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As an area lost to the interest of American psychoanalysis since the mid-20th century days of Franz Alexander, “Psychosomatics” seem to be quite vibrant in some European countries and South America. As the Medical Director of “Psoriahue Medical Center” a center specialized in the treatment of patients with psoriasis in Buenos Aires—Argentina, Dr. Ulnik comes from an unusual background for those of us who are used to Anglo-American medicine/psychiatry.
Dr. Ulnik describes a fascinating organization—at the very end of the book. I will take the liberty to begin where he ends to provide a context to his unusual medical/psychiatric/psychoanalytic treatise. As per his report (pp. 236-238), the patients who come to this clinic have psoriasis and are treated in a state of art dermatology combined with a psychoanalytic approach. Upon entry, a team comprised of a dermatologist and a psychoanalyst consults with the patient. During this consultation the patient “shows” his troubles to the dermatologist or “speaks” about them to a psychoanalyst. If the patient is admitted to the facility, then, besides modern dermatological treatments of their severe skin condition, he/she joins psychoanalytic groups on a weekly basis. In these groups of “speech,” the traditional “observer/visual” doctor par excellence, the dermatologist—continues with his role and observes the sessions. These groups of five to eight members last from 1 to 6 years and it is not unusual that the members enter individual psychotherapy.
With this unusual experiment in his personal background, Dr. Ulnik opens his book with a chapter on Freud where he follows all the references Freud made to “skin” in his oeuvre. This covers almost all of the Strachey “Standard Edition,” including references to the “Project for a Scientific Psychology.” Dr. Ulnik locates, summarizes and expands on Freud's concepts of “skin as an erotogenic zone,” “relation of skin to unconscious,” “contact and contagion” and many others. “Touching driv