Transactional Analysis and Psychosomatic Medicine: The Case of Psoriasis

Abstract

Psoriasis is a skin disease in which a sizeable psychosomatic etiological component is widely recognized. The research described in this article was aimed at identifying this component and describing is within the reference system of transactional analysis.

The initial hypothesis was that specific psychiatric disorders, or characteristic script patterns, might be associated with psoriasis or that these disorders or patterns might make patients particularly sensitive to stressors that frequently precede the onset of psoriasis. This hypothesis was not confirmed by the research data. Nevertheless, in 89% of the sample the onset of the disease was preceded by a psychological stressor, although it was generally mild. Only in 32% of the cases did it prove to be of at least moderate intensity. Independent of its severity, in all cases in which the stressor was detectable, it represented a direct threat to script beliefs. This led us to hypothesize that the unifying element in the psychosomatic development of psoriasis may be the undermining of script beliefs. These are for the patient a sort of “script identity,” and the threat that the stressor represents to such identity was experienced by the individuals in our sample as dangerous for self-perception.