In psychotherapy, the body and mind are looked at as one interdependent unit. Research shows that approximately 30 percent to 60 percent of people who seek out medical care for skin problems have some kind of underlying emotional issue, and these issues can inhibit an otherwise effective medical regimen. I often see adults still struggling with adolescent skin conditions who have unaddressed emotional issues also stemming from their adolescence.

There is a range of acne triggers, including hormones and genetics, but it is often the emotions that we are not tuned into that come out via the skin. I often tell my patients: If you can feel it in your heart, you don’t have to feel it on your skin. “Avalanching”—when a triggering stressor causes breakouts, which cause more stress and so on—also is possible.

For treatment, mental exercises such as relaxation, imaging, meditation, self-hypnosis, and focus psychotherapy (targeting the specific life issues causing the symptoms) can be effective. Imaging, for example, deals with the body’s ability to translate pictures from the mind into literal reality. Focus and concentration on an outcome, in this case clear skin, helps you achieve the goal. As part of a self-treatment program, these exercises can provide valuable diagnostic information and deeper understanding of emotions behind your condition.

–Ted Grossbart, PhD, senior clinical supervisor, Massachusetts School of Professional Psychology, and assistant clinical professor of psychology, Harvard Medical School, Boston,