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Episode 4

Skin in Psychoanalysis

Jorge Ulnik MD, PhD

Buenos Aires

“The skin disorder got worse every spring time coinciding with the time of the death of his father.”


Harvey Schwartz welcomes Dr. Jorge Ulnik, who is a Training and Supervising Analyst at the Argentine Psychoanalytic Association. Dr. Ulnik has devoted his professional career to the mind-body interface especially as it expresses itself in psychosomatic conditions and even more focused in the world of dermatology. He writes about the psychoanalytic approach to dermatology for medical journals and has lectured around the world on this subject. He has published 22 papers in Spanish in addition to 7 book chapters in 2 books and his latest book in English, called Skin in Psychoanalysis

In this episode Dr. Ulnik talks about his extensive clinical experience in this area, his work with individual patients and the conceptual thought that backs up this clinical approach.

Key Takeaways:


[3:05] The contributions of psychoanalysis to dermatology.
[4:49] Parallelism between the functions of the skin and the ego.
[5:10] Joint consultation.
[7:11] Integration challenges.
[8:28] Treating psychosomatic skin disorders.
[10:22] A case where integration was successful.
[13:56] The emotional background of Dr. Ulnik’s patients.
[14:15] Lack of touch.
[14:45] The gaze: being seen through a skin disorder.
[17:05] Being seen and being known.
[18:40] Formal representations. The Skin Ego by Didier Anzieu
[20:31] Access to affect in psychosomatic patients.
[21:20] Action vs. words.
[22:30] Intense suffering as a result of feeling certain emotions.
[24:20] The skin as a mirror to project emotional pain.
[25:06] Skin patients need to be touched.
[27:40] Analyst takes on the sense of darkness.
[30:25] Threat of being cured from a skin disease and instead becoming disorganized or going crazy.
[31:37] Interchangeability of somatic symptoms.
[33:17] Localization of lesions in the body.
[34:58] Finding order when the nonsense is commanding the situation.
[35:40] Humor and metaphor as splendid tools to work with in psychoanalysis.

Recommended Readings

Connor, Steven. The Book of Skin. Reaktion books, London, 2004.

Lemma A. Under the Skin. A Psychoanalytic Study of Body Modification. London: Routledge; 2010.

Schur M. Comments on the metapsychology of somatization. Psychoanalytic Study of the Child 10: 63-68.1955.

Ulnik, J. Skin in Psychoanalysis. Routledge, London 2007

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Jorge Ulnik
Jorge Ulnik