Psychotherapie bei Vitiligo (Weißfleckenkrankheit) in Berlin

Vitiligo (Weißfleckenkrankheit)

Auf dieser Seite erhalten Sie Informationen zur ergänzenden Psychotherapie bei Vitiligo (Weißfleckenkrankheit) im Allgemeinen und zum Konzept der ergänzenden psychotherapeutischen Behandlung der Vitiligo (Weißfleckenkrankheit) in meiner Praxis in Berlin-Charlottenburg-Wilmersdorf.

Die Vitiligo gehört zu den psychosomatischen Hauterkrankungen. Dies bedeutet, dass psychische Faktoren bei der Erkrankung ursächlich oder in der Folge eine Rolle spielen können. Die genauen Ursachen der Erkrankung sind noch nicht völlig aufgeklärt. Eine erbliche Belastung kann die Entstehung der Erkrankung bei einem Teil der Patienten begünstigen. Betroffene leiden in der Regel auch unter einer Fehlsteuerung des Immunsystems.

Die Diagnose stellt der behandelnde Hautarzt. Dieser sollte auch konsultiert werden in Bezug auf die nicht-psychotherapeutischen Behandlungsansätze: Medikamente zur innerlichen und äußerlichen Anwendung, Photo- und Lichttherapie, Verwendung von Salben, Ernährungsumstellung, Bewegungstherapie etc.

Leitsymptom der Vitiligo ist eine Depigmentierung von kleineren oder größeren Teilen der Haut aufgrund einer Degeneration der Melanozyten (Pigmentkörper, farbstoffbildende Zellen) durch erhöhte Konzentration von Wasserstoffperoxyd in der Haut.

Die genaue Entstehung der Erkrankung ist noch nicht geklärt.

Als Ursachen der Vitiligo kommen folgende belastende Faktoren in Betracht:

  1. Mechanische Reizung bestimmter Hautpartien an Händen, Gelenken etc.
  2. Traumatische Ereignisse in Form von Schnitten oder anderen Verletzungen der Haut, von denen aus die Depigmentierung sich entwickeln kann
  3. Die Einwirkung chemischer Substanzen bei induzierter Vitiligo z.B. durch ptButylphenol
  4. Hinweise auf Störungen des Immunsystems mit Tendenz zu Autoimmunreaktionen
  5. Erbliche Belastungsfaktoren
  6. Oxidativer Stress im Rahmen von Stoffwechselprozessen
  7. Vermutete Mangelernährung an bestimmten Vitaminen, Spurenelementen, Aminosäuren etc.
  8. Psycho-sozialer Stress

Die dermatologische Behandlung umfast in der Regel verschiedene Formen der Lichttherapie, die Verwendung von Salben, eine Ernährungsumstellung zur Reduzierung von oxidativem Stress und die Vermeidung von Mangelernährung sowie die Vermeidung von Curcumin (Curry).

In psychotherapeutischer Hinsicht sind von Bedeutung:

Verhaltensmodifikation zur Reduzierung von mechanischer Belastung betroffener Hautpartien, tiefenpsychologische Lösung psycho-sozialer Konfliktfelder zur allgemeinen und situativen Reduzierung von psycho-sozialem Stress und die Verbesserung des Umgangs mit den subjektiv als stigmatisierend erlebten Folgen der Erkrankung.

Zur Komplexität der psychosomatischen Aspekte: Für die Entstehung einer Vitiligo sind psycho-soziale Faktoren mitverantwortlich. Bedeutsam als Belastungsfaktor ist u.a. auch emotionaler Stress.
Sekundär kann die Hauterkrankung auch Ängste vor Ablehnung und Zurückweisung verstärken und so in die soziale Isolation führen und damit den psycho-sozialen Stress vergrößern. Damit wäre ein Teufelskreis beschrieben: unbewältigte Auflösung von Stressfaktoren, psychosomatische Erkrankung, sozialer Rückzug, Verstärkung psycho-sozialer Stressfaktoren etc.

Ein wichtiger Einstieg für die psychotherapeutische Behandlung ist die Grunderfahrung, dass Betroffene sich zu wenig geschützt in ihrer Haut fühlen. Die Haut schützt und vermittelt die Beziehung des Menschen zur Umwelt. Bei Vitiligo ist diese Funktion der Haut gestört. Betroffene können sich weniger gut von anderen abgrenzen, sind zu dünnhäutig und im Umgang mit anderen leichter kränkbar und weniger wehrhaft.

In meiner Praxis wird auf die Vitiligo mit den Methoden der tiefenpsychologisch fundierten Psychotherapie oder der analytischen Psychotherapie eingegangen.

Die Therapie begleitet häufig einen längeren Prozess der emotionalen Ausdifferenzierung der Persönlichkeit des Patienten und kann nur in Form einer Langzeittherapie durchgeführt werden.

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