Book Review - Skin Deep: A Mind/Body Program For Healthy Skin by Ted A. Grossbart, Ph.D., 1986, William Morrow and Company, N.Y. pps. 280

Reviewed by John A. Speyrer

"Man is the only animal that blushes - or needs to."
-- Mark Twain

Skin Deep looks at skin disorders from a psychosomatic viewpoint. Although not discounting the effects of heredity, clinical psychologist, Ted A. Grossbart, believes that our skin disorders are symptoms of a deep, oftentimes repressed, much earlier frustrated need.

He feels that the roots of many skin problems have psychological origins of long ago -- sometimes even before birth. No, he does not recommend that we re-live our birth and inutero traumas in therapy, but he does recount the fantasy of one of his clients who said that the ultimate solution to her continuous itching skin was to be covered with cold cream and placed in a tight sack!

By listening to your skin you can find out what it is trying to tell you. It may be your repressed feelings crying out for "love, respect and protection." Perhaps, your skin is crying out for touch. A baby can go from needing love, crying for love with a tantrum and then develop infantile eczema. The author believes, "Unfelt unexpressed anger is the most common psychological mechanism beneath troubled skin." (emphasis in the original). You might not remember because of repression, but your skin remembers! Grossman lists eleven different ways that the largest organ of the body, the skin, can reveal its secrets.

He believes that certain mental exercises can force our mind to tell us the cause of our skin diseases. He asks, "What do you see in childhood photographs?" "How do you dress?" Even the timbre of your voice. he writes, can be revealing. Dreams and fantasies, when analyzed, also have a lot to tell us. Even what we forget can be significant. And then there is that deep quicksand quagmire of emotions -- our troubled relationships. These and other behaviors, uncomfortable feelings and attitudes point to earlier similar emotions that we do not recognize.

Why does our skin choose to get worse at times? If we need nudging to find out, Dr. Grossman recommends keeping a biographical time-line from conception (that's what he wrote) to the present time. Listing the important events of our life will necessarily include everything which made us what we are and will also contain the secrets of the origins of our skin disease. When symptoms wax a present day time-line chart will answer the question, "why now?"

The author includes the interesting Griesmer Index in Skin Deep. It shows how long it takes for an emotional upset to trigger an episode or an exacerbation of a long list of skin diseases. Although very conservative, it gives a rough idea of the importance of emotional triggers in inducing flare-ups in specific skin disorders.

Yet even if a skin sufferer pays close attention to the "time-lines" and the Griesmer index, he will soon notice that recognizing cause and effect is not always logical. Asking "why now" might not give you a answer. Sometimes it seems that there is no connection between our present upsets and the waxing and waning of our skin symptoms. Horrendous stress arises and yet your skin condition does not deteriorate. For example, Dr. Jacob Shannon of Israel mentioned that even in the most objectively stressful situations (the Holocaust, for example) one's skin disorder might not get worse. The culprit, thus, is not universal stress. Sometimes the particular stress arises after the horrendous event is over. What gives here?


Shannon believes it's because there are two types of stress:

  • One which resonates with and thereby arouses the repressed memory of the earlier conflict because of a similarity of emotions in both. (For example, desertion by a parent when the client was a toddler and desertion by one's spouse - both can elicit the same feelings). I believe that it is highly likely that the skin of the child was adversely affected by the earlier event, and,

  • One which does not resonate with a past trauma.
But even if the stress which aroused the earlier repressed feeling is present, sometimes the skin will still not be affected. This I believe is because in "good times" when we are relaxed, our defenses are not galvanized and the energy from the repressed feelings can more easily arise and make us sick.

During World War II, in Britain, for example, there was less psychosomatic illness than before the war. With the arrival of peace, psychosomatic illness returned to its previous levels. The author seemingly looks at the problem from a different angle. He writes that when an unrelated health problem can "take over the task of paying dues their skin gets better." The skin symptom, he believes, then "can take a rest."

That is probably just another way of saying the same thing. In any event, Grossbart believes that "(n)o matter how painful, feelings themselves cause us less trouble than our efforts to protect ourselves from (feeling) them." This is because our part of our defended self still sees the earlier event and its accompanying feelings as a threat and has a need to protect us from their memory. We are adults now, but our child consciousness still sees the earlier event(s) as dangerous. When the event(s) occurred, they were a serious threat to our wellbeing. Our unconscious mind acts as though they still are.

In Part Two of Skin Deep, he writes about what we can do to help our skin to heal. Relaxation exercises, self-hypnosis, imagery, and biofeedback are all helpful. The author shows us how to create an ideal imaginery environment and has other suggestions for quieting our screaming skin. If all of his many suggestions fail, then one can turn to psychotherapy. Even then, that might not help. Grossbart analyzes the results of psychotherapy and reports the results as equivocal. Therapy requires work and you've got to be ready to do the digging that is required.

Relating to transference metaphorically, the author writes that ghosts from our past can interfere with our getting relief. He writes,

"These ghosts inhabit the twilight zone of the mind, where past and present meet and mingle. They are the shadows of fathers, mothers, other all-important persons -- as they were experienced very early in life. Just as unfinished business from childhood often generates or aggravates today's skin symptoms, these ghosts can intrude on, influence, even dominate today's relationships."

The author includes a factually important skin disease directory which he compiled by researching decades of scientific reports. The directory is thirty-two pages of explanations of thirty-four different skin conditions. He insists that one not focus too completely on the diagnostic label itself. It is the repressed feelings that are important, not its particular skin manifestations. The stress from those early feeling reminds the sufferer of the early hurt because the emotions involved are the very same. He repeats this many times, and I am happy that he does because it is the most important lesson to be learned from Skin Deep.

* * *


"When you feel you're overeacting to an apparently unimportant event, it's because you're also responding to all the earlier events, that the experience brings to mind. . . "
-- Ted A. Grossbart, Ph.D.

During the writing of this book review, strangely enough, my face itched! But it was really not strange since I am no stranger to skin disorders! As a child I was very bashful and blushed intensely and often. Anyone turning their attention to me for more than a few seconds often triggered a deep blushing reaction.

The symptom and the shame of having it was so uncomfortable that I did not attend my grammar school graduation exercises. By my senior year in high school the condition had improved to such an extent that I even appeared in our class play. Seemingly, the hormonal surge of puberty had covered over a multitude of symptoms. I became happier and more self confident. My grades improved considerably.

I began re-living my early traumas in 1974 in self-primal therapy. The regressions had happened spontaneously while I was in gestalt therapy ( See Diary of a Self Primaler ). One of my most vivid infantile crib primals dealt with visions of my mother's young face.

The primal visions were different from others I had had, as it was composed of changing montages of my mother's young face. Each image, in turn, after I viewed it became superimposed over the previous one, somewhat like a number of windows screens on a computer monitor. The many picture images appeared consecutively with the right and bottom edges of all of the previous images remaining visible! My mind was making a computer-like video presentation of hidden information which it figured I needed to know.

During the primal regression, I "saw'' her face as it had appeared to me during many different periods from my early infancy to later infancy. During the last of the series of changing images, I was drawn to notice my mother's eyes.

Her eyes usually looked tired, but their most important characteristic was their indifference. During the regression I saw her eyes from different angles. The tiredness was usually there. The uncaring indifference was always present.

As the deep feeling continued, I recalled my early childhood discomfort and phobia of people looking or glaring at me and immediately realized its source was the view I had of my mother's eyes when I was an infant! In college, I would drop a course if an oral presentation of a report was required, since being the center of attention for more than a few moments would embarrass me and make me feel anxious, shameful and inadequate.

And that is how I learned the origins of my early phobia of being looked at. I even was intrigued by the idea of being with women who were slightly cross-eyed - never realizing that their unconscious appeal was that I subconsciously felt that I would not get triggered into feelings of shame by them (at least not that way!). These women did not seem to be looking at me! The movie star, Karen Black, was very appealing to me for that reason.

Decades later I was to learn how both my fear of blushing and my attractiveness of such slightly cross-eyed women were tied in with early infantile trauma.


Rosacea is a skin condition which presents itself as a persistent flushing of the face, the nose and of the area around the nose. It also itches a lot. Two well known individuals with this condition are the 1920's and 30's movie actor W. C. Fields and ex-president Bill Clinton. Dr. Grossbart in Skin Deep, writes,

Studies have found typical rosacea sufferers to be anxious and vulnerable to feelings of insecurity and inferiority, sensitive to crtiticism, easily discouraged, shy and socially ill at ease. Guilt and shame are commonly described by these patients. They seem unusually dependent on the good opinion of others. . . . Another repeated theme is having to grow up prematurely, possibly due to the inadequacy or death of a parent or economic hardship. Social or sexual stress often triggers exacerbations."
Two days after I had done something for which I was very ashamed, the condition presented for the very first time. My face began itching, blanched then flushed, and in a day or so I had a full blown case of rosacea. Researchers and others have written that rosacea usually appears in those who almost always have had a history of childhood blushing.

My rosacea would get worse and then improve. The larger unattractive veins around and on my nose were zapped by my dermatologist and after a few years, with the use of medication, my symptoms subsided. I had concluded earlier that shame and humiliation were the feelings that had triggered the outbreak.

Even though I had had two decades of regressive relivings, I still had no insight into the cause of my rosacea because I had not uncovered my rosacea's true origins in my primal regressions. I knew that the source of this misery was to be found in my repressed feelings from early childhood and infancy, but there was no way that I could induce my mind to specifically dredge up those particular early hurts related to the skin condition.

A few years after I had experienced my first rosacea outbreak, I attended a primal therapy week-end group near New Orleans. One participant, after having regressed into early infancy, spoke of the toxic shame, humiliation and embarrassment he had endured as an infant. He explained to us that during the feeling he had the insight that his shame had been due to a lack of love from his mother.

His descriptions of the origins of his shame rang true and seemed probable for me also. But I considered this only as a plausible hypothesis. The identification I had with his truth was for me more on an intellectual rather than on a feeling level. But, for the first time, I could consider such an origin for my rosacea. Unfortunately, I was not able to tap into the sources of this possible truth in my regressive work. I would have to wait until my unconscious mind was ready to confirm or disprove my supposition.

Fast forward another few years. As I was walking for exercise in my neighborhood, I noticed a young woman walking towards me on the other side of the street. I looked towards her when we passed each other, thinking that we would exchange greetings. However, she did not look at me! I felt rejected as I usually do in such situations.

As I continued my walk, I became sad, although insightful, as to why I was feeling this way and began spontaneously thinking of how devastating it would be for an infant to realize that he was not loved by his mother. What situation, I thought, could be more embarrassing, humiliating and shameful than that?

While continuing the walk, I began accessing the ascending feeling and although not knowing what its contents were, realized that a regressive primal experience was online just begging to be released. I had no idea what material was breaking into my consciousness, although I realized that it was related to what I was thinking about. I was becoming more and uncomfortable because of the pre-primal tension.

I was only one block from home, so I turned around, hurried home, opened the door and laid on the living room floor. Within seconds, I had burst into tears and began feeling deeply and insightfully, the humiliation, shame and inadequacy I had felt as an infant when I had concluded in a crib that "my mother doesn't like me." What scenario could be more upsetting to an infant than realizing that since even its own mother did not love it, how could anyone else love him -- ever? It was such a shameful situation to be in that its mere contemplation would be enough to make a baby blush with shame!

And why, later in life, would being looked at, trigger in me a blushing reaction of shame?

Because it had been through my mother's eyes, while I was in a crib, that I had come to the conclusion that I was not liked by her. In her eyes I had seen the rejection - the same feeling of rejection which so upset me when I had again seen it in the eyes of women whom I had liked and whom I had wanted to like me. But, that's another story which I discuss in other articles on this website.

For an interesting article on blushing, see this article in The New Yorker Magazine, although it is not about its in depth psychological aspects.

Dr. Ted A. Grossbart's website containing many selections from his book, may be viewed at

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