What Psoriasis Taught Me About Effective Communication

James Presbitero Jr.
Upside Down
Published in
3 min readSep 26, 2023

An illness that was supposed to break my confidence instead built my communication skills.

Author.

When I was just starting college, I manifested severe psoriasis. It was a terrible time to be sick — specifically, a terrible time to have that kind of outward-presenting autoimmune disease.

For those who don’t know, psoriasis results from your immune system going haywire and targeting your skin. What it means are a lot of angry rashes that can develop quite readily into sores and wounds that itch and hurt.

It also means insecurity.

And for an adolescent with tons of his own home-grown insecurities already, that illness should have been the nail in the coffin.

But it wasn’t. Weirdly enough, psoriasis actually helped build my confidence in the long run.

Because the lesson that I learned was:

It doesn’t matter what you feel; it’s all about what you present.

Make no mistake, I felt absolutely terrible. There were the physical symptoms, of course. The perpetual energy-sapping itch, the mind-numbing lack of sleep. The toll of time and money poured into just making my day to day livable.

But more keenly felt are the mental tolls. When you have an illness that disfigures your physical appearance, it messes with your head and changes your perceptions.

Just the act of being seen felt degrading and embarrassing. Drawing attention felt like an act of self-inflicted humiliation. Being asked, “What’s wrong with your skin?” felt like an attack I had to automatically guard myself against.

I was always tired, always down. Some nights, I cried myself to sleep.

But I didn’t show it; fake it till you make it to the extreme. And that’s how the magic happened. Because people aren’t mind readers; they’re body readers, signal receivers, and emotion-oriented decision-makers.

And somewhere along the way, I consciously decided to do my best despite my circumstances.

I wasn’t giving out signals of my defeat and insecurity.

Instead of keeping to myself, I deliberately joined the debate club. I entered public speaking competitions. I made friends, pursued relationships, and did everything I would have done even if I didn’t have angry rashes from scalp to toe.

In the micro sense, I was the same. I researched what made a person “confident.” I became obsessed with how to smile, looking at other people in the eyes as I talked. I swear, even until now, I would subconsciously straighten my spine and puff out my chest if I noticed anybody looking.

It definitely wasn’t easy. But guess what: nobody noticed. Nobody noticed how insecure and scared I was until the time that I wasn’t.

And I think that’s the key to it, really.

Divorcing your internal self from your external self is the foundation of all effective communication because not only does it hide your imperfections and present your best foot forward, but it also allows you to always keep your audience in mind at all times.

And what you give out, they take in.

That’s why, despite how hard those 6 years were, I can’t help but look back on it as ultimately positive. It was a make-or-break thing — and I made it.

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