Coping with other people’s reactions

13/02/2020 - By Dr. Catherine O'Leary

post preview

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. 

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.