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Author:  margharris [ Sat May 23, 2015 10:24 pm ]
Blog Subject:  Body dysmorphia: Stories we tell to explain.

Body dysmorphia: Habit refusal and storytelling.
I think a lot of my son’s behaviours need modification through some intervention to reverse habits. The touching habit is so destructive. I almost feel his hand should be stuck to his head to show him how often he does it. I can get so distressed by it as it so often triggers a sizeable panic but he still never learns from experience to stop it. The urge to check is stronger than the subsequent panic that needs avoiding. I liken it to an instinct pattern beyond logic.
Habit reversal usually requires mindfulness. Writing down your own triggers to touch and building on awareness. Then substituting another behaviour you can do with your hands. It is sort of like chewing gum for a smoker.
Having the list of compulsions is also a must. It allows you to see really what has to be worked on. It sets up the goals to be symptom free.
This gets me to the very well experienced but rarely mentioned in the literature: Storytelling. Once my son’s circuit is triggered he will recite sentences that are attempts to explain his distress. Most often they are verbatim replicas of what he has said the day before. He has no ability to dissolve these sentences. Regardless of who has discussed them or how deep into the burrow I have gone with him to internet search their murky origins, they still are repeated as though they are illuminating. I now try not to buy into any discussion of them. He will still try to repeat at least one each day. It is a habit now that I probably realise can only be sorted with medication.
Now many of you might think this is all only a learnt fear. But regardless of how well his hair is regrowing since he has finally stopped cutting and shaving it, he only assesses it in terms of loss.
This value and assessing of hair then is encoded in his brain. It is likely to have arrived there at most likely the age of 8. He would have seen the back of his father’s head and he indeed has reported to me that he recalls loathing it from the viewpoint of the backseat being driven to school in primary school. So he was visually fine tuning his values as soon as he was able to personally assign his own emotion to the things he saw.
His father was the detached type. Born in a work camp in Germany to a Polish mother who had suffered the most unspeakable. She had been a gorgeous looking tall blonde 18 year old at the start of the war. Her emotional shutdown lasted all her life. So as a result, my son didn’t know his own father emotionally either. A legacy handed down from a heinous war experience of what men can do to each other.
So maybe valuing his father negatively was a reflection of a love bond that was strained by distancing. He was too young to understand. He reflexly made a stronger bond with me to fill the void. Perhaps most boys do make stronger bonds with their mothers. But at some stage they do have to own their own skin and become the man that is their destiny. But he had already set himself up to rejecting a part of himself that would remind him of his own father.
Integrating himself with his own body image might need a revisit of childhood and the value he placed on his own father. By resolving the discontent with your own parent’s looks, all of you might be comfortable to own your own.
So he needs a new story to tell. One that integrates and understands how he saw his father and how that might have translated to an overvaluing. This still might not be able to reach and integrate into a circuit that was laid down as an 8 year old so diffusing in this way might not help his BDD. It may help with his ongoing relationship with his father. There is no evidence for talk therapy in this kind of psychoanalytical way as a treatment for BDD. This is the opinion of Katherine Phillips in her book based on her research work. However mental illness has a way of spotlighting lots of other problems that need a bit of work. So a repair of my son’s relationship with his father is now part of the healing.
To this end I ferreted out a couple of old photos of a young couple. His grandparent’s, just after the war. She was early twenties and he maybe mid thirties. I explained that these ancestors have given you this body to live in temporarily. They did their best for you. Allow yourself to fill it and own it. The photos now sit of the shelf overlooking his bed. He said he liked them there.
We have to all know who we are. Unique. We are not just a product that needs to conform. We bloom where we are planted. Marg

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