Linear IgA and the Meanings of Skin: An Interpretative Phenomenological Analysis of Living with a Rare Dermatological Disease

Year 2023, Volume: 3 Issue: 1, 10 - 26, 30.06.2023

Saba Basoglu Yavuz

Abstract

Linear immunoglobulin A (Linear IgA) bullous dermatosis is a rare, idiophatic and specific dermatological condition characterized by blisters forming in the skin and mucous membranes. Linear IgA is known to be an autoimmune disease, however, it is also defined as a group of Medically Unexplained Symptoms, since the exact mechanism of lesion development is not well understood and the treatment is contentious. Although Linear IgA is identified as being strongly related to psychological features, these have been investigated by a very small number of studies. The study presented here can be the first qualitative psychological research on Linear IgA. It employs Interpretative Phenomenological Analysis (IPA) in order to engage in a deeper examination of the impact of undergoing Linear IgA experience, and how the patient attempts to make sense of the skin. The participant is 50 years old male who lives with Linear IgA for ten years. Data collection was designed in the form of a semi-structured, one-to-one, in-depth interview, which lasted ninety minutes to elicit the detailed stories, thoughts and feelings from the participant. Five superordinate themes emerged from the analysis of the participant’s experiences. Findings suggest that Linear IgA affects the participant’s life by the appearance of skin, which shapes how he construes himself and his social world. The skin also represents a projector, which allows him to see his own emotions, fantasies and existential concerns. These findings were discussed by engaging in a dialogue with both clinical psychological and phenomenological philosophical literature.

Keywords

Interpretative Phenomenological Analysis, Self Representations, Qualitative Research, Psychodermatology, Linear IgA, Medically Unexplained Symptoms, Psychosomatics, Skin-Ego

Thanks

I would like to offer my special thanks to the participant, without whom there would not be any findings. I would also like to thank Prof. Dr. Sibel A. Arkonaç for supervising the data analysis to reinforce my self-reflections and critical awareness, and Asst. Prof. MD. Serhat Yüksel, a faculty member at Dogus University Clinical Psychology Doctorate Program, for encouraging me to improve the quality and validity of this IPA research. I would like to express my sincere gratitude to BA. (Hons) Simon Riley for the English language editing of the manuscript.

Linear IgA ve Tenin Anlamları: Nadir Görülen Bir Dermatolojik Hastalık Yaşantısının Yorumlayıcı Fenomenlojik Analizi

Abstract

Linear immünoglobulin A (Linear IgA) bülöz dermatoz, mukoza zarında ve deri yüzeyinde yayılmış kabarma ve yaralar ile seyreden nadir görülen, idyopatik bir cilt rahatsızlığıdır. Linear IgA, otoimmün bir hastalık olarak tanımlanmakla birlikte, belirtilerin arkasında yatan mekanizma tam olarak anlaşılmamış olup, tedavi yöntemi ve etkileri halen tartışmalıdır. Bu nedenle, Tıbbi Olarak Açıklanamayan Belirtiler grubu içinde de yer almaktadır. Linear IgA’nın psikolojik faktörlerle önemli ölçüde bağlantılı olduğu belirtilmesine rağmen, bu konuda yapılan oldukça az sayıda çalışma bulunmaktadır. Bu çalışma ise, bir Linear IgA vakasının niteliksel psikoloji yaklaşımı ile ele alınan ilk araştırma olabilir. Bu vaka çalışmasının gayesi Açıklayıcı Fenomenolojik Analiz yöntemini kullanarak, Linear IgA tanısı almış olan bir katılımcının, süregiden hastalık deneyiminin etkilerini ve ten üzerinden kurduğu anlam dünyasını derinlemesine bir şekilde incelemektir. Katılımcı on yıldır Linear IgA ile yaşamakta olan 50 yaşında bir erkektir. Veriler, katılımcının deneyimlerine, düşünce, duygu ve hikayelerine detaylı bir şekilde yer vermek amacıyla tasarlanmış olan, doksan dakika süren, yarı yapılandırılmış, birebir ve derinlemesine bir mülakat ile toplanmıştır. Katılımcının deneyiminden beş üst tema ortaya çıkmıştır. Bulgular, Linear IgA’nın katılımcının yaşamında yarattığı etkilerin merkezinde tenin görünürlüğünün yer aldığına, bunun üzerinden kendisine ve hayata dair inşa ettiği anlamları aksettirdiğine; tenin aynı zamanda katılımcıya kendi duygularını, fantezilerini, hatta varoluşsal kaygılarını gösteren bir projektör konumunda olduğuna işaret etmektedir. Bu bulgular, klinik psikoloji alan yazını ve fenomenolojik felsefe arasında bir diyalog kurarak tartışılmıştır.

Keywords

Yorumlayıcı Fenomenolojik Analiz, Benlik Temsilleri, Linear IgA, Niteliksel Araştırma, Psikodermatoloji, Tıbbi Olarak Açıklanamayan Belirtiler, Psikosomatik, Deri-Ben

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