PSYCHOLOGICAL ASPECTS OF DERMATOLOGY



In the homoeopathic technique the therapist listens to the tale of the patients every unpleasant sensation, and meticulously equates them with a remedy. In addition, and equally careful physical examination is performed. It would be a grave mistake to discount the effect of those procedures on the patients state of feeling.

Then there are the great healers, usually outwith the ranks of the medical profession, who claim to heal the sick through spiritual agencies. These practitioners, though wanting in scientific knowledge or critical assessment, are often possessed of infinite compassion and pity for the weak. Through this great love an ecstatic exaltation is aroused in the patient akin to that experienced in a love affair.

In submitting to any of these techniques the patient has not taken active steps to alter the pressure of his environment in his favour beyond acquiring a relationship with the therapist. He is cured, but relapses before long and must return to be re- cured. The situation closely resembles that of the young child when he recoils, bruised and battered from his contact with the outer world, back to his mother. She employs drug therapy, physiotherapy and psycho-therapy in giving him a sweet to suck, in stroking and fonding his body and in murmuring words of love and hope. His feeling change from despondency to confidence and he is ready to re-enter the fray.

As the child grows older, however, the good mother tries to equip him more effectively to find for himself pleasure, satisfaction and success in his environment. She cannot improve his hereditary endowment by granting him a more attractive appearance, a keener intellect, a more virile body or a livelier wit; but she can help him to make the best of the tools at his command. For instance, if he is unpopular with playmates and censured by teachers, she may enable him to gratify his need of esteem by advising him to admire the accomplishments of his fellows instead of boasting of his own, and of paying attention to his work in class and at home.

The doctors role is not dissimilar to the good mothers. He also is entitled to exploit the techniques of prescribing a medicine to be swallowed, of referring him to a masseur to be stoked and of encouraging him by the spoken word; but if the cure is to have real permanence he must do more. He can learn much by prompting the patient to talk of his domestic situation, his work and his associates and can deduce from the information received and the way it was given something of how the patient feels and has been feeling. If it should emerge that the patient is in a predicament which renders a healthy attitude impossible, his escape from it should be the easier from an appreciation of its significance. Such advice as the doctor can advance stems from his own first hand knowledge of life itself, rather than from his technical training.

My own therapeutic career is strewn with failures. Its first ten years were spent in blotting out symptoms with drugs in accordance with the orthodox teaching of the time. Then contact with homoeopathy led to the quest of the total symptoms picture and stimulated an interest in the whole man; but I could not stop short at the discovery of the drug which fitted the symptoms. When I learned, for example, that some women felt worse before, others during, and yet others after the menstrual period I had to seek a reason.

Then came my association, and later, friendship with Dr. James Halliday while he was engaged in his work on psychosomatic concepts. For a time I viewed the psyche in the manner of the orthodox psychological school, and found it a Herculean task to engender a spark of sympathy for those misfits whose lives were punctuated with endless complaints, despite constantly muttering to myself, “Without Charity I am nothing.” Latterly I found peace in the belief that the chronic sick are the victims of circumstance.

When they find themselves wed to an emotionally incompatible mate, or in jobs for which they are manifestly unsuited, they did not choose so and thus try to make their lives intolerable and their bodies the subject of biochemical imbalance and ever-recurting discomfort. They just lacked the wisdom or, perhaps, the good fortune to do what was best for themselves. The better we learn to know them, and the more effectively we help them to know themselves, the better we serve as doctors.

G. Gladstone Robertson