Like most things that happen on this blog, this new category was not well thought out. Dr. Ted Grossbart saw that I posted on psychodermatology and suggested some more links that might be of interest to me. I checked the links out, found them interesting but had more questions (about the information and Dr. Grossbart). I asked if he would be up for an interview, not thinking he would say yes. But he did. So here I am, with a new category for my blog and a line-up of interviews waiting for you now. (Ironically, in my original e-mail to Dr. Grossbart asking for an interview, I explained that I was just a blogger interested in his topic, not a reporter from the New York Times. What I didn't realize was that he had been interviewed by the New York Times! Talk about performance anxiety.)
Dr. Grossbart is the author of Skin Deep: A Mind/Body Program for Healthy Skin. He is an assistant clinical proffesor of psychology in the Psychiatry Department at Harvard Medical School and a senior supervisor at Beth Israel-Deaconess Hospital. He specializes in the areas of psychological treatment of skin problems using relaxation, imaging, hypnosis and psychotherapy. Originally from Detroit, he now resides in Boston.
1. What do you see as the one thing that someone who knows nothing about psychodermatology would find interesting about the field?
The coolest thing about the field is that at this point most people are pretty clear about the point that stress makes things worse in a lot of ways with the mind-body connection. But what most don't realize is that it can work for you too, not just against you. People who are more vulnerable to the negative side, are also pretty vulnerable to the positive side too. (Take this quiz to find out how important emotional factors are in your skin condition.)
2. Have you ever considered starting a blog covering psychodermatology issues?
I consider myself an early adopter. I had a Web site up before most in the field did. And I'm looking into blogging but haven't really decided yet.
3. Have you had a lot of phone consultations? How would that work? Wouldn't you need to see someone's skin to help them?
I am having more and more phone consultations. I have consulted with patients as far away as India, France, Vietnam, Mozambique and Canada. But there are no physical examinations at all. I'm not a dermatologist. Generally, phone consultations are weekly and last for 45 minutes. It has been surprisingly effective - and several patients eventually come through Boston at some point and also have a face-to-face session. Some patients prefer the phone and some prefer in-person visits. It's just another option.
4. I see stress mentioned a lot in psychodermatology materials. What specific effects does stress, in general, have on our skin?
Stress brings many physiological changes to the body: changes in blood flow, moisture level, the ability to heal, resistance to allergens and immune system functioning.
5. Because we are so psychologically connected to our skin, how do medical professionals separate the physical manifestations of a disease from the psychological ones? Do you actually go through a form of psychotherapy while a patient to weed out the mental from the physical?
It's very rare that there's a pure case of one or the other, physical problems versus psychological ones. They are most likely in tandem. The skin problem is usually both medical and psychological.
6. Most all I've read has said that you were a kind of pioneer in this field. Did people think you were a bit nuts at the beginning? I know psychodermatology has gotten a bit more mainstream recently but 25 years ago it would have been quite a strange concept. Did colleagues support your research?
Twenty five years ago is just like today. There are more enlightened professionals who are very tuned in to new research and findings - and there's always a group that is quite skeptical. I was actually encouraged by dermatologists to explore more about the field of psychodermatology. In fact, it was a patient who incessantly itched and scratched for years who led me to study more about the psychological aspects of dermatology.
7. Is your book, Skin Deep, geared more towards a layperson or a medical professional?
It was written for both. But it is written in plain English and would be understandable for a layperson. The book not only describes what I do in the office in Boston, but also gives readers some things they can do on their own. So there's also a self-care manual. aspect to it. (Read excerpts from the book here.)
8. How do you keep your own stress in check, with a private practice and a teaching gig, in other words?
Private practice is not as stressful as other medical ventures, so I'm lucky in that regard. I enjoy sailing and do it as often as possible. I also exercise often and try to sleep and eat well.
Some people are naturally more resistant to bad stress. But it's not all negative. We need a certain amount of stress. We need to think about an optimal level of stress rather than just trying to get rid of it altogether. If you put someone in a sealed room with nothing around them, they are not going to have any outside stressors, but they are not going to be happy either.