Hives and intense emotions

Townsend Letter for Doctors and Patients, May, 2006 by Robert A. Anderson

In this classical 1950 study on a volunteer subject, after baseline measurements demonstrated no forearm skin response to mechanical stroking and exposure to very small amounts of pilocarpine and histamine, the subject was then engaged in a discussion of a disturbing topic, which caused the patient to feel abused and angry but helpless to do anything about the situation. At the height of her troubled state, repeat exposure to stroking, pilocarpine, and histamine caused a vigorous urticarial hive reaction. Soon thereafter, after calming words of reassurance, exposure to the stimuli yet a third time resulted in no reactions whatsoever.

Graham DT, Wolf S. The pathogenesis of urticaria. experimental study of life situations, emotions and cutaneous vascular reactions. J Am Med Assoc. 1950 Aug; 143(16):1396-1402.

COMMENT: This is the emotion-body effect, analogous to the mind-body effect. Intense emotional trauma can precipitate organic processes, including plaque rupture (heart attack), congestive heart failure, and metastatic cancer recurrence. Practitioners so often ignore the emotional component of any disease entity. For instance, depression is perhaps the greatest one-year predictor of not doing well after a heart attack, but it is often ignored. When it is recognized, the most common response is pharmacological. The most therapeutic gambit would be to listen to the patient and invite emotional expression, as demonstrated in this next study.