Key Takeaways
I share my adversity, including with body dysmorphia, as a means of relation to the read and to my patients.
Formative struggles, like body dysmorphia, seldom vanish once appearing. Instead we work to manage the thoughts and behaviors to enjoy life.
It is hard work to wrestle with deeply seated thought patterns, like body dysmorphia. Healing is a journey, not a destination.
How I write my blog, including about body dysmorphia
You might have picked up how I write from my other blog posts. I like to share about my experiences. What makes me different is my use of self-disclosure as a tool to foster a real relationship with patients. When the conversation because an open dialogue we are empowered to uncover difficult secrets that need to be unearthed in order to move past them. I take a lot of time to craft my writing in a way that limits the use of self-diagnosis for the reader and instead encourages a thoughtful discussion with a provider. I purposely use of words like “we” instead of “you” – because we are in this together!
My struggle with body dysmorphia
Body image has been a struggle for me since puberty. Schoolmates, cousins, friends, all made fun of me for my “man-boobs” – which is really the common development of breast tissue in boys going through puberty – called gynecomastia. I found myself only wearing certain clothes to hide my chest. I hated taking off my shirt for any reason around anyone else. I would hunch over in hopes my breast-buds wouldn’t protrude through my shirt.
This was the start of an unhealthy obsession with how I looked. This began to spill over into other aspects of my physical appearance. This impacted the way I presented myself in general, from the car I drove, my music choice, parties I attended, and even my performance in school. I wanted to fit in – to not be the boy with boobs. My doctor said I’d outgrow it (spoiler, I didn’t). Family said they didn’t even notice it – which didn’t help because it felt invalidating. I finally convinced my mom to take me to a plastic surgeon who said she could fix my worry but that it would be many thousands of dollars and lots of downtime – neither of which I had.
In high school and college my self-confidence was low, but I presented as the opposite. I would make digs at others to feel better about myself. It never worked. I began exercising to look good everywhere else. That is a double edged sword because the external validation never filled my cup for long enough to distract away the problem on my chest. All of this was further compounded by trying to understand my sexuality. Control over my appearance became critical in order to be the kind of person society demanded of me. It was truly a torturous way to live – still only wearing certain clothes, heightened sensitivity to criticism, avoiding certain settings, and perfectly posing in pictures.
Body dysmorphia is still a struggle for me
Oh, I bet you’re looking for my epiphany? That didn’t come for many years. I was stubborn about talking to therapist about it. It wasn’t until I was forced to look in the mirror, after a failed marriage. I only get one life to live and that if I don’t respect my body and myself I can’t expect anyone else to either. The struggle is still with me. I still have difficulty. But my relationship with my body gets better every day. It is a work in progress. The tools I have learned have made a tremendous impact on my ability to enjoy life. I now view my body as a vessel – without proper care and respect this vessel probably won’t take me very far.
Let’s be real about expectations, especially for conditions like body dysmorphia
A 100% “cure” is unrealistic. Substance use, for example, is a lifelong battle for sobriety. Abstinence does not equal a cure nor does it mitigate cravings, desire, or the internal emotional scars that addiction left behind. It is no debate that body dysmorphia and substance use are quite different. However my point is that we must adjust our concept of healing to be more realistic.
Healing does not mean invasive thoughts are gone forever, or that there is a green pasture awaiting us after three months of working in treatment. Healing is not a destination. Healing is a journey itself – and nonlinear one! Healing from the wounds of body dysmorphia looks like making today better than yesterday for most days. Healing means recognizing the weight of anxiety will never be fully lifted. It means learning about what we value, surrounding ourselves with healthy support, and making the conscience choice to be gentle to ourselves. It means seeing the way we relate to our bodies as a relationship with a friend – the closest friend one could have. It means compassion, empathy, understanding, acceptance. Healing means learning to balance and display compassion for yourself and others.
Expect to work, to grow, to begin to heal, knowing that weaknesses will swell and old habits will sneak in, but hopefully for shorter periods of time with each meeting. Expect to learn tools that give you the ability to look in the mirror – and believe it – when you say “I am enough.”
If you have questions about integrative psychiatry, are interested in seeking care, or are interested in learning about how to practice integrative psychiatry, please reach out to me via email at ryan@proactivepsychiatry.com. I am working to spread the word about integrative psychiatry, so feel free to repost this blog, just be sure to cite my post!