However an individual with anxiety or tension symptoms may have a skin disorder that is unrelated to his stresses. Moreover, some disorders may occur more frequently in neurotic people yet not be caused by their neurosis, just as atopic eczema occurs in people with a tendency for allergies although eczema is rarely allergic. Likewise the flaring up of a skin lesion following an emotional upset is not necessarily proof of psychogenic origin. Psychic factors often ‘trigger’ an eruption which can be easily misinterpreted as a psychogenic disease. For instance, an attack of herpes simplex may be precipitated by emotion, but it is not psychogenic—rather the causative factor is a virus.

The reverse of this situation is the crediting of a therapeutic result to some physical therapy—such as creams, tablets, X-rays etc.—when in reality unrecognized psychological components in the therapy are responsible. When one doctor gets good results by dietary means, another by allergic management, another by eradicating foci of infection, and when the practitioner of one school is unable to repeat the results of the other, there is a strong liklihood that the factor common to all is psychological. Large doses of the doctor himself are often the curative agent.

On the surface the doctor-patient relationship is one in which a sick person requests help from an individual trained in medical science. There is however an emotional substratum, often not recognized by either party, having to do with one of the oldest relationships in human life: that between parent and child. Even in these sophisticated and perhaps sceptical days, the patient unconsciously fits the doctor into the prototype of the wise, omnipotent, loving, giving, parent, and much of the benefit of any type of treatment derives from this transference. It must, however, be remembered that many general physicians and specialists are extremely stress-ridden themselves— indicated by frequency of heart attacks, suicide etc.—and this may be one of the reasons many of their patients are turning to less conventional methods of stress relief.

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