I don’t talk about this diagnosis often; in fact up until now, only three people know about it. It’s a psychiatric disorder of cognition known as Body Dysmorphic Disorder. In BDD, your brain distorts how you view your body. Rather than looking at yourself as you are, BDD forces you to see your body in the most negative ways possible. It’s not talked about often in the landscape of psychiatry, part of this is due to the patients themselves who experience enormous shame.
The body is a shame-inducing aspect of life on Earth, isn’t it? After all, we turn red when we fart; we have euphemisms for bowel movements and urinating. We have a host of names we us to call our genitalia, some cute, some offensive. We embody the moment when Adam and Eve suddenly knew their shame. BDD takes shame to a whole new level that a fig leaf just can’t cover up.
In BDD, your brain gets stuck on a part of your body and spends minutes to hours to days ripping shreds into your sense of self for the perceived imperfections that part of the body has. And god forbid, you actually have a flaw in the area—then there is no end to the vitriolic whispers that seep into you as your brain thinks. And because it emanates from your brain, it is with you all the time. Every waking moment your sense of self is slowly eroded until all you want to do is hide in a closet until the world ends, which you pray is sooner rather than later.
It’s a painful disorder. I’m not sure if it translates into physical pain and contributes to my illness. I would think not since I’ve had BDD since I was around 10 and my physical pain started in adulthood. But it does cause excruciating psychic pain; this is because during the day and night, your inner voice tells you repeatedly all the things that are wrong with your body in the most abusive language possible. The voice is laden with cruelty.
For me, this inner demon has a range of commentary. If I catch a glimpse of myself in the mirror, I get stuck staring. Like Narcissus staring at his beauty in the glassy lake, I stare at what is ugly in the smudged mirror. What I look at can be my skin, the small droop to one eye, the unevenness of my face, the flatness at the back of my skull that gives a rectangular view to my profile, or the thin smear of facial hair under my chin (this I focus the most on, so much so I resist hugging my significant other lest he fee any prickliness on his skin and begins to think “ew how gross”. And that’s just the face, so I avoid mirrors as much as possible. If I don’t have the visual input I can get away with not thinking about my features, except the hair on my face. I know intellectually, that what I find imperfect is actually normal and if I see it on someone else I don’t think the person is ugly. But it makes no difference to my brain because it means I am not attractive.
Then comes the body. I have always been at war with my body, ever sense I was a child. My body was the landscape where insults and arguments with my mother, my grandmother, my peers were launched. My body was the landscape of violent abuse and repeated rape all by the time I was sixteen. It was a body that I wished to be gone from. But it was one I was stuck with and my brain never let me forget this.
By the time I was five, my hair was a battle zone between my mother and I. She wanted it long and silky. I wanted it short and less tangled. Night after night, I cried as she attempted to detangle my hair with sprays and water and special shampoos to get it the right consistency. Finally, I took scissors and cut the bangs, right before picture day. My mother was horrified, but I felt a small victory and soon learned that scissors and my hair was one thing I had control over. And I got my short hair.
But I still wasn’t “Ladylike” enough according to my maternal grandmother. My feet were too big, like blocks, nothing compared to my mother’s dainty feet she paraded and wiggled in front of me. My feet were too big—to big blocks of marble that a sculptor failed to finish correctly. And I never wore lipstick and a “lady does not leave the house without lipstick on”—I was allergic. But most of all, my boobs were too big and uneven. Most humiliating of all, I “didn’t look the way I was supposed to”.
My BDD coupled with the reinforcing statements of my mother led to a drastic measure of breast reduction surgery. It was so bad that when I met with the plastic surgeon I told him to cut my breasts entirely off. Instead, I endured the humiliating process of him telling me in great detail how my breasts were poorly made. The nipples hung too low, the breasts too pendulum like, not perky. “So we just move the nipples up to the center, take all this extra fat out”—sharpie marker tattooed my wrong boobs. Years later I would learn my breasts had been fine, the exact shape to nurse an infant. Nipples are supposed to be down so babies can feed more easily. Who would have guessed that nature and God actually designed something more perfect than what man could come up with. But now I looked like a Porn Star—bright perky boobs, with scars however. I was promised no scars. I had something to explain to every boyfriend and something else to focus on. But according to my mother, “You look just as you should have looked.” My body was temporarily right.
But not for long…damage was done. For the next 23 years, I would slowly erode what self-esteem I had to become someone who was afraid of being seen in public. Self-conscious that all my disfigurement would be noticed. I gave up careers, failed at relationships, and avoided restaurants like the plague. And of course it didn’t help that my body failed me entirely and became riddled with a disease. And the one side effect I prayed would never happen, happened. I gained and gained and kept on gaining weight.
I had been thin most of my life. Big boobed, but thin. I didn’t have to hear “you’re too fat”, instead I heard things like “she’s big on top and has a long waist to her crotch” when my mother took me to fit me for an 8th-grade prom dress. But I never heard, “she’s fat.” Until years of corticosteroids, antidepressants, and antiepileptic medication turned me into a round apple of a woman. And my BDD went into overdrive. All mirrors had to be avoided, all pictures shredded. I was horrified when a picture of me ended up on facebook from a family trip to Medieval Times and I stared and stared at the picture in sheer horror.
I’m lucky, however, it appears my Nudexta is a wonder drug for BDD, although no research has ever studied it with BDD. So my symptoms are not so bad most days now, but recently they have been creeping in again and I find myself staring at the mirror, ready to fall like Alice Through the Glass Darkly
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