I received an email a few days ago asking me why I never mention body dysmorphia these days. (This reader also has body dysmorphia and wrote that she liked this blog because there’s not a lot out there about it). And I realised I did rather abruptly stop talking about it.
Well! There’s a few reasons for that.
The first one is that I have never liked to discuss it as I just felt vain. It’s also a very boring topic, your looks. The times I talked about it most were when I was going through CBT, with body dysmorphic disorder being the diagnosis that led me there.
The second and most important reason it doesn’t feature largely on this blog is because it no longer features largely in my thoughts. I don’t have body dysmorphic disorder any more. The rituals are gone, as is the overwhelming anxiety. So I consider that one dusted.
So, in this entry I’m going to talk about why that is, and what helped me.
This got long…
I certainly did- and grasping that, really grasping that, is part of the reason why I, well, why I don’t. I could say, “I have BDD”, but I never really thought that I did. I thought (ha!) that people were being kind saying it was all in my head. At times, I looked into support websites and felt totally despairing because the people there were so beautiful. I’d feel sympathy, a bit of recognition, but I’d be thinking, “But I’m really that hideous. I’m that ugly. I don’t have a problem, except that I’m a monster”. And it made me feel more alone.
Body dysmorphic disorder is largely illustrated in the media via the incredibly beautiful feeling incredibly ugly. It was to highlight the illogical nature of it, the severity of it. But I just felt very isolated when I read those things. The only thing I ever truly identified with was a girl who, like me, was fat. She only trusted one mirror in the world, in a bathroom in a shopping centre. I reckoned, cruelly, but truthfully, that people who read that article thought, “Huh, but she is kind of ugly”. I am doubtlessly not conventionally attractive, and I found comfort in her story. She was not beautiful and she was diagnosed with BDD. So maybe there was some truth in my diagnosis, too. What people would be ignoring about it were her rituals- and that’s what I ignored, too.
The saving graces of my proper extremes of mood were beautiful release from my rituals. When I was a bit high, I’d think I was pretty sexy. Most of London has seen my boobs at some point. I felt like I was a slamming sexpot, able to seduce anyone with my wit, charm and, of course, my boobs. When I was pretty low, I just wouldn’t care. I’d hate my looks, but I didn’t care enough to do anything about it. I didn’t go out, there was no one to see me and laugh at me.
When I was more normal, my looks were the trigger of short-lived despairs. I was full on, at points. I once tried to cut my lips off because I hated them so much. I cut my face for the same reasons- quite a lot of my self harm is down to me hating certain parts of my body, failing to grasp, until much later, until now when I am forced to live with the scars, that I was genuinely deforming myself. My self-hatred was based upon my appearance, my inadequacy on my appearance. If people didn’t like me I thought it was because I was ugly. I thought people were looking at me and laughing at me because I was ugly. For about 18 months I only went out in the dark- through a summer. I’d spend hours and hours putting my make up on to go out for 20 minutes to the garage. I still have a throwback of some of my rituals- usually, I wear much more than I should, especially coats with hoods, or hats (this is why my social worker panicked when I was high last year, showing up without a coat, a cardigan, or pants, in a very thin dress).
I have always avoided mirrors. I had, like the girl in the article, one trusted mirror. It was a very small one, encased in purple plastic. I couldn’t handle a mirror that showed too much of my face at a time. It was dirty. I use broken mirrors. More recently, I’ve started having mirrors in my house, but I still avoid them, a little.
I left a trail of smashed mirrors in my wake. My looks set me off. If I saw myself in a club mirror, there were times all I could do was slam my fist into it because I couldn’t believe that the thing looking back at me was me. I wanted to die because I couldn’t bear the fact that this is what I was. I couldn’t live with myself.
I took thousands of photos of myself, searching frantically for one, any one, I could bear to look at. I exhorted people not to take photos on me, I have fallen out with people who dared post them online.
My rituals were mostly that I couldn’t stop touching my nose- it was my least favourite feature. I no longer worry about it but I still have the tic of covering my nose with my hand or rubbing it- this has, erroneously when a little high, made people think I had been taking cocaine. I also spent hours upon hours doing make up, for no real reason. If I made a mistake, I’d have to angrily wipe it off and start again. It hours into my day and most of the time I’d end up near tears. I have always, on some level, known how illogical it was, but I couldn’t help myself. I pretty much put it on with a trowel as well. And that made me look worse!
If someone complimented my appearance, I felt they were taking the piss and respond with a thousand self-loathing rebuttals. I never believed a boyfriend who said I was beautiful and eventually most of them stopped telling me because it would upset me. I never felt unworthy because of my intelligence or anything like that- it’s my looks. It was always my looks. My romantic relationships have mostly been alright, except for that. There were times I believed that people were laughing at me behind my back, thinking, “What’s he doing with her? She’s so ugly!” So I’d think then they must be thinking it and get paranoid.
My self esteem has never hinged on what other people thought of me, so I don’t know why I felt so afraid of judgement. It was, I guess, just confirming things I already believed, and it was my looks. I’ve been crap with criticism, but equally crap with praise. Apart from when I was young and bullied, the only voice telling me I was ugly was myself. I have never been in a bad relationship, for example, in which my partner insulted or belittled me. I have always been in very loving, even relationships were my partner has told me I was beautiful and lovely. So what gives? It made me angry at myself because rationally I knew it was fucked up. I didn’t know how to stop thinking that way and I felt like shit when I saw the hurt in their faces.
At points- especially when extremely depressed- it did become outright delusion. There were times I thought my face was swelling or parts were rotting. Then I asked, “Am I red? Am I swollen?” and I would touch my face and ask my sister or boyfriend to touch it and tell me if it was hot and red. It felt that way. I’d look into a mirror and feel afraid- afraid I was rotting.
And, of course, I had an eating disorder for years. The best way I can describe is non-binging bulimia. I threw up normal amounts of food. Fat (ha!) lot of good it did when I started taking medication- I ballooned anyway, without being able to control it, which just made me feel worse. That also meant I stopped taking medication without telling people, and I still think that is largely why my moods were sometimes fucked, because they certainly sped up and became more chaotic than they had been when I wasn’t on any medication.
But there is nobody in the world who would guess by talking to me that I had such low self esteem.
So, what changed?
Firstly, I started having CBT. I didn’t get far because I had a depressive episode in the middle of it and could no longer engage. But it did help because I grasped the model of it and was able to apply it when I felt better.
The therapist, on our first meeting, said we were going to look at our hands. I found that difficult. I don’t like my hands. They are small, squat and scarred from being dragged against my teeth so often. I was willing to try anything, though, as Rob had pretty much begged me to get help as things were getting out of control. I had shuffled there in a full face with my hood up, in August.
I’d never had therapy before so I didn’t know what to expect. I thought we’d go into the reasons why I felt this way (it’s probably because I was bullied very badly as a kid, and it was drummed into me that I was small and ugly and crap). We didn’t, and I have come to understand that we didn’t need to, either.
We looked at our hands. I felt like a bit of a div, sitting there staring at my hands. She pointed out the flaws she could see in hers. She said that you’ll always find flaws, if you look hard enough. I agreed that this was true. We discussed the things I felt wrong with me. I found it excruciating because I just felt vain and ridiculous. I told her that I was just ugly. I listed the reasons why. She said, “So, you think you are hideous and revolting”. Enthusiastic nods. “So, with our time together, let’s see if we can discuss the possibility that you are not as hideous as you think you are”. “Yeah, right” was pretty much my response.
When I got home, I drew a picture of myself. As I recall, it was a giant circle with another circle on top, with stubby limbs, fat hands, a huge nose, unaligned eyes, scarecrow hair, small, but chunky lips. I felt it was an accurate reflection on what I looked like.
I had homework to do each week. On one week, I had to do a, “mood map”. Now, this was when I was still very dogmatic that I had manic depression and thus nothing else ever affected my mood (even if you do have manic depression, of course other things affect your mood, because you are human). It is true that the dominant mood is difficult to slice through- for example, I don’t laugh when I’m depressed and happy events don’t touch me. But generally, yeah, of course I have moods!
It was interesting to see. There were headings: How do you feel when you do x, y, z? So things like… “look into a mirror”, “have to go out”. I also have quite big problems with social anxiety (still, alas, but I’m getting better, LONER 4EVA!) so that was interesting and painful to write down. Scared. Embarrassed, above all else. Scared scared scared.
Looking into a mirror- anxiety. Anger! Anger! And then depression. Almost despair. It passes. But then I don’t want to look into mirrors again. Fear of going outside or seeing friends passes (though at my most iffy I was having panic attacks), but then it makes me not want to go outside and see my friends. So largely, I didn’t, and still, largely, I don’t. I do have the idea of, “safe place” firmly in mind. It’s why, “home” is so important to me, as a place and as a concept. Although I’m pretty much fine with my mood these days, I still find it hard to get over social anxiety. Ah well! I like my own company anyway.
Anyway, my next homework was to go outside with no make up on. “Can I still wear my hat and coat?” is what I asked. Yeah. But I had to take my coat off at some point in the session.
I went to the newsagents, with no make up on and no hat. I ran home, but it felt good. Then I came to a session with no make up on. That felt good, but did send me on a rant about how much I hated my skin.
Next: she wanted to show 100 people a photo of me and ask for their responses. She was absolutely certain that they would say, “Yeah, she’s not a hideous blob monster”. I wasn’t. It panicked me, and I also set out some rational responses as to why they would say that. For one, I had to be there- hiding, of course, but able to hear. The set up itself is a contrived one- people would respond nicely out of politeness, especially if they spotted her recording equipment. Two, it would involve having my photo taken, or me giving her one of my ridiculous, posey, self loving photos that embarrassed the fuck out of me.
I refused that one. Then we went into interrupting negative thoughts- this was a throwback from my mood back. She taught me how to distract myself and helped me realise that when I started on a chain of thought, it was a downward spiral. I’d get increasingly despairing, increasingly self hating and that’s when the mirror smashed, my arm split open or I’d go and hide in the bedroom so nobody had to look at me.
We worked on accepting compliments and rationality. Why would people lie? At the time I wasn’t ready to accept the rationality, but I eventually did. Likewise, instead of going off on a rant, I learned- over time- to just say, “Thanks” when people complimented me.
We also talked about the good things about my body. Not the way it looked, but the way it worked. What could my body do for me?
Not long after, our sessions ended. I had become depressed (and it was possibly triggered a bit by the therapy, although I resented that implication and denied it) and thus stopped giving a toss.
But over the next few years (and it has taken that long), I thought about it more and more. I started going out without make more often. Yeah, I felt ugly. But people didn’t laugh at me- they didn’t notice me. I began to think, “Christ, how egotistical am I, to think the whole world turns to look at me and gawp when I step out of the house?” I reclaimed my time, minute by minute.
There was a paradoxical egotism involved. It is egotistical to think everyone’s looking. But counter to that was that I felt feeling you were less than ugly was egotistical. I felt that liking your appearance was just vain.
I also thought more and more about what my body did for me. I never really discussed it with anyone. But I considered it. My legs- okay, I don’t like them. But they’re strong legs. Flabby (shut up, brain) but they do a good job at being legs. It would be awful if I didn’t have legs. Hey legs! Cheers.
And I know I look quite young, and I know that because I’m a woman, people view me as a woman, first and foremost. And there are advantages (and huge disadvantages) to that. In a way, my appearance protects me. I get free sweets sometimes. I also get hit for ID daily, but I’m non-threatening looking for the most part. I’m very short, very young looking, and thus, I get to play on the swings and nobody thinks I’m a paedophile. (Even though I am). I don’t get hit on by random men, because I look too young and too silly for that.
I began to realise that blaming my appearance on everything was a get-out clause that stopped me examining other reasons why certain things happened. I connected too much to it. It was never my personality- it was my looks that made people dislike me. Hell it was. It was because I was, and often am, obnoxious, loud and irritating. I am a nightmare when I am drunk and on medication and I can be indiscreet and rude. It’s also because some people just don’t get on with each other. And if people did think I was ugly- well, there is no person in the entire world that everybody thinks is beautiful. Take Angelina Jolie and put her in an African village and she is not going to be the beautiful one.
I also began to understand that, in a way, my BDD was a coping mechanism. Don’t grieve for your father- look into a mirror and hate yourself instead. Don’t feel sad because you miss your friend- think about how hideous you are, that’ll do. The rituals in themselves were time-consuming and they were almost on auto-pilot. I used it as a way to distract myself from real, painful thoughts I could not face. I have never been a person who shows strong emotions and that was partly a reason why- I channeled those strong emotions into my appearance. Controllable, sterile, in a way.
I saw, over time, that I did have a distorted way of thinking. I’ve never quite been able to believe that the distortion is one of how I viewed my appearance. I haven’t gotten to the point- and I don’t think I ever will- to which I think I’m pretty. I don’t think I’m pretty. I am indeed quite fat, and I am funny looking. I look weird. I’m tiny and tiny people are supposed to be dainty and petite. I am not dainty nor am I petite. I have huge breasts and odd hair, a strange nose and a long torso. I dress oddly and part of the reason why is because there is nobody who makes clothes for 4ft 11″ side 14s. However, my funny looking fatness is not going to cause the world to cave in and sink into space like water down a plug hole. It doesn’t really matter. That’s where the distortion was- I thought I was so hideously ugly that I was world-shatteringly ugly, people throwing parties when I died ugly. Ding dong, the witch is dead.
Because I began to realise that I was just, to me and some other people whose taste I was not to, boringly average looking, I also began to actually appreciate compliments. I did start saying thanks. Now I have a boyfriend who I let kiss my belly. My belly! The first time we went out in 2000, I didn’t let him look at my feet, my stomach and I strategically hid my bum. He tells me I’m beautiful all the time, and although I don’t see it myself, I know he does. I believe him.
My tipping point in terms of bulimia came when I began regularly coughing up blood. It took a while but I started, at first, phasing out laxatives. This- coupled with it being around an emotional period were I was utterly miserable- meant I didn’t eat for about six weeks and dropped a lot of weight. From there, I very slowly began eating. I had, by that point, been unable to cope with food in my stomach, so I’d throw it up or take laxatives. I hated feeling full. So I didn’t stuff myself. Just little bits. It was the weirdest moment ever when my social worker applauded that, after a week of nothing- no laxatives and no, er, movements- I had a poo! Hooray! But I was proud of myself. I had gone that time feeling pain every day and I still didn’t take laxatives. I didn’t have to run into a pub and leave my friend outside for half an hour. I didn’t have to walk past my friends, cheeks burning with shame, after we’d finished a meal and I’d chucked £20 of Italian food down the bowl on their birthday.
Two years on, I tend to make sure I eat enough a day, rather than too little. I’ve relapsed a few times but in those times I have understood that the reason I have done so is because I have been stressed. I get back on track. I’m also with someone who gets a Jewish Mother pleasure out of cooking, and views food in incredibly healthy and social ways. He encouraged me to eat and made food appetizing to me. He let me have a lot of control over what he cooked and let me get involved cooking it. He doesn’t mind when I look at calories and ask him if he can maybe use reduced fat butter because full fat butter scares me. He hasn’t judged me when there have been periods in which I’ve resorted to throwing up or laxatives again because I have explained to him that it’s often a response to stress and my grabbing back control, uncomfortableness with being full (because when I am stressed, I tend to get nauseous, when I’ve nothing in my stomach, that is easier to bear), and it passes. And it does.
I’ve gained weight, yep. I’ve never been thin, anyway- I’ve nearly always been a bit overweight. My slimmest was in May 2009, when I was 7st 12lbs. That was due to not-eating emotionalness (I’d had an abortion a month before, and my relationship ended partly as a result of it. It was a pretty shitty time) and then a vague mania that visited upon me as a result. My heaviest was 12st 7lbs, and that was after Lithium, Olanzapine and friends. Now I am 9st 7lbs. That’s overweight for my height (I’m 4ft 11″). I do hate it, yeah. There are times I can’t bear to look at myself and I want to break down and cry. But in my saner moments I know it doesn’t really matter. I take Seroquel and I should be exalting the gods that I’m only a stone overweight and not four (again). I also know that it is not worth me trying to strictly diet because that way leads to compulsive behaviours, and I am sadly prone to compulsive behaviours. I’d just go down the bad route again. So I figure it’s worth being a bit overweight if it means I can enjoy a meal with my boyfriend and not throw it up afterwards, if it means I no longer wake up in the middle of the night feeling like I am dying because of heart palpitations, or that my blood pressure is so low I keep blacking out. (I still do that, though, ho hum!) I can’t imagine ever thinking that way before.
I still hate having my photo taken. And, funny story, I only look at articles where my photo has been taken by someone else (such as my BBC Ouch interviews) on a mobile browser with images disabled. Big lol. But I don’t mind most photos I take of myself, or ones that are just off my face, front on. I can deal with those ones now.
And sometimes, even in my normal settled mood, I feel like I look alright. Not beautiful or gorgeous, but, y’know, nice. Nice eyes. I still wear big coats, and I am still dreading my nurse training and having to wear my sleeves up. But I wear a lot less make up these days. I go outside wearing none at all. I want to feel the sun on my arms some day. I’m confident that some day I will. I will walk down the street wearing no coats and no sleeves and I will do in sound mind and I won’t care if anyone’s looking at me.
I’m certainly not even in the top 50% of the worst cases of BDD. But it was bad enough that it fucked my life up a fair bit at times. It drove those close to me to distraction, almost moreso than my mood swings did. It made me utterly unbearable at times and it was RELENTLESSLY self obsessed. It caused problems at school- I got regularly bollocked for being late and wearing make up- and it caused problems at work. It was the violence of my self-hatred that did it, the irrationality of it. Because it is irrational, to hate your appearance to that degree. The world will not end if you go outside looking a bit crap. Your partner- if you can bear to have one- is not going to wake up one day and realise he’s sleeping with yer Man from the Goonies.
It’s okay to not think you’re gorgeous.
It’s okay to think other people are.
It is not okay to think that because you’re not, you’re not a good person.
It is not okay to think that because someone is beautiful, they are also intelligent, righteous and etc. That’s a ridiculous media stereotype that equates beauty with virtue, and it’s bullshit.
It doesn’t matter. REALLY.
Anyway, there’s your BDD update.
Filed under: Body Dysmorphic Disorder