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October 1979

Exploratory Psychotherapy in the Treatment of PsoriasisTwelve Hundred Years Ago

Author Affiliations

From the Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine.

Arch Gen Psychiatry. 1979;36(11):1242-1245. doi:10.1001/archpsyc.1979.01780110096012

• Twelve hundred years ago, Jasālīq, a Persian physician, treated a patient who was suffering from psoriasis. Although psoriasis was not clearly differentiated from leprosy in the West until the 1840s, it was clinically described and differentiated as a separate entity in Persia in the eighth century AD.

In this case history reported in one of the oldest Persian texts, Chahar Maqala, written in 1155 AD, the physician formulated a dynamic relationship between the outbreak of psoriasis in his patient and the existence of severe interpersonal conflicts. In treating his patient, he skillfully used therapeutic modalities that are now prevalent in exploratory and psychodynamic psychotherapy. The techniques of developing a therapeutic alliance, therapeutic confrontation, clarification, dynamic interpretation, and exploration of intrapsychic and interpersonal conflicts are in accord with our present concepts of exploratory and dynamic psychotherapy.