It was a tough weekend. My son experienced his first date in ten years. It went well even though he had moments of BDD intruding. It brought into focus the difference between being with someone who has a history with you to constantly criticise and someone who is keen to hear just anything about you. His trip home on the train became a nightmare as he started the comparing and the BDD thoughts took over. The emotion and the fear. He was screaming inside about how easy everyone must have it without BDD ruining their lives.
The euphoria of going on a date had been short lived. The doubts returned as soon as he was home. Had he made a good impression? But then the phone made that little familiar tingle. The texts started arriving. She was a texter. Maybe not much of a talker but a ‘Whats up/ whats on? Kind of girl. He is not used to this type of attention.
This put into focus the much needed paperwork for a divorce. Not knowing the exes address is a bit of an issue but it can be done. He became a basket case all yesterday. The emotion of having to deal with life was so obviously a trigger for an upping of body concerns. It was an extra anxiety that he hated to handle. His stories took over. Body hair and Dute causing loss, were all he could hear in his brain. I darkened the house by 6pm. No noise at all. We had taped an episode of “Better Call Saul.” But not a possibility.
This morning he was still off. Texted his ex to do the paperwork for a divorce and then changed his mind and said he would do it. About 6am it started. By 8am, he had two Valium, and one beta-blocker. His eyes are now wild looking. He is in angry mode ready to punch something. The emotions of grief have past the day before.
Donna, my supporter, has provided insight into how the unravelling of BDD will look in one of her emails to me. I include it below:

“There may be a lot of crying, as there will be a lot he will be facing in his unravelling. In order to find closure. This is not a painless journey, his healing. But he just needs to be reminded of the value in it! Priceless! Eliminating the cutting is one less thing he will find to beat himself up over. One less fleeting intrusive thought. He will gain strength in his own accomplishment. “

I have taken on board more of what Donna has shared regarding the emotional content of the thoughts. Rather than debate the logic, I am asking about the emotions they carry. So the thoughts have become the Sanjeev thoughts from Mumbai call centre and then I ask what emotions they carry. It is a shift away from focusing on the message but the fear behind it. The thoughts have never brought any closure or logic to work with. They are fear stories and that is what he needs to discover He is beating himself up with them and that diverts attention from his real life. Real life remains in the too hard to look at basket.

He just called out from his bedroom, his Dute to Fin story has arrived and he is in distress.
I call back, that ‘Sanjeev has got him hooked online.’
He could up sell him to a Fin story next. It is a bit of mocking but it is my sanity as well needing to vent.
He calls back telling me that I am saying it is all rubbish.

So I managed the intrusive thought attack without actually naming or debating the thought. I have classified them and so this should work for all future thought attacks. Sanjeev is going to be kept busy. I just have to keep myself ‘on message’ and not fall into his baiting game.

Hope we all can get a better understanding of the way out. Marg

I had to go with hubby to have stitches removed from melanoma surgery. He does well as a stroke survivor to just toddle to the car and then it is a wheelchair for anything more. During the procedure, I happened to be facing him and looked down to see a very red lower leg. Yikes! new splints two weeks ago. During all the kerfuffle at home, I had let him put his own splint on or leave day splints on overnight. Price paid. All the splints off and the mobile wheelchair had its baptism.
I can't describe the mayhem. Hubby was steering dodgem style, over steering, over revving. I was over it before it began. Where was turtle speed? To make matter worse, hubby needs a cane to walk. The cane lay on his lap jutting forward like a lance fit for a horse joust. The mobile chair can spin on the spot but with the cane protruding you have got to leave the room if he enters. For the first couple of hours, I was running ahead of the chair trying to clear tables and chairs away. He was on a mission to continue life without any alteration to his schedule.
Go get dog food frozen in fridge. Oh! too high to reach.
Move dogfood to lower shelf. Maybe remember to get dogfood out in the morning myself.
Feed fish. Oh! cant reach the light. Call out.
Need to use computer. Run ahead to remove clothes drying rack.

So my son and his BDD took a backseat. He was better for it. My son was very anxious all weekend with his thoughts. No approach is sticking with him. He still wants to open debate with the thoughts. But they are not protective and not safe. I have now nicknamed them his 'call centre' thoughts. Sanjeev calling from Mumbai telling you something you must buy. I am not trying to be disrespectful but link into the idea of dismissing that he already has in his brain. I was trying to classify these intrusive thoughts into some already managed thought circuit for dismissing and not opening the dialogue for debate. It is the thought attack we are trying to stop. The content of the thoughts changes but is still irrelevant.
He calls out, "Mum " in alarm. I am now calling back from the other room. "Just Sanjeev calling. Don't pick up" Because I use this approach myself for dismissing something intrusive like call centre unwanted calls, it has more power as it is established.
It is a long way from taming this because really the important step ahead is to refocus his life. He needs a wellness plan that is more important than doing BDD.

Got a lovely post from my supporter Donna, will add some of her words below. She describes her thoughts and her mindset. It works like a filter to just give her negative thoughts. It can happen all the time.

“My entire life, and still tweaking this, I have been my worst enemy, in that I always thought people thought poorly of me, no matter what the circumstance. If someone glanced at me, my mind ran full speed at trying to figure out what they might be thinking about me.”……….. ..
“It just amazes me how much I think we all are really so much alike in this world. I think everybody sufferers this way in one form or another, at some point, or unfortunately always.”
“So yes, it's what are they thinking, and the "what ifs" we are coming up with, are of course all negative. So we are within negative energy, bringing ourselves down. etc. But for those that are extremely insecure, this manifests into sort of paranoia. So that is why when it's large groups, we are analysing not one persons perceived thoughts and opinions, judgment, but a group of many. Wanting to escape their view and when we do, when we aren't glanced at, that is a whole other scramble of negative thoughts as well. We must not be worth looking at.etc. Anything that happens, the energy of our thoughts is negative. Walking into a crowded room, or store, what have you, feels the same to person with disorder as it would as if we walked into a room and everyone in that room began yelling out terrible names at us. Yes, it is that stro...

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Well the success with just calling the thoughts questions in disguise was short lived. The very next day the thoughts rebounded with even more intensity. The thoughts left him screaming for relief. He is back believing they must be true. He read it online from dermatologists. If you go from Dute to Fin you get loss. If I finally convince him he has only made this up to fit his need for " knowing the answer to why?" he calms down. But that isnt the end of it. He is soon onto another story. " Upregulation of receptors, Fin will never work for me, the loss is permanent." The catastrophic outlook takes over. I know it is not debatable. It is just another hypothesis of worst case scenario.

But all this storytelling allows no one to have time to mention the elephant in the room. Where is his wellness plan? Where is his life? The genius mind has been so distracted by all the fracas that he doesn't seem to figure, life needs some work. Will he get up to function today? Probably not.
Does he feel that life is too difficult and this is his way out. The known pain of familiarity might just feel safe.

Is it a way to process 'inadequate' without realizing it?
From a carer perspective, the illness is not being processed as something to remove from life but something that is safe and protective. My son is not willing to give it away. He fights me to remain believing in his storytelling. So does BDD offer a control over life that real life doesn't offer? He is doing a good job of remaining in his illness and controlling me as well. There are very few times in the whole day that anything like cooperation is achieved. Even taking a shower only works with a bribe. Is this his passive aggressive tendencies or is mental illness in general something that requires a willingness and readiness to move towards recovery only when some inner transformation has occurred. The adult needs to be ready and willing to take up the reigns of an adult life.
He is in disorganized loops of fear at the moment. He is now asking for Valium. This is as bad as it gets I suppose so if you are feeling like you have this disorder get help when you still have the ability to do therapy. I tell him that his thought attacks are not real but just what he fears.
He replies and mentions his Dute to Fin is true though. And in all this, he has me back in his room getting him drinks of water, meds and reassuring him again. Is this a control issue? I think it is but that maybe just one aspect of it.
If he is in control, everything will work in his world and he will know all the answers. If he knows then he will not have that alarm going off in his brain. Marg

One month update from starting this blog.
It has been rocky. We have had some wins along the way. He has given up alcohol, cutting and mirror checking. The reduced compulsion time has spiked the thought attacks. Most mornings take hours to get out of looping thoughts. This is very hard to live with but it is still progress out.
I think making the list of compulsions to tackle was valuable as it set up a goal to achieve...Compulsion free. The idea being, if you reduce compulsions, the thoughts will be deprived of the fix. They will in the short term increase but ultimately become boring and will reduce. The panics they have brought have been truly horrendous.

As odd as it might sound my latest approach to label thoughts as just all questions in disguise seems to have worked. He didn't ask me to verify any of his usual BDD stories that arrive with a scream, panic and demand for Valium or a betablocker.
He did go over his stories yesterday quite often. I replied by adding," you mean..What if"
I think I was able to convince him his stories were really his hypotheses. His genius mind was wanting to find answers. No one knew for sure, what drug could save hair. He would answer, "But I think it is my fault."
That response is so typical of the hyper-responsibility of a BDDer. You want to take the blame for something. But would you think everyone was at fault for how their body looked? You really mean. " What if it is my fault?"..... so it was just his BDD talking again making him feel responsible for things he could never control. He didn't know it was his fault at all.

He has asked if he is too ugly to date again. He already has someone interested. Can he pull himself out of this? I told him he was fine but I wouldn't get into a debate with his BDD.
So the 'What if' approach seems to have taken the venom out of his BDDs.
He still is wearing the hat, touching a lot and taking the hair meds in panic, so there are compulsions still needing attention.
He is now on a cocktail of meds. Started 10mg of Prozac to get him moving in the morning. Started 75mg of Prothiaden to settle him at night. He is not running to the fridge so that is a plus. I think my son is just too unwell to do it without meds. Those of you who can still function might not have to deal with this side of treatment but we do. We don't have an option.
Thanks to my supporter, Donna, I plan to continue. Donna has made it out of her disorder. It is possible. She has been in a bad place and turned her life around to be able to extend herself to help others. Her OCD brain has been tamed. There is hope for us. Wish you all well over Easter. Marg

It is a battle we are in. The intrusive thoughts can be relentless. What makes them so potent and continually coming. In the last few days I have put my mind to analysis more closely. This is what i have come up with so far.
1. The intrusive thoughts are what you fear and not what truly has happened.
2. The intrusive thoughts seem to be telling you answers when really they are only questions. You don't realize they are questions because in your brains haste to provide context for your alarm, it hasn't added, "What if." to prefix the thought.
What you really should be hearing in your head is...
"What if I left the tap on?" rather than.."I left the tap on?"
In reality your brain knows that your thought is a question. Your brain knows you really don't know so you have to ask someone who might. But then the thought comes again and you get confused.
So what you should be hearing is...
" What if my hair is thinning?" That question connects to my son's fear that baldness is ugly, embarrassing and his responsibility to avoid. It is a weakness, needing nerves of steel to tolerate. But his thinning is only minor. He responds as though he has total loss.
I can extend this way of thinking to all OCDs and BDDs.
" What if my jaw is crooked?" is heard as " My jaw is crooked?"
" What if I am ugly? is heard as "I am ugly?"
" What if the surgery is botched?" is heard as " The surgery is botched?"
The alarm has truncated the sentence so you fail to recognize the thought is a question and is not a statement of fact. This thought then seems like an answer but it is an answer that never sticks. And it never can stick because it was always a question.

My son has repeated his, " If you move from Dute to Fin, you get loss" He both asks as a question and then repeats as a fact. It is impossible to debate because it is only an opinion. He is trying to find the answer to why but only comes up with questions. This keeps him continually searching and in distress.
3. Intrusive thoughts are a search for certainty as a way of reducing anxiety. There is so much anxiety about not knowing for sure that answers are continually sort as a way of reducing anxiety.
But real freedom comes when you accept not everything is known. Some things are accepted as normal even though they are not desired.
4. The intrusive thoughts are overvalued as meaning something really important. They come with such authority that you are sure that you have the right answer. The punch of anxiety alters your perception of reality so much that you fail to recognize you have created the worst case scenario in your head...
"What if the woman at the photocopier thinks I am ugly?" ....is heard as " The woman at the photocopier thinks i am ugly?"
Then all the 'add ons' flood in that link to your concept of ugly..You are worthless, hopeless, inadequate, a failure, never going to find love.
All those thoughts are enough to give you a panic, leaving you hiding under the desk.

So from my experience with all my son's OCDs and BDD, intrusive thoughts are really questions in disguise. They are all fear questions that link to your worst fears. They are overvalued because you feel they are meaningful and telling you something important. They are telling you what you fear. They are your attempt to manage anxiety by finding certainty and maintaining your high need for responsibility over life.
Liberation will come when you take the risk that you are OK not knowing. Some things are just not known. Most things are managed with a level of uncertainty. You can do this life. It was the life you were born to do. That is not a mistake. So let the thoughts come as they may. They are just thoughts and not reality. Don't be alarmed by the questions they raise. They aren't meant to be...

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