When you fall, get back up.

I’m not going to lie to you.  Some days just suck.

I try to stay positive on this blog – recovery is a tough enough process without negativity floating around our heads.  Actually, LIFE and PEOPLE are negative enough.  I pride myself on being happy most of the time and on fighting the good fight and pushing myself forward.

I want to encourage everyone to overcome their most difficult moments, to look forward to a better life, to LIVE instead of exist.

But you have to remember that I am currently trying to do the same.  I am not recovered.  I am not undiagnosed.  I am still dealing with my issues.  Some days I am still suffering from my issues.

Today has been one of those days.  Last night I picked my face like I used to.  I didn’t even attempt to stop myself.  I woke up scratched, bruised and embarrassed.  Giant step backwards.

Then I got an email from my therapist – he is going to be out of the country for the next three weeks or so and we will (obviously) not be meeting.  So I will be fighting this alone.

Part of me wants to curl up into a ball, fall asleep and wake up when this is all better, but I’ve tried that before and I know it doesn’t work (FACT).

Instead, I am going to put it behind me.  I picked.  Fine.  Now I will heal.

I will be moving forward alone.  But I will be moving forward.

And when my therapist comes back in three weeks, I have to think about how amazing I am going to feel that I took steps towards a full recovery by myself. 

I continue to be tested.  This life isn’t easy.  I must continue to rise to the occasion.

How to manage your anxiety

No matter what you struggle with (BDD, OCD, an eating disorder, etc.), compulsions arise from extreme anxiety.  I’m not going to pretend to understand the intricacies of other disorders, but I do know that the methods of managing anxiety work the same for everyone.  I’m going to speak in terms of my experience with BDD, but you should be able to substitute your own thought patterns and compulsions and get similar results :) Go team!

The end of the world

When I look in the mirror, I become extremely anxious.  I see tons of imperfections, and all I want is to remove them from my face and body.  I see acne, clogged pores, ingrown hairs, uneven skin tone and dryness.  I start to think that no one will be attracted to me if I continue to look the way I do, that everyone will be disgusted by me, that I am worthless, I will never succeed in life.  Negative thoughts begin swirling in my head until I literally feel that I am drowning in them.  I can barely catch my breath; it feels like a family of elephants is sitting on my chest.  My head starts pounding, my legs are weak and my insides feel like they are shaking and about to crumble.  Sometimes I get extremely nauseous and dizzy as well. 

For those of you who do not struggle with a body image or anxiety disorder, this may seem like a completely blown-out-of-proportion series of thoughts.  I agree to some extent, but you have to realize that neurological disorders are not meant to be rational.  That’s part of the reason that they are so frustrating to deal with in the first place.  When I see a blemish on my face I don’t think, “oh crap a pimple” like the majority of the human race.  I think “oh no, here it comes – the end of the world is upon us.  Why am I the ugliest person in the universe?  I can’t believe that I am so unworthy of love.”

Relief

BDD is sneaky in that it offers a quick release from the grip of extreme anxiety.  I would imagine other disorders offer compulsions that promise similar results.

All I have to do to stop feeling like I’m going to pass out is pick at my face.  In the moment, it is a no-brainer.  Collapse into a heap of pain and sweat on the floor, or scratch at my imperfections, which I want to remove from my face anyways. Done.

This is the habit we all want to overcome.  We want to stop restricting what we eat, purging, picking, cutting, measuring or any other harmful habits we use to get rid of anxiety.  In order to do this, we need to learn another way to stop feeling so anxious.

A new way to manage

I always thought that fighting anxiety was the best way to get rid of it.  If damaging thoughts entered my mind, I would try to ward them off and convince myself that they weren’t true.  I spent a lot of time and effort fighting against my own mind – trying to make myself believe things that I never really accepted.

In therapy, I’ve been learning another way – allowing anxiety to enter my body and acknowledging (and welcoming!) damaging thoughts.  This is counterintuitive, but it has been working.

The steps

~ When you begin to feel anxious, and your compulsions are trying to take over, stop what you are doing and acknowledge your anxiety.  Do not try to ignore or overtake it.

~ Take a seat.  Find a chair and sink into it.  Close your eyes.  Let your arms and legs hang limp and your head droop forward.  Try to relax the muscles of your body.

~ Begin taking deep breaths.  The anxious thoughts are still going to be floating around in your head.  Let them.  Just breathe.

~ Decipher your thoughts.  Exactly what is floating through your mind?  If you do not follow through with your compulsion (picking, purging, cutting, etc.) what is going to happen?  Be specific.  What does the future hold for you if you avoid your compulsions?  How awful will that existence be?  This will cause your anxiety to increase.  This is good.

~ Use your imagination.  Visualize your worst-case scenario.  Pretend you are living it out. 

For me, I imagine that my face is covered with acne and blackheads and that, when I go into work, people avoid me because they don’t want to look at me.  I imagine that customers don’t want me to help them and that everyone whispers behind my back.  My dad shuns me.  I end up old and alone because no one wants to date or marry me.  I never get my dream job because I am too hideous.  I die unhappy and unfulfilled.  I am a disgusting waste of life.

What is your worst-case scenario?  Think about how this makes you feel, and how anxious you become.

~ DO NOT give in to your compulsions.  Even if you feel like you have no other choice.  Even though your anxiety is currently spiking into the stratosphere.  Even though you are thoroughly upset.

~ Live in this.  Live in this moment.  Keep thinking those thoughts.  Keep listening to your anxiety.  Acknowledge it.  Be fully aware of how your body is reacting, how hard your mind is working, how awful you feel.

~ Keep breathing.  Breathe through this.  It hurts like hell, but it’s going to work.

What happens when you work through these steps is that your anxiety spikes.  It gets really intense really quickly. 

However, your anxiety cannot remain at this level, as it’s impossible for humans to function during intense anxiety (which is why you should be sitting, by the way).  Usually, we use our compulsions in order to remove the anxiety and get on with our lives.  In doing so, we override our natural habituation systems.

By listening to our anxiety and allowing it to spike, but NOT using our compulsions, we allow our habituation system to take over, as it naturally should.  We sit in the anxiety until our bodies can no longer handle it, and we habituate, or get used to, being anxious. Our anxiety slowly but surely decreases. 

Habituating to habituating

Over time, your body learns that it does not need to turn to compulsion to decrease the anxiety it is experiencing.  All it takes is some intense focus, deep breathing and will-power. 

My homework assignment this week was to avoid picking as much as possible.  I have been using the technique above to manage my anxiety when I feel like scratching in the mirror.  One night, I lowered my anxiety from an 80 (on a scale of 1-100) down to a 35.  It took about half an hour, but it was well worth it.  I didn’t pick for the next two days.

In the past couple of days, my anxiety has never gone back up to an 80.  It has actually been spiking around a 40 and quickly decreasing to a 20.  My picking has gone down substantially, and I am not feeling as much of a craving to run to the mirror as I used to.

Healing

This week has been, and continues to be, extremely difficult.  I am operating with a base level of anxiety around a 15 (instead of a 0, where I would like to be) and this is causing me to feel very tired.  However, to say it’s worth it would be an extreme understatement.  Since I am not picking as much, my skin has been given time to heal.  I have to say, it looks better than it has in a long time.  I am able to see my efforts paying off, which makes me want to continue down this path.  

My life is changing in ways I never thought it would.  I am still not fully recovered, and I will continue to take medication and go to therapy, but I am gaining tools to deal with my compulsions.  I am winning.

Let me know if these steps work for you, or if you are finding them difficult and need some extra advice.  I’m an anxiety expert ;)

Battlefield

It’s on, folks.  The time of “now or never, all or nothing” seems to have arrived.

I wrote recently about my latest CBT homework assignment, and how I was starting to actively work on ridding my life of BDD-related compulsions.  My main compulsion, skin picking, has been the hardest thing to stop doing, but is the one compulsion that I need to remove in order to move forward with a healthy, happy life.

I was all fired up about my new homework assignment, and was feeling more than ready to move ahead with it.

However, something strange happened over the past two weeks: I found that apathy began to overtake passion.

Progress?

In the past, my BDD made me feel anxious, worthless, ugly and depressed.  I hated myself and hated my life.  I picked to relieve all of these sensations, and the picking would cause me to feel even worse.  It was a sneaky hate spiral that didn’t seem to have any potential of getting better.

Recently, due to a combination of medication and therapy, I no longer feel so awful about myself.  In fact, I’m tempted to say that my depression is completely gone.  I can see that I have a bright future, that I am worthy of being on this earth, that I am smart and have a great personality.  I no longer ask myself why I have friends or how people could love me.  I believe in myself.

My anxiety has also gone down, though it still very much exists.  I don’t feel as anxious before OR after picking as I once used to.

While these all seem like great steps, they have led to an unusual outcome: the aforementioned apathy.  Instead of being excited at my progress and wanting to move foreword even more, I seem to have stopped caring about my recovery as much as I used to.  It’s almost as if, because the anxiety and depression are nearly gone, I don’t mind the skin picking.

Think of it this way

If you are doing something that is pleasurable to you (skin picking) that has damaging effects (anxiety, isolation, depression, bleeding and scarring), you obviously want to stop the action and find another pleasurable activity that does not have any negative results.  However, if you have found ways to skirt the damaging effects (in my case, through means of therapy and medication), then why would you stop the pleasurable activity?  I enjoy picking my skin ~ it gives me a feeling of accomplishment and relief ~ and since I don’t mind the results anymore and am no longer avoiding social or work situations because of my scratches, I might as well continue.

This is the mood I have been in for two weeks.  I feel like I have arrived at the furthest point of my recovery ~ I can’t get any healthier than I am now.  I’ll just accept that picking is a part of my life and move on.

Oops

I spoke with my therapist about this today ~ I told him that I feel much better, but that the picking hasn’t gone away.  I also mentioned that I don’t mind the picking as much anymore, and asked why this may be.

His answer was basically that I need to push myself even harder.  I’ve felt awful about myself for so long that the mental place that I’m at now is a huge improvement over my past self.  Because I am healthier, it’s easy to simply stop fighting and accept my current situation. 

This makes a lot of sense to me.  Honestly, I’m scared to move forward.  I’ve lived with BDD and skin-picking for about seven years!  It’s a part of me, and getting rid of it feels like giving myself a lobotomy or killing an old friend.

It’s also EFFING difficult!  To change a deeply engrained behavior requires concentration, strength and perseverance.  It is a constant battle, and I can’t become apathetic or decide that I’m “fine” with where I am.

I deserve an amazing life

If I really think about it, I am NOT okay with where I am – I don’t like looking at my face and seeing all the places where I have scratched and picked.  I don’t like that I have scaring and uneven skin tone because of all the nights I spent ripping my face apart with tweezers.  And if I’m fully honest with myself, I don’t enjoy picking as much as I convince myself that I do.  It causes me a lot of pain, physically and emotionally.  Even more than that, I know that I am letting my BDD win.  I am allowing this disorder to share my life with me.

I don’t want to continue down this path ~ I want to FULLY recover. 

I want to get to the real finish line, not just to the place I am now where I feel generally okay.  I don’t want to be average, I want to be exceptional.  I want to live to my fullest potential, to recognize all of my dreams and to feel confident in myself.  I want to be happy.

Superhero homework

I am fighting again.  I took two weeks off, and now I’m back on board.  This week is going to be extremely difficult, because I have to fight my apathy and my BDD.  I am so close to being recovered, but that doesn’t mean I can stop the fight ~ I have to continue punching my BDD in the face until I cross the finish line.

I am not allowed to pick this week.  I know what is going to happen ~ I am going to experience intense anxiety.  There will be frustration, tears, nausea, headaches and feelings of weakness.  I am going to want to pick, I am going to be fighting against myself in order to move forward.

My BDD is going to wrestle me with all its might to get me to the mirror, to grab the tweezers, to squeeze and pick and prod at my pores until I’m back at square one.

This week is going to make or break me.  I refuse to give in. I’m going to win.

I’ll keep you all updated.  If you are at this point in your recovery as well, please join me.  We can fight together :) 

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. 

Homework

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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Compulsive Skin Picking

I want to talk about my therapy session this past week and update you on how I’ve been doing, but I feel like I can’t do this without some background info.  So, here we go.

The manifestations of BDD are both mental and physical.  I have discussed in some detail the mental anguish that accompanies the disorder: feelings of inadequacy (biggest understatement of life), hating yourself, believing that you’re ugly and worthless, and a general obsession with appearance, to the point that it completely runs your life.  I have yet to discuss the ways BDD physically affects people with the disorder because, for me, it’s much harder to talk about.

BDD is different for each person, meaning that the symptoms are not necessarily the same for everyone who has the disorder (though some symptoms have a much higher rate of occurrence).  Not only can BDD lead to panic attacks, frequent migraines, nausea and fatigue, but also to many different compulsive behaviors.

For a list of common compulsive behaviors, please click here.  About 50% of these compulsions have appeared in my struggle with BDD, but the two major ones are mirror checking and skin-picking (often referred to as “dermatillomania"). 

Skin picking is exactly what it sounds like ~ picking at your skin.  Most people (especially during their teenage years) pick at their skin to some degree.  It’s very common to pop a pimple, scratch at a bit of dry skin or try to pull out an ingrown hair.  It’s normal to see an imperfection on your skin, become a bit aggravated and try to remove it.  Compulsive skin pickers, however, take these behaviors to the extreme. 

For me, BDD compounds the issue.  I see blemishes on my face that either do not exist or are so small that others wouldn’t even bat an eye at them.  To me they seem so large and obtrusive that I feel extreme embarrassment and my self-worth plummets.  I don’t want to be seen ~ my skin is just too awful.  In order to “fix” the problem, I pick.  Honestly, as I am picking I feel that I am making things better.  I will spend hours in front of the mirror, washing and rewashing my face, picking at “blemishes”, pulling out hairs, exfoliating dry skin and digging into my face to remove blackheads and dirt.  I think that if I can just remove all of the bad stuff from my face, I will feel more confident and be able to get on with my life.  Though my skin-picking is focused mostly on my face, I have also picked at my back and legs over the years.  Of course, this never ends well.  Picking results in scratches, bruises and scars.  When I’m done it looks like someone has taken a knife to my face.  There’s nothing subtle about skin-picking ~ you can tell when someone has done it. It’s awful.

So why don’t I stop?  Why can’t I simply remind myself that it hurts and that it only makes things worse?  Well, BDD is a sneaky little bitch, that’s why.  I get trapped in two endless cycles that require that I pick.  Picking becomes a necessity rather than an option.

·       The cycle of anxiety ~ I have tried to stop picking at my skin thousands of times before.  I’ve been doing it for about 7 years, and almost every day I vow to be done with it.  However, the instant I stop picking I feel overwhelming anxiety.  I go through a script in my head about how I will be ugly if I don’t pick, I’ll break out, I’m unclean, people are going to wonder why I haven’t tried to remove such grossness from my face.  I have panic attacks and feel physically ill.  I start picking again just to stop feeling so horrible.  Picking brings a sense of relief, as it calms the anxiety down and allows me to enter a trance-like state.  When I’m picking, I only focus on what I see in the mirror.  I don’t have any other problems or worries.  It’s an escape, and my body and mind know when I’m trying to take that escape away.  I pick to relieve stress and, like an alcoholic or drug addict, it has become the only thing that makes me feel better.

·       The cycle of scratches ~ After picking, as I have mentioned, I am left with bleeding scratches/cuts on my face (or legs or back).  It sometimes looks like I’ve been attacked.  I have gone from having minor flaws on my face to have open sores that eventually scab over.  The scratches and scabs further trigger my BDD, because now there are actual blemishes on my face to pick at.  So I do, and the cuts don’t get a chance to heal, and the cycle continues.

BDD wins by trapping the sufferer in these cycles of anxiety and harmful behavior.  It becomes more severe over the years, until you literally do not know how else to live.  It seems that there is no way out.  This is where CBT comes in.  Cognitive behavioral therapy teaches techniques to overcome anxiety without resorting to picking, and also attends to the script in my head so that I don’t feel such high anxiety about my appearance in the first place. 

This past week, my therapist and I laid out a couple of very specific behaviors that I should employ to combat my skin-picking routine and the anxiety that would inevitably follow.  I am happy (ECSTATIC) to report that it has been going very well and I am seeing results.

I definitely want to explain what my homework assignment is this week and how I have been doing, but I am going to save that for another post.  I don’t want this one going on for days. [update: follow-up post is here] 

For now, I hope this has given you all some insight into the compulsions surrounding BDD and maybe given some people hope that it can be overcome :)  More soon!

On my way

This is just a quick post to say that I think I am finally starting to feel better.  For real this time.  I am starting to believe that I am at the top of the mountain, ready to descend ~ that there is a light at the end of the tunnel (yay metaphors!).  So many times (too many to count, really) in the past few years I have felt better ~ less self-conscious, less anxious, more in control ~ but have never been at peace.  I always had a strong feeling in the pit of my stomach that the fight wasn’t over, that I was just waiting to crash again, to be suddenly ripped out of my seat, whirled around and dropped back at the beginning of the same long journey.  And this is always what happened.  I didn’t have the tools to move forward, I was simply willing myself to get better.  I didn’t even know where to begin or how to get help; I just wanted everything that was bad in my life to go away.

This time is different.  There haven’t been crazy ups followed by paralyzing crashes.  There have been ups and downs, of course, but there has been an overarching increase my well-being.  I have seen things slowly but surely get better in these past few months.  I have taken my treatment one step at a time and have been living my life one day at a time, which I believe has made all the difference.  Instead of expecting a sudden miracle, I have allowed everything to slowly fall into place.  I am taking time every single day to gauge my mood, my compulsions, my self-image.  I am constantly working on my identity and my life, steering myself in the right direction and allowing my past to move me forward instead of hold me back.

I don’t have the same sense of dread that I used to have.  I don’t feel like I am going to crash.  If I have a bad day, I honestly believe that I can come back from it (and have had to many times before).  I am at a place where I never ever thought I would be ~ steadily walking the road to recovery.  I had so many days where I would lay in bed and wonder if my life would ever get better, or if I was doomed to exist as a lump for eternity.  Would I ever become a real person?  Would I ever feel confident or pretty?  Would I be able to actually live my life?

I’m definitely on my way, and it feels amazing.  I can’t believe I’m here, but I’m so very glad that I am.

CBT: I hope I get an A+

My homework assignment from my CBT session last week was to recognize when I was having a BDD thought.  I didn’t need to change my reaction to these thoughts or even write them down, I just needed to notice when I thought them, take a second to acknowledge this, and then move on.

My therapist and I made a list of my typical BDD thoughts, and I want to share a few of them with you:

·       I am ugly

·       I am unattractive

·       I am unworthy

·       I need to make up for how I look by having an above average personality (being extra nice, bubbly, happy and/or accommodating)

·       People are going to talk about me behind my back because of how I look

I’m sure some of you who are struggling with body image/eating disorders will recognize these mantras.  Not all of these things run through my head at the same time, and it is not a constant dialogue in my brain (it used to be, but thanks to medication these thoughts have decreased significantly), but they do pop up multiple times a day.  In the past week, when the thoughts did arise, I would say “okay, BDD, I hear you.  You think I’m ugly, and that person over there is going to talk about me behind my back.  Thanks for the input,” and I would move on.

I found that simply recognizing these thoughts as what they are ~ BDD thoughts ~ automatically helped stopped my typical reactions, which usually consist of shame, guilt, depression, anxiety and the triggering of BDD-related compulsions.  This acknowledgment forces me to recognize the thoughts as something outside of myself, something separate from reality.  It has taken the negativity and sequestered it in a small thought bubble, which I can actively fight.

And this is the key.  It’s incredibly hard to fight something that is within you, that IS you.  In the past, I couldn’t fight my BDD because, to me, it was reality.  You can’t fight negative thoughts when all of your thoughts are negative.  Now, I am able to categorize the thoughts in my brain – BDD thoughts versus all other thoughts.  It is preparing me for the next phase, which will be to (hopefully) eradicate the negative thoughts, leaving only the positive behind.

Homework

My homework assignment for this week is actually kind of amusing, since last week I mentioned that simply stepping back from the mirror would not cure BDD.  Well, that’s exactly what I have to do this week ~ take a few steps back from the mirror and recognize how I look overall, instead of focusing in on what I see as my flaws.  Again, this is not going to completely erase my BDD, but it is a step in the right direction (pun not intended, but noted).

This, plus continuing my thought recognition should help me further understanding the discontinuity between what I see in the mirror and what others see when they look at me.

Full speed ahead!!! *insert CHAAAAARGE music here*

Tell Me What You See

I had my first official CBT session on Tuesday and ohmygosh I am so excited about it.  I seriously didn’t think that I would enjoy going to therapy, but I’m already looking forward to next week.

Let me back up for a second.  I mentioned previously that I started taking medication for my BDD a few months ago.  It has worked wonders in certain ways; my mood is more regulated, I have more energy and I feel more like myself (as opposed to a depressed, self-deprecating version of myself).  I also have less anxiety about my BDD.  In other words, the medication allows me to go about my every day life and actually accomplish things instead of just existing. While I am able to manage my life, I spend most of the day recognizing how others respond to the way I look, and I am constantly aware of my appearance.  Also, my BDD compulsions themselves (which I’m sure I’ll discuss in detail at some point) have shown little improvement. CBT is the final push towards recovery.

I was extremely nervous about therapy, as I have had sub-par experiences with it in the past, but this time is completely different.  I am seeing a BDD specialist, so I don’t have to explain to him what I am going through – he already understands.  This makes all the difference.  I can’t tell you what a relief it is to have someone nod when I say things, instead of staring blankly back at me or furrowing their eyebrows in confusion.  He. Actually. Freaking. Gets it!

Even though we went over some information I already knew (such as the basics of BDD and why I react so poorly to my appearance in the mirror) my therapist explained things in a way that helped me understand further.  For example, when I look in the mirror I see a myriad of imperfections on my face.  To me, my skin is my worst feature.  I think it’s blotchy, scarred, broken out, dirty and discolored.  Simply put, I hate looking at it.  This is not really news.

However, instead of rehashing this list of flaws, my therapist and I discussed exactly how I look at myself in the mirror.   This was something new for me.  I tend to get really, really close to the mirror and inspect every pore on my face.  You think I’m kidding.  I wish I were kidding.  It takes a seriously long time for me to get out of my house in the morning.  After describing my “facial inspection process” he pointed to the wall across from me and said, “tell me what you see.”  The rest of the conversation went something like this:

Me: Where?

Him: Between the door and the painting.

Me: Um, a bulletin board?

Him: No, No, right there.

Me: Where do you mean?

Him: Right here. Here.

Me: Um, wall? A part of the wall?

Him: Yes?

Me: A…white…wall?  Some white wall! WALL?!

It was like a really bad comedy act, but I got the general answer he was looking for.  Then he brought me up close to the wall so that my nose was practically touching it.  In other words, I was as close to the wall as I would have been to the mirror had I been examining my face.  That close up, I could see that the wall was bumpy and uneven.  There were large dents in the surface, scuff marks and random tiny ink blots.  It wasn’t just a white wall anymore, but rather a used, old surface dotted with imperfections.  I think you can see the comparison to how I look at myself in the mirror.  That close, nothing looks perfect.

Now, this does not mean that the miracle solution for BDD is “take two steps back from the mirror” (otherwise I’m pretty sure I would have figured it out before the experimental medication and roller coaster therapy sessions), but it is an analogous situation.  Other people see me like I see the white wall from afar.  I look at it, I take in its major features and I make a judgment.  It’s a wall, it’s white.  Done.  People look at me and say “cute” or “pretty ” or [insert positive or negative reaction here] and move on.  Their assessment has been made.

I, on the other hand, view myself as a close-up.  I look at my face and see every single thing that could possibly be considered a flaw automatically magnified a thousand times by my BDD.  Since I am “close to the mirror”, there’s no way I can miss the “blemishes” on my face.   The wall analogy clearly shows the disconnect between what I see and what others see when looking at my face.  This is something that, without proper help, is out of my control.

Well, now I’m getting help.  So hopefully it will soon be under my control and I can start seeing myself the way I really look.  Yay!

It’s going to take a while, and I’m sure the sessions will become less fun and more anxiety producing as they go on, but I am absolutely determined to move forward with my life.  I finally feel like this is the right time – there is no turning back.  Can’t wait to give you more updates next week!