Psychology and Mental Health Forum

Author:  margharris [ Fri Mar 27, 2015 11:10 pm ]
Blog Subject:  Body dysmorphia: Mornings are hell.

Mornings are particularly awful. Through every exacerbation this has been so. He wakes up in a panic. He calls out and cries in the pain of it. Some doctors have thought the behaviours have some resemblance to Tourettes. I rather think he has just a flood of fear that his brain simply operates at a very primitive survival level. Calling out is that alarm response to peak distress.
He ran for the shower early, but not for any mindfulness of his daily needs. He believed our agreement was he could take the Propecia tablet after a shower. So the urge to take the tablet to halt hairloss and kill off DHT was so great, he was busy with a compulsion as soon as he woke.
The tablet is something he knows at some level is something he should stop, so I think it is highly likely that just taking the tablet spikes his anxiety and sets him off.
To get through the panic we have tried the 4 staged approach like Jeffery Schwartz suggested. It is a basic label and attribute approach with refocusing the big hurdle for us. It is so hard to focus in a panic on anything but how you feel. The distress gets to me too and all I want to do is scream back. Staying calm can be hard if it goes on for hours. Sarcasm starts up fairly easily now a days.

I decided a new tack was needed. A clench fists moved strongly downwards while saying, 'False thoughts." This is like throwing down an anchor. The physical movement linked to the dismissing label might be more powerful in taming the panic and recognizing the thought attack is merely the amygdala hijack showing up in his brain. It gives a bit of space and time for perspective to enter.

I have tried to introduce a mindfulness chores list as this is part of a mindfulness training to stay present and connected to what you can do now. I wrote down about three thing you could do on entering a room of the house. Not at all successful. He will have to initiate this somehow himself to own what he does. There is little reward in doing a job well if you haven't been the one wanting it done. Improving motivation to stay present and commit to an adult role still seems a way off really. I spoke this morning of the idea to just enter a room at any time and scan to see one job to be done and then try to do it as a form of meditation. It is like an exercise in self control and discipline. Will he take up suggestions like that? It is a leap of faith but perhaps it suggests I have more hope than experience.
I have put on a youtube meditation to echo through the house. He finds this soothing.
On a positive note, he said yesterday he would try to stop wearing a hat. Now today that might have been forgotten, only time will tell. Just pleased to hear him say that. It means it is on his to do list. There is some forward planning.
Also on a positive, he is more resolved in his understanding of his problems with his wife. She never saw herself as being beneficial and really connected to his recovery. He had to do it for himself and she would ignore anything that did not conform to what she wanted. This rejecting of illness and need to conform or control or ignore is most likely a cultural thing. But it can't work. The resentment list is held tightly on both sides. The criticism and lack of approval or appreciation for how hard a road this illness is will never be understood. I suppose any huge upheaval tests a marriage. You go along smoothly only because nothing major is happening to test whether needs in the relationship are being met. The problems surfacing is like pulling off a bandaid to see the woundings below. The bottom line is you need to be able to trust the person with your dreams, fears, secrets and your heart. To get over BDD, you truly need to find yourself as valued, loved, balanced and supported. While he battles this without her, she has gone on her own journey to find herself. She had work to do as well. Maybe in time he will understand that she just didn't have it in her to respond well.
The Prozac is giving more morning jitters. He is particularly bad and calling out. Hope we have a better afternoon. Marg

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