Personality Typology and Treatment Phases in Patients with Self-Inflicted Dermatological Injuries

Background: The prognosis of patients with self-inflicted dermatological injuries has been rated unfavorable. To motivate the patients to accept psychotherapy is often difficult and requires close cooperation between dermatologists and psychotherapists. The present study comprises personality typology and the course of treatment of patients with self-inflicted dermatological injuries treated at the University Clinic for Psychotherapy and Psychosomatics in Halle over a two-year period. Patients and Methods: 18 patients receiving in-hospital integrative psychotherapy were examined at the beginning and 2 years after completion of therapy. Focus was on recording of psychopathology, psychodynamics, the doctor-patient relationship and the documentation of risk and protective factors. Results: The self-inflicted injuries usually occurred in the context of personality disorders. Psychodymanics enabled differentiation of two subgroups: a subgroup of patients who had grown up in an existentially threatening milieu in which physical integrity was violated and a subgroup subjected at the emotional level to experiences of withholding and aggression. The structuring of a three-phase treatment concept was an essential prerequisite to long-lasting improvement in symptoms.