The Shame of Psoriasis

What are people thinking about you when they look at you?

OMG how ugly
She looks dirty
That’s disgusting
I don’t want to go anywhere near him in case I catch it

It’s tough to live with those thoughts going around your head and little wonder we try to hide our skin and cover up.

People with psoriasis often rate other people’s reactions to their skin as the main difficulty with the condition.

But are you sure you’re always right about what people are thinking?

A psychology experiment carried out in 1980 took a group of women and made them up with fake scars. The women, who thought they were ‘disfigured’, then had a conversation with a stranger who knew nothing about the experiment. After the conversation, the disfigured women felt stigmatised. They were more aware of the stranger’s behaviours like staring and related this to their appearance. They thought the stranger was reacting negatively to the scar and this affected how favourably they rated the stranger. What women didn’t know was the experimenters had actually removed the scar before the conversation took place so any negative reaction to the (non-existent) scar was imagined. This study tells us that believing you look different heightens your awareness of other people’s behaviour and you are more likely to interpretate their behaviour as negatively related to your appearance – whether or not that is actually the case. Because of this, you are less likely to warm to strangers.

There’s no doubt some people are rude, unpleasant and insensitive. I’ve met a fair few of them. I’ve written about one particularly upsetting encounter here. But perhaps it’s not quite as bad as you think. Try some CBT and see if there is a different way of thinking?

 

Reference

Kleck RE and Strenta A (1980). Perceptions of the impact of negatively valued physical characteristics on social interaction. Journal of Personality and Social Psychology, 39 (5), 861-873.

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Sun, Sand, Sea and Psoriasis

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It’s beach weather and that can be very stressful for people with psoriasis. Whilst most people are thinking about sand castles and seashells, we are thinking about skin, skin, skin.

Our options for the beach are:
* Stay away
* Go but cover up
* Brave it in beach attire

Neither option is the right one and I have done all three at various times in my life. Here are my beach tips whether you decide to cover up or strip off.

1. Pick the right swimsuit. In my time I have worn long surf shorts with a tankini top and I also own a stylish modestkini (yes that is a thing!). I wear a wetsuit to swim in the sea which is quite sensible on the Welsh coast even when your skin is perfectly perfect.

2. Wear sunscreen. Whilst the UVB rays can be helpful, burning never is.

3. Try waterproof camouflage make-up. I spent a wonderful afternoon with a Red Cross camouflage make-up consultant and I came away with a prescription for my exact skin colour. The service is now provided by Changing Faces. I urge you to book yourself in and see what a good concealer can do.

4. Use a few windbreaks. It will give you privacy, as well as keep the sea breeze from chilling you.

5. Let your children/partner/beach buddy bury your legs in the sand. Cover your plaques, exfoliate and keep them entertained at the same time.

6. Be prepared for comments and questions so it doesn’t ruin your day if someone asks about your skin. Read this for more advice about dealing with unwanted attention.  This blog post might help too.

7.  Identify your thoughts that are making you feel anxious.  Try some CBT techniques to challenge them.

Enjoy!

Urgh what’s that? How to cope with nosey, ignorant and plain rude people when you have psoriasis

 

Hands up if you’re too scared to show your skin, psoriasis and all.

Me too.

What is it we’re afraid of?  That people will judge us or be disgusted by our skin?  Are we afraid of attracting unwanted attention or that people will be cruel?

I’m a consultant clinical psychologist and my training in cognitive behaviour therapy (CBT) tells me that my fears are based in faulty thinking. I can challenge my thinking by telling myself most people won’t notice my psoriasis and those that do, won’t judge me.  I don’t judge people and I’m not so special, so why do I assume that everyone else is judgemental?  So I know how to do CBT and I know it can work really well.  Then why am I still scouring the shops for long sleeve dresses and wearing trousers on the hottest day of the year?  I’ll tell you.

I was 17 and it was summer.  We had planned a girl’s night out in the village pub.  I had a lovely dress I’d never worn and I braved it with bare legs despite the plaques.  No-one would notice I told myself and besides, my dress was gorgeous – that’s all anyone would see.  We got served at the bar, despite being underage, and spirits were high.  And then I heard him, ‘Oh my God.  Look at her legs.  It’s disgusting.’  I froze, drink in hand, cheeks flushed and held my breath.  Was he talking about me?  And then I felt someone poke my leg, actually physically touch a plaque of psoriasis, and the group of young men behind me broke into delighted screams and laughter.  I said nothing.  I wanted to die.  My friends moved around me protectively and glared at them, trying to change the subject.  I don’t remember saying much for the rest of the evening, barely moving, hardly breathing, wishing for a power cut so I could escape under the cover of darkness.  When I got home, I cried and cried until I was exhausted.  Thinking about it makes me shake even now, nearly thirty years later.  This experience means CBT will never work 100% for me.  And it’s not the only time someone was thoughtless or downright mean about my skin either.

So if CBT doesn’t work, what’s going to help me face the world in my swimming costume?  If I do get unwanted attention, I need to be prepared.  I need to have thought carefully how I am going to respond to questions and comments and then practice saying it in front of the mirror or with a friend so when it happens, I respond automatically rather than freeze.

A good response to the ‘Oh that looks sore’ comment is an explanation (It’s psoriasis), followed by reassurance (It looks sore but it doesn’t hurt), followed by distraction (Have you been here before?).  Distraction is a great skill and once you learn how it is easy to change the direction of a conversation your confidence will soar.  People love to talk about themselves and very soon they will have forgotten about your skin.  You can read more in earlier blog post.

For the unkind comments, you might want to have a couple of witty comebacks up your sleeve.  I wish I’d said, ‘’Does it take a lot of practice to learn to be so rude?’ in the pub all those years ago.

Someone once told me that when a complete stranger approached her to tell her how sore her psoriasis looked, she would clasp them in a warm and close embrace, thank them for their concern and say, ‘It truly is a terrible disease and horribly contagious’.  Not true of course but made her feel so much better.