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Kay789

Seeing a therapist about preoccupation with acne

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Last year, I finally started to see a therapist about the anxiety, depression, and obsessive compulsive behaviors that have developed as a result of my acne. My therapist and I established that I have Body Dysmorphic Disorder, and I imagine a lot of people on this forum do to some degree.

From wikipedia: "Body dysmorphic disorder (BDD) is a mental disorder characterized by an obsessive preoccupation that some aspect of one's own appearance is severely flawed and warrants exceptional measures to hide or fix it. In BDD's delusional variant, the flaw is imagined If the flaw is actual, its importance is severely exaggerated."

I had always thought BDD was only used to describe people with an imagined flaw. I didn't think it applied to me because my acne is quite real. But I let myself believe that my acne genuinely affected how people felt about me - even people who love me, like my family and my husband - and that just isn't true.  And that's where the BDD came in.

It was a slow process, learning to accept myself the way I am. It involved a lot of exercises that sounded ridiculous to me at first (for instance, since many days I was too embarassed to go to work because of my skin, I would stand in front of the mirror every morning and tell myself 'You are smart and talented and beautiful and the people at work will respect you no matter what your skin looks like.') . But I have made amazing progress.  I have even taken many steps to correct my mild OCD (I used to suffer from extreme anxiety if I missed even a small part of my 2 45 minutes daily skin care rituals. I would suffer from the same anxiety and guilt any time I splurged on a mini bag of chips or a half candy bar) Modifying these behaviors has been even more difficult than self acceptance, but I have to say I am making progress.

Bottom line - I highly recommend therapy or counseling to absolutely anyone who can afford it. I know that's a big if - therapy is expensive. I only decided to give it a try last year because I had already met my deductible from dermatologist visits and acne prescriptions. However, it has been so helpful and life-changing, I am continuing, even thought I actually have to pay $60 a session for it now.

Good luck!! <3

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Thats good to head. I definately need therapy for this but have no accwss to a therapist right now. Can you share some of your techniques for coping? Whenni get a new spot i panic and cant leave the house. I suffer huge anxiety attacks if I dont check my skin for a while

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I must admit it is something that has always confused me about BDD. I had always assumed that it had to be an imagined "flaw" rather then a real one to qualify. I also wonder how they would define "exaggerated". If I have 20 spots on my face and look in the mirror and see 200, I assume that would count as BDD. If I have 20 spots on my face and look in the mirror and see 20 spots on my face, but am still deeply uncomfortable with this, is that BDD? 

And then there is the uncomfortable question of whether or not people do treat you poorly due to your "flaw". I've known many people who have openly expressed their dislike of others purely because of their appearance. Its hard enough to avoid those people in a social setting, but it would be near impossible to do this in a working environment. If this is the case, is it responsible for a therapist to tell you that the problem is effectively all in your head?

I suspect that I may be a sufferer of BDD, but as I don't yet have the resources to see a therapist I can't know for sure. My one experience of therapy when I was a student wasn't really helpful, but at least it was free!

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I have been suffering with BDD for close to 20 years. I will look in the mirror and force myself to say, "You're beautiful, you are loved". You need to believe it when you say it and not just say it to say it. When I think negative thoughts about my skin, I tell myself that it's only a thought and not the truth. I also think about all the things I do like about myself like my blue eyes, straight teeth, pretty hair etc. I believe meditation and using affirmations can help anyone suffering with BDD. BDD can be so hard to control but you need to put your "flaw" into perspective and think about how great life really is despite a few blemishes on your face that most likely only you see. 

You Tube has a lot of "self help" videos for those who can't afford a therapist or are to embarrassed to see one. 

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Hello jenguard82.  Have you used CBT or ACT to change your thought process?  I feel so hopeless sometimes.  I have a job interview tomorrow and all I can think about is my scarring.  It's such an awful way to live.

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I will simply say this: the effects of acne and/or scarring on how strangers interact with you cannot be denied. I am not imagining different treatment that I receive compared to people without an obvious disfigurement.

For example, a few years out of college (post my 2nd course of Accutane), my skin was the best it has been in 10 years.  I usually went t bars and such by myself and looking back, I did notice that some women noticed me.  As I was walking away a  bar once, I walked past a group of 3 young women and I just kept walking.  I heard one of them say "maybe he is gay"  as if they were expecting me to try to talk or walk with them and then buy them some drinks...  Back when my skin was the best it has been in 10 years, I was still a virgin, very socially awkward (due to going to a 75% male technical college and mainly being introverted).  As such I did not have the burning desire to seek out and talk to women - if I felt tension, I just jerked off.

However, by my mid 20s, I was starting to get impatient about still being a virgin and thus decided to take matters into my own hands and start seeing escorts.  Anyway, I learned quite a bit about the physical aspects of sex, but not much really about the emotional aspects and how to really talk to women.  Anyway, coincidentally (or maybe not, since God might be punishing my sinful behavior), around my mid 20s my acne scarring started to get worse, especially the large atrophic scar on my left cheek....   So as I became more interested in dating and have a burning desire to have sex with them, I haven't met one woman yet who could see past my acne scars....    Oh the irony.... 

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On 2/10/2016 at 9:33 PM, tigardo said:

Hello jenguard82.  Have you used CBT or ACT to change your thought process?  I feel so hopeless sometimes.  I have a job interview tomorrow and all I can think about is my scarring.  It's such an awful way to live.


Hi Tigardo,

I am just seeing this now. My apologies. In the past I went to see a psychologist and sociologist but I felt like I wasn't getting the help I needed.  This was over 10 years ago when I was in my early 20's. My BDD was at it's worst and I was in a very deep and dark depression. The only thing that has really helped me was changing my attitude. It's so easy to be negative and unhappy but it actually takes effort to be happy and appreciate all that life has to offer. At this point, I am just happy to be alive and be healthy. Of course, some days are harder then others. For instance today, I just found out that I am being demoted and I am taking a pay cut at my job that I have been with for 8 years. I was in the top 3% of my company for performance and they are still doing this to me. I cried when I first found out but I am putting this into perspective. I still have a job. Some people lost their job today at my company. I try to see the positive in everything. My face broke out last night with three new pimples also but instead of focusing on the new acne I focused on how clear the majority of my skin is. I sometimes still get caught up with staring in the mirror and focusing my thoughts on my skin and when I am going through that I meditate, exercise or focus my attention on something I enjoy. Life isn't perfect, it will never be perfect. We are all humans and we all have flaws. The people on this site are dealing with acne. Other people are dealing with cancer, HIV, paralysis, missing limbs etc. Some people are dealing with emotional and psychological issues. My point is, we as humans are all dealing with something. The best advice I can give you is to learn to be happy and go with the flow. When I first started out learning how to be happy, I had to force myself. I was faking being happy. Now I feel like for the most part, I am just a happy person in general. Nothing can beat me, nothing can get me down for long (that's my mentality). Dust it off, move on, forget about it.... When I stopped caring about my acne, when I allowed myself to live again and enjoy life (instead of punishing myself for having acne) is when I noticed my skin cleared up. Instead of spending 5+ hours in the mirror, I would only allow myself 5 minutes in the morning and 5 minutes at night after my shower. That's it. No exceptions. My stress and anxiety levels decreased because I was focusing on other things. When my stress and anxiety levels decreased my skin got better. To answer your question above, I have only tried self help CBT from watching YouTube videos. I do feel like watching this videos helped me out. It helped me put things into perspective and it helped me realize that I don't have to have clear skin to be happy. I wish you all the best and good luck to you. 

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