Behind the curtain

I’ve been putting off writing this post a bit.  Even though I have a public blog and am clearly open about my body image issues, it is still hard for me to talk about sometimes.  BDD is extremely under-diagnosed, simply because people who suffer from the disorder often feel too ashamed to discuss their symptoms (and therefore never receive an actual diagnosis).  Well, the shame has not fully disappeared for me yet.  I want to be open about my experiences and the recovery process, but I often worry that people are laughing at me behind my back, or that they say they understand when they really have no idea. 

Putting yourself out there is hard, and this post has been especially tough for me to start.  It is really going to open up my inner world of crazy.  However, I have to remind myself that I’m not doing this for me.  I’m doing this for everyone else who is suffering.  I’m doing this for anyone who feels ashamed because they don’t understand where their symptoms are coming from and why they can’t stop their compulsions.  I want others to see that they are not alone.

This is what it looks like

I’m standing in only a towel, having just stepped out of the shower.  Drops of water roll down my skin and fall from my hair.  I have already made my way to the mirror, and am staring at my face.  With all of my makeup washed off, I can see every imperfection.  There are too many to count.  It is overwhelming. 
I can see each pore that is clogged, every section of skin that seems ready to burst with acne, each ingrown hair or hair that need to be plucked.  I can see lines and indentations ~ some are there naturally, and some are scars from past picking episodes.  Everything about my face is ugly, and I know I have to fix it.  I need to do something. 

My first step is to grab a washcloth and run it quickly under the faucet.  I have learned from hundreds of similar episodes that a damp washcloth removes excess skin better than a dry or soaking wet one. 

I begin rubbing the washcloth over my face in small, frantic circles, starting at my forehead and moving around my face.  I am not just trying to exfoliate the dry skin, but am also hoping that this process will somehow clean deep into my pores, removing breakouts and erasing my scars.  It never does, but I try anyway.  

The scrubbing is anything but a gentle process.  I push down so hard on my skin that I worry my skull may fracture.  I often give myself a tension headache from the sheer amount of pressure I am applying.  The scrubbing lasts quite a few minutes. 

When I’m done, my skin is red and tender.  I have taken off any dead skin, but have also removed a significant number of healthy skin cells as well.  My face is sore to the touch.  Often times, the scrubbing has opened up pimples or recent scratches, leaving my skin bloody in places.

I’m still not done.

Having “cleaned” my skin of the outer layer of dirt, I can see even more distinctly where I am broken out and which pores are clogged.  Standing mere centimeters away from the mirror, I scratch, dig and squeeze at these blemishes, determined to remove any last bit of dirt or oil.  I always use my fingernails, and almost always use tweezers.  During very bad episodes, I have used nail clippers to cut away parts of my skin.

When does it stop?

Sometimes I can pick for hours.  Literally.  Hours.  I have stayed up all night before, digging away at my face, hoping that it will miraculously become flawless.  Sometimes I only pick for a few minutes (though I often return to the mirror soon after to continue the process).  I don’t know how I stop, I just sense that I am done and take a step back to survey the damage.  I am almost always in a trance-like state when picking, and only stop when I somehow un-fog.  Sometimes it is due to exhaustion, sometimes due to pain, sometimes due to time limits.  Most often it happens inexplicably. 

How does Cognitive Behavioral Therapy help?

How does one stop the madness?  CBT makes me more aware of the process I use to “fix” my face.  I wouldn’t have been able to write out my picking process before therapy because I honestly didn’t notice a pattern.  It was just something I did automatically.  Also, as I mentioned, picking is usually a response to anxiety, and both the initial anxiety and the release occur in a foggy mental state.  Often times I am not fully aware of what I am doing until I decide I need to stop.

My therapist has spent the past few weeks drawing the above information out of me in segments by asking me a lot of questions and teaching me to be present during my episodes.  For the first few weeks we didn’t try to change my actions.  Instead, I simply recognized the thoughts and their accompanying behaviors.  Acknowledging them was the first step towards recovery.

By asking the right questions (and through my “mental excavations” over the past few weeks) we were able to sketch out exactly what happens when I become anxious and discover how the BDD has a hold over me. 


This past week was the first time I had a homework assignment that involved action instead of thought. Once I start picking it becomes hard (and by hard I mean basically impossible) to voluntarily stop, so we decided to cut the process off at the very beginning.

When I get out of the shower or wash my face, I am NOT allowed to scrub my skin with the washcloth.  I can dry my face, but I can not scrub or use the cloth to scratch at any blemishes I may see.  I pat my face dry and walk the hell away. 

To say it’s difficult would be an insanely ridiculous understatement.  Obviously it has been impossible in the past or I would have stopped a long time ago.  Not picking and scrubbing to relieve anxiety makes me feel, well, ANXIOUS!!!

Fortunately, I have been learning some techniques to deal with this anxiety, and I am happy to say that I am moving in the right direction and learning to manage without causing such extreme damage to my face.

I definitely want to discuss what has helped me manage my anxiety, as I am sure any readers out there with high anxiety are trying to figure out how the heck it’s possible.  I will leave that for my next post, as this one is already extremely long.

What I want to know from you

~ Have you experienced similar picking episodes from either BDD or other comorbid disorders?
~ Who else out there is in recovery or has already recovered?
~ What else do you want to hear about my personal journey?  What would help you to know?

Please comment below or message me.

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