The repressed person: when the skin erupts (acne rosacea)

Daniel, a 36 years old public relations man, had been afflicted with allergic symptoms and other dermatological problems ever since he was child. At age 22 he received the diagnosis of acne rosacea, a chronic skin disorder that affected most of his face.

His job was adversely affected, as it depended very much on physical appearance to please his clients. Daniel was aware that the symptoms worsened after family fights. As an introvert he did not react to brotherly provocation and tried to keep their fights under control. He was considered the family mediator. According to Daniel his marriage was fine: his wife was very demanding but he knew how to avoid fights. Denise Ramos treated this case in only a few sessions using the sandplay technique and reports two scenes that reflect the transcendent function at work.

In the first scene Daniel put his hands in the sand and left deep imprints. He had the sensation of a deep uterus and felt sheltered. The handprints depicted a recognition of his own self and the taking possession of a territory. Being a middle son in a family of various siblings he had never had his own space and had always given his place over to his more aggressive brothers. Daniel was moved by the image of his hands and realised how little he used his hands to express his emotions.

In the second scene Daniel draws a volcano spouting powerfully with cars driving around it that pay no attention to the danger. He cries a lot after finishing. The symbol of the volcano became central in the amplification process and was the central metaphor for his acne. Through it he was able to perceive how much he was repressing his emotions by always being submissive. Raised as a fervent Roman Catholic he thought he should always imitate Christ by “turning the other cheek” and had great difficulty expressing his feelings and repressed anger. The cars run close to immanent danger, representing his idealised persona, which, indifferent to danger, sought always to appear calm and in control of the situation.

The “third” in the symbol of the volcano that was produced by Daniel engaging his unconscious led, through association and amplification, to his realisation that the acne rosacea was the exploding volcano and the pus that ran down his face a lava of emotions he had repressed for so many years. This allowed the new attitude, as a liberating force, to set in and Daniel began to voice his anger, no longer serving as a mediator of family conflicts. Furthermore, his opinions destabilised the family relations that counted on his apparent good sense. As he began letting go of his aggression his skin improved dramatically and he was able to make conscious the unconscious feelings and emotions, via sand and then verbally, that were affecting the relationship of ego to Self.