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This week we break down how adjusting your attitude and being more mindful can help you in your life with psoriasis.

Welcome back! Last week we spent an entire seven days getting into the groove of daily meditation and learning how to just sit with our breath for a hot sec. Why are we doing this? Because meditation (even for just a few minutes) helps us slow down and de-stress, which can actually help us live better with a chronic condition, like psoriasis (click back to Week One for a primer). Reena Ruparelia and Evan Rieder, M.D., are back to help you get started on your own meditation journey to stop the stress-psoriasis cycle.
In her nearly 30 years of living with psoriasis, Ruparelia, of Toronto, Ontario, has learned a lot about playing the long game when it comes to managing this immune-related disorder that comes with itchy, sometimes painful skin lesions. And if you have psoriasis or really any chronic condition that requires lifelong management, you know there are times when you have to just sit and wait… for a symptom flare to resolve while doing your best to take care of yourself, for a new medication to start working. If any of this sounds familiar to you, then you’re already well on your way to becoming a meditation master.
Dr. Rieder is assistant professor of dermatology at NYU Langone Health in New York City and he’s one of only a few physicians in the United States who is board-certified in both psychiatry and dermatology. He sees the power of mindfulness exercises in his own patients’ lives. “There are a lot of things I recommend to people that I think are easy to do to help modulate stress levels and decrease them when done on a regular basis,” he says. “[Managing stress] can help regulate psoriasis, mood, and sleep.” All those things combined can translate to you feeling healthier and your skin looking clearer.
Week Two Goal: Up Your Meditation Practice to Five Minutes Every Day
This week, add a few more minutes to your daily meditation session. Try to get to a total of five minutes if you can. It’s going to feel more difficult to sit with your thoughts for that extended time, so know that these benefits await you: a calmer mind and calmer skin. Keep your eye on the prize!
This Is Not a Competition
Unlike climbing the corporate ladder, raising your kids, or reaching new personal bests in the gym, meditation isn’t about achieving an end goal, Ruparelia says. “This isn't about being the best, but just learning how to sit and when a thought comes up, bring it back to your breath. That’s it; there’s no goal here,” she says. Don’t get us wrong. It’s OK to have the goal of shedding stress to improve your disease management. But if we zero in on that goal during the act of meditating, it can have the opposite effect. “That will take away from the process completely. It’s about being in the journey with all its crunchy bits and mucky stuff,” Ruparelia says.
That includes boredom. If you’re thinking, “But meditation is just so boring; I can’t sit still for that long!” that’s the point. “The feeling of boredom is good to come up,” Ruparelia says. Boredom means your thoughts are not wandering; it means you’re focused on the here and now, which, honestly, won’t feel all that exciting if you’re sitting and meditating.
Adjust Your Attitude
“One of the things that’s missed with meditation is the attitude,” Ruparelia says. The truth is, no one expects you to sit still for over five minutes and think of absolutely nothing other than your breath. Other thoughts will pop into your head. The key is to have an attitude of “nonjudgmental acceptance,” she says. The physical act of sitting and breathing intentionally will automatically calm your body, yes. But it takes a little more effort to develop a meditation practice—and use it as a legit tool to transform the way you think and feel. What helped Ruparelia was taking meditation one step further and using it to reframe her thoughts and how she felt about herself and her skin.
For example, if you feel your skin itching, or happen to glance down at a psoriasis lesion on your arm, don’t let that throw you off. Recognize and accept how you’re feeling, but try not to assign value to it. So, instead of “My skin is itchy; this sucks; I can’t believe I have to deal with this!” think, “I’m having a psoriasis flare. My skin is itchy today. If it’s not better in a week, I will call my derm.” No good or bad feelings—just recognize that it is what it is.
This mindset shift will help you start to relate to yourself with more kindness and compassion, Ruparelia says. “If I have an itch or pain, I notice it and then come back the next day and see if it's still there. I relate to my pain and think if it has to be looked at or if it’s temporary,” she says. “Overall, I’ve become a little more objective with my body sensations and health and wellness—rather than falling into a pity party, just recognize you’re struggling and think about what you need.”
This will also help you assess how your new mindfulness routine impacts your skin week over week. Realistically, you’re not going to notice changes overnight. But with a few weeks of regular meditation and its stress-relieving effects, you’ll likely see a difference in your flares. So, check in with your skin weekly and keep it as objective as you can. A few tools to try: Keep a journal and rank your skin itch on a scale of 1-10 each night or take daily selfies of the same patch of skin so that you can compare weekly.
Try Guided Imagery
Dr. Reider recommends trying guided imagery if you need a little more of a visual help to stay mindful. “Picture a place that feels peaceful to you,” he says. Many people pick a beach (for obvious reasons). “Feel the water going over your feet, squish your toes and feel the sand, breathe in the fresh air and feel the rays of sun being warm on your skin.” No matter your chosen location, it’s all about visualizing a peaceful moment in a peaceful place and letting all of your senses experience it, even if it’s just in your mind. This can have a real meditative response, Dr. Reider says. “It’s really easy to do and doesn’t require a huge commitment.”
If you need some help with imagery, your meditation app should have some sessions you can try where an instructor will talk you through it, telling you what to picture in your mind. If not, do a quick Google or YouTube search for guided imagery meditations. Keep working on your practice and check in next week for the next step!