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Book Review: When Blushing Hurts

When Blushing Hurts.
Overcoming Abnormal Facial Blushing.

Author: Enrique Jadresic
108 pages
Bloomington, New York, iUniverse, 2008

In an excellent book entitled When Blushing Hurts, noted Chilean psychiatrist Enrique Jadresic M.D. enlightens a clinical disorder known as pathological blushing (PB). The book presents an outstanding clinical description of the illness based on the author’s own experience as a patient accompanied by his precise phenomenological approach, derived from years of clinical practice. In the first part of the text, Dr. Jadresic describes and classifies this illness emphasizing the concept that  PB must be considered a psychiatric disorder when “it is triggered by minor psychological precipitants, causes psychological suffering, and interferes significantly with a person’s academic/occupational functioning or interpersonal relations.” In the chapter dedicated to discuss therapeutic options, a detailed description of pharmacologic treatments is provided emphasizing the role of SSRIs, SNSRIs, betablockers and novel anticonvulsant agents. This section is also accompanied by useful “pearls” concerning psychotherapeutic modalities in which the role of cognitive behavioral techniques is discussed. At the end of the first part Dr. Jadresic presents a description of a novel surgical procedure known as endoscopic thoracic sympathectomy (ETS) which he successfully used to treat his own PB some years ago. In this regard, the author presents five clinical cases from his practice, describing their clinical presentation, therapeutic strategies used and each patient’s description of the entire process of healing in what can be called a “first person account” of the illness. In my opinion, it is in this second part of the text where the reader should find most of the clues to understand the suffering derived from PB as well as the prudent use of the therapeutic alternatives available. These clinical clues are, as usually happens, the result of years of dedicated work associated to the genuine sensitivity acquired through personal experience. When blushing hurts is one of those books where the mixture of clinical expertise, precise descriptions and the author´s honest effort to educate mental health professionals and common readers conjugate in perfect harmony.  The result is simple and direct, a truly original contribution to contemporary psychiatry.           

Rodrigo Correa M.D.
Visiting Scholar Program in Mood Disorders
University of California at San Diego

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