease hard at work.

One of my genital herpes patients, for example, noted how childhood events

involving sexuality stood out on her Time Line. She recalled her parents' dismay and

her own shame when they caught her and a little neighbor boy "playing doctor." The

onset of menstruation was a moment of anxiety, again reinforced by parental

reaction. As her memories of those years became clear, she came to appreciate how

her early years had sensitized her to the whole issue of sex – how her parents'

discomfort had silently taught the lesson that sex was an anxious business.

Her herpes, then, had stirred up a feeling of uneasiness that had been planted

long before in her mind. Her genitals were now truly defective and unclean, as she

had always suspected. Herpes for her was more than a physical illness, but also the

focus of fears and anxieties with roots in the long-ago. Realizing the connection

between her troubled sexual feelings and her herpes anxiety was extremely

comforting: the distress now made sense given the logic of her own psychology; she

wasn't crazy to feel as bad as she did. She could begin to bring these feelings out into

the light of day and release herself from their grip.

Why was the remembered shame and anxiety my patient experienced when

discovered "playing doctor" important? This event, in itself, didn't shape