Psychosomatic skin disorder in an adolescent: wounded by gaze and tongue-lashing

This article presents a psychoanalytic exploration of a psychosomatic skin disorder in an adolescent girl, focusing on the intricate relationship between early maternal interactions, affect regulation, traumatic experiences during the transition from the predominance of tactile and imagistic modes to the primacy of language, and the emergence of skin symptoms. Drawing on a detailed clinical case, the study explores how the skin may function as a site of expression for emotional experiences when verbal articulation is inhibited or unavailable. The patient’s recurrent eczema is understood not merely as a medical condition, but as a message in a bodily mode of communication rooted in early childhood experiences of inflicted physical and emotional injury, imposed silencing, and maternal neglect. Through repetition compulsion and object choice organised around a unitary trait, unconscious conflicts and associated affects were re-enacted within relationships and expressed through the body, resulting in treatment-resistant skin symptoms. The paper argues that when bodily and affective experiences rooted in early childhood cannot be symbolised in language, they may return in the form of psychosomatic symptoms, with the skin assuming the role of a messenger. Clinical implications are discussed, including the demonstrable impact of psychoanalytic treatment on the amelioration of these symptoms. This study also emphasises the importance of psychoanalytic work and interdisciplinary collaboration in cases of treatment-resistant dermatological conditions of psychic origin.