Until recently, I’d never heard the word “excoriation,” but now I know it was my primary symptom: “scratching so severe as to tear the flesh.” That’s what I did every night, clawing until blood flowed. I was shocked to read that neurotic excoriation is caused by emotional difficulties 98 percent of the time. I was taken to doctor after doctor from 1957 to 1971, but this was never mentioned; no one acknowledged that I had emotional problems. Perhaps my parents thought the problems would go away if they pretended they weren’t there. Maybe they were ashamed to admit their daughter might have such problems.
Nighttime was the hardest time. Without the day’s distractions, it was just me and my itching, me and my skin. Kids with severe eczema have an early self-awareness that comes from confronting themselves in the dark every night. The nightmare is your own body; the monster is you. This is emotionally devastating to a child because it breeds self-hatred; when you feel so bad, you think you must be very bad, what did you do that you’re being punished for? Parents’ reassurances are dwarfed by the power of the itch, like an evil spirit. It was basically a solitary struggle.
At age eight I was fascinated by Houdini because he had been able to escape any physical confinement, handcuffs, straitjackets, chains. I myself was put into straitjackets, handcuffs, chains, and gloves to keep me from ripping my skin to shreds every night. I would spend my nights figuring ways out of confinement; I’d wriggle my skinned and bleeding wrists out of the cuffs and tear at my flesh with a sense of triumph.
Eventually, I learned to stop myself from scratching by concentration: I tucked my hands under my butt and pretended they were paralyzed. But whether I struggled to free myself to scratch or to stop myself from scratching, I would only strive for a harsh physical control over my body. For three years, I was a wild animal with myself as prey.
I was a secretive child, always ashamed of my skin. Trying to hide, to pretend I was normal, to fool everyone by remaining mysterious, I lived in a fantasy world. I hated to explain my allergies: I told all sorts of lies, believing no one would go near me if they knew the truth. I became cynical at a very young age, hardening myself after so many disappointments: the doctors promising miracle cures, my parents promising miracles from God.
Looking back, I can see the sexual side of my eczema. I was able to touch and play with my body more openly than most children; strangers were always peering at and touching my naked body. I needed to have oils and lotions rubbed all over me, a task I particularly enjoyed when performed by my father. He gave me a good workout with his big, muscular hands.
Scratching was like ecstasy to me: digging my nails in and running them up and down my body was orgasmic; I moaned and grunted as I scratched and clawed myself.
I can remember the advantages. Everyone gave me and my skin attention; it made me important, although in a negative way. I got sympathy and affection that other kids didn’t get. It was a way to miss school, sleep late, be lazy and spoiled, feel special and unique, spend time alone and in fantasy, avoid social confrontations.
My situation was painful, but it was safe and familiar, keeping me dependent and afraid of risks. I always had an excuse to avoid an unwanted task?I was the exception to every rule.
Before age eleven, I believed a fierce vigilance the only defense against the all-powerful itch. The only relaxation I remember from those years was exhausted collapse after scratching myself into a frenzy, but then I learned to relax consciously.
This came about through my attempts to overcome my insomnia. Left to themselves, my hands would scratch automatically, and it was scratching that kept me awake. To keep my hands otherwise occupied, I held them up in front of me and touched the fingertips together one by one, watching them slowly move and lightly touch, thumb to thumb, forefinger to forefinger, down the row and back again. In this way, I hypnotized myself to sleep.
After a while, I realized that this not only helped me sleep, it lessened my desire to scratch. I wasn’t forcing myself not to scratch; I just didn’t need to. I was overjoyed with this new feeling: for once, I would let go of my vigilance and still feel safe. I then observed that my slow, deep breathing during this little exercise was in itself enough to relax me; soon, whenever I sensed a wave of fitful scratching approach, I’d close my eyes and breathe deeply to break the chain reaction.
I learned to defuse triggering situations. For example, if I exercised or got nervous to the point of sweating, I’d start scratching wildly. I believed I was allergic to my own sweat, and I convinced the doctors that I should be excused from gym class for this reason.
Then I developed an alternative. When I started to sweat, I’d relax by deep breathing and tell myself: “You don’t feel any itch. Your skin is fine. Sweating is okay. You don’t have to scratch when you sweat. Just relax, sit quietly until you stop sweating, and you’ll be fine.” With my relaxing and soothing self-talk, not only didn’t I itch, but the redness, welts, and hives that often accompanied sweating no longer appeared.
I learned to ignore the itch and my ravaged skin, leaving it to heal in peace. After years of ripping scabs off partially healed gashes and clawing them open to bleed and deepen, I finally learned to enjoy watching wounds heal.
I became able to limit my scratching to circumscribed areas. I’d allow myself to scratch my legs, for example, as long as I left the rest of my body alone. Then I gradually reduced the permissible area until there was no place left to scratch, or I’d first let myself scratch my arms, narrow that down to the hands, then to one finger. For some time, I had my scratching narrowed down to my lower legs, which I continued to use as a battleground. Since last year, however, I’ve been totally free of rashes, wounds, and itching. I’ve let the hair grow on my legs to seal that “tomb” forever.
Before, my hands had been the enemy, inflicting rape and torture on my innocent body. I hated them. Once I learned to relax, I made peace with my hands, treating them with the same tenderness and respect I wanted them to show my body. I learned to use them for healing. Saying, “What do you really want, skin?” I’d stroke the damaged, itchy areas, kissing them and rocking as I hugged myself.
I learned to communicate with myself, talking out loud. At first, I told myself stories to distract myself from scratching. Then I learned how to tell myself what I needed to hear. I would pretend I was my mother telling me that she loved me; then I’d speak in my own voice, saying how afraid I was that I’d never get better. And on and on, taking turns with voices until I’d said all I needed to say and hear. As I hugged and stroked myself, I’d cry and assure myself, “Don’t worry, I’ll take care of you,” creating my own support system for changing my life.
I began to tell myself?and believe?that I was doing my best at every moment: if I couldn’t control myself this time, I’d do better next time. “Can I stop scratching now?” I’d say. “If I can, that would be good. If not, that’s okay too?I’ll give myself five more minutes to scratch and then stop, but next time I won’t have to scratch at all.” I gave myself high praise when I didn’t scratch. The praise, I knew, had to come from myself since I no longer believed anyone else. I congratulated myself for keeping clear what areas of skin I could.
When I decided that I, not my parents or my doctors, was my own savior, I stopped worrying about other people’s infuriating questions, their warnings about scars, and their promises of miracles. I stopped worrying about looking ugly or causing a public scene by scratching when I needed to scratch. No longer ashamed of my uninhibited self, I started answering questions frankly and addressing people’s fears of contagion matter-of-factly.
I saw that I had a right to handle my disease in my own way, whether or not it was offensive to others. I claimed my right to be treated with respect, not like a leper or an uncontrollable child. I developed the confidence to go out in public, whether or not my skin was beautiful. I finally realized that no one was scrutinizing every pore of my skin, and that even if they were, it was none of their business and I was not obligated to look good for them.
I learned not to fear my emotions, gradually understanding how to deal with them calmly instead of falling, in an overwhelmed panic, into a chain reaction of scratching. Listening to my deepest instincts, developing a relationship with myself based on love, respect, and communication, I experienced a rebirth.
My strongest memories are of crying myself to sleep every night. My mother would come in and rock me and reassure me that she loved me and that maybe tomorrow there would be a miracle and I would be all better. I prayed for that miracle and waited for that miracle for a long time. Then I just stopped believing in God.
Shelley went back to school and is now a licensed psychologist in private practice. She works with people who have skin problems in San Francisco.
By Dr. Shelley F. Diamond
drdiamond@drshelleydiamond.com
