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Body dysmorphia. BDD eruption.

Permanent Linkby margharris on Sun Jul 05, 2015 3:33 am

Things had been going quite well. He was heavily invested with the new girlfriend and a mate was to stay over. No time for an all day bed rescue but he could cope we thought. The AA was to help stop the desire to implode with drink.
But it all became too much. He had visited beer pubs as this was the scene they once were into together. He was able to refrain and make an exit home early. The guy made his own way home.
In the safety of his own home. The explosion happened. A BDD session commenced. The stories poured out of how bad it was. He couldn't stop hairloss. He drew trajectories of future loss and demanded further treatment even at the expense of his overall health. He crossed the line into insanity. I tried to escape as I was the target for the tirade. At one point I thought of leaping from the back bedroom window. He blocked the bedroom door and in my panic I beat at his chest to try and get him away from me. Then I felt the blow. It hit hard and it was over. An immediate bruise blew up the size of a tennis ball on my arm. I took off out the door and stayed in the car for an hour. It was too late for a motel on Saturday night and too cold to stay in the car all night. My biggest fear is that my husband and I are always at risk of violence at his hand. Either of us could become the victim once he loses touch with reality. A criminal charge would finish all of us in a completely different way. His job prospects would be over and we would then enter a new phase of the criminal justice system.

We are to visit the psych tomorrow. The obvious move is a ramping up of the dose. But i still think the behaviours need addressing now through CBT. He has been deemed too sick to confront anything so far. No psychologist will see him. There is no point really second guessing what the psych will say. It is wishful thinking to imagine a psychologist could do better than I have done. But we have to get to the bottom of what keeps driving the disordered behaviours and thinking. He has to account for that himself.

His identity has merged with this conviction that hair matters second only to breathing. Why only hair and not skin or teeth or wrinkles demonstrates the bizarre nature of the illness. It is only hair that he abhors. His life has been hijacked by an intention to have perfect hair and prevent loss.
Interpersonal costs come a distant third in the drive for maintaining a perfect hairdo for life.
The worry about hairloss drives it, I suppose and the intention then becomes to prevent hairloss regardless of the cost to himself and others.

If he went to CBT he would have to be able to submit to this three pronged approach. Reducing avoidance, engaging in response prevention and practicing full on exposures to eliminate any situational phobic triggers occurring in the future.

How this works out is that Avoidance is usually tackled first. What things are you not doing out of fear? The thinking and behaving links would be explored to highlight the lack of wisdom and fear, avoidance, generates. My son is not washing his hair. He is not combing his hair. He is not looking in the mirror. So these very normal things that he once could do would be requested of him.
In response prevention work. You list all the things he now does that he shouldn't. Online browsing, comparing, checking, thinking about it and talking out his stories are things that keep the problem fueled up in his mind. The concern is kept alive and given breath by these sorts of behaviours that are a response to fear.

So once the things he avoids and things he does that are not safe are worked through, then exposure is artificially set up. You go under bright lights and take a look at yourself. You set this up yourself so you are more in control.

You keep practicing recovery language.too.... My worry is just a brain circuit problem. My hair is normal. I don't need to be worried. I need to have the courage to let my hair take care of itself. I am not in control of everything. I need to focus on what is really important in my life and value those people in my circle that make life worth living even through hard times.

Hopefully he would stop taking hair meds and focus on real life. The meds seem only to be fueling the fear and his DHT stories. No one living with him feels he is happier taking them.
But that is a real optimism stretch.

He has had 10 mg of Valium through the night and another 5mg this morning. Part of me feels the hate. The hate is fueled by the anger. I can't reach him when he goes into that place where insight no longer means anything. This dissipates quickly and the tears flow. I bear up to so much pain. It is the most horrid of pains to know your son is insane. And we still just don't know how to stop it. We can't do it for him. He has to want wellness rather than that hairdo he has idealised in his mind.
But tomorrow morning he will wake as though nothing has happened. His island of insanity will most likely have subsided.
Wish you all a better future. Marg

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