Unfortunately CW, none of what you mentioned is realistic for people that have serious or cystic acne. You don't think happy thoughts and your skin clears up... its hormonal sometimes, genetic sometimes, and sometimes it could be something like a specific food ingredient, gluten or wheat.

My sister had cystic acne years ago and believe it or not, what helped most after trying alot of other things, was the Serious Skin Care acne line that is sold on HSN.com (at the time, they weren't online, just television). Last year I ordered it for my young cousin and it helped her tremendously and her mom ended up continuing to buy it after she ran out. I recommend the glycolic cleanser, dry-lo, and buff polish. Those are the ones I remember using on myself. I think there is a masque also and an oil-free hydrator as well.

Its not expensive and has the money back guarantee that Proactiv has. I know someone who spilled some Proactiv on her rug and it BLEACHED her rug - of course it would make your skin peel off!