The good minutes here and there are all I have to cling to for hope. This illness is ferocious and my son has a very severe case. He cried for hours yesterday. it was his wife, then his hair, then the thoughts. He was crying over the grief of it all and the cost it had taken.
Did he lose his marriage over it? The marriage most likely never met either person's needs for quite a long time. My son just didn't know until a big problem arrived and she wasn't there beside him. She was busy in her own life. She is the criticizer type, so finishes the convo with, 'but I do love you'. He being super sensitive to criticism and a self criticizer as well could never find happiness and his own sense of adequacy with that type of person. She must have done a good cover up act at the start. O he was such a pleaser at heart that he didn't see what she was. He only felt what he was doing felt good.

So what is keeping all this BDD going? I can see the pattern:
1. His negative objectifying assessment. He is a bit of a body. Even though all bodies let us down and are not satisfactory in some way. He wants that bit of him to be just so. The rest of him and all he does., What kind of person?., The quality of his heart? All these are not valued.
So he is ugly, embarrassed, helpless and angry.
2. His negative predictions. Everyone will see his hair and be stunned. I can lift my head from my computer and he screams.."Why are you looking at my hair?"
I generally look at people's faces to see who it is. Apparently he is used to looking at scalps to compare. He only sees the great one's so that makes him feel shame.
3. The tricks and avoidance. Just use a hat. Just use toppik. No one will know why you don't go swimming on a 40 degree day. Bake on the sand to avoid a wet hair look.
4. Ask those questions why yet again. The made up stories allow for venting the concerns. They become a big part of the problem. The constant retell and defence legitimizes the illness.
He is stuck on the going from Dute to Fin you get loss. I say you get sterility with both, different type of loss. It doesn't help. Not expecting it to. Just whole heartedly sick of hearing it.Reassurance of any kind doesn't work. No debating with a story.
5. The compulsion for surgery will be the fix. A fue transplant, tattooing your head, artificial hair grafts. More online browsing. I just haven't found the answer yet.

So all of the above explains why the illness continues. It is in the pattern of thinking and behaving. If you have a mild illness, CBT that tries to tease away thinking and behaving to show how destructive it is might work for you. You can have the thought but don't react to it by avoidingor reassurance or just getting angry.

I had been leaving the house over night in order to get some rest and so he would stop the questions. I tried to stay last night. He had cried so much he seemed tired. He was calm so we were able to watch some TV for a couple of hours. This hasnt happened for over a week. He is medicated with sleepers but they don't work fully. So I stayed or tried to stay. He was up at 4am wanting more meds to sleep. He started up about how correct his stories were and everyone knows they are true. You lose everything. Back to bed for a minute. Then the door flies open again. I hear a bang as it swings violently and hits the wall. Another scream and water drinking to calm anxiety. I hear the tap. Time for me to go. Turn of the water mains off as I go. Half hour drive to my safety bed.

He starts on a new med Prozac tomorrow. The switch over might be tough in the next few days. Doc appointment again on Friday. This is the hardest thing I have ever done in my life.
A forum the tells people they haven't got an illness just hasn't experienced BDD. I hope we get through. God willing we will. Marg

The urge reduction and restriction had been working well to limit the time and effect of compulsions. The initial list I made has served well to draw attention to all the components in my son's illness. Storytelling and touching might have been on that list.They are proving the most difficult to shift and down regulate. He still cringes at the thought of tying his hand to some clothing. A barbaric restraint..Oh my good... But you do do it to dogs and babies to prevent scratching.
But he is in the illness still and trying to defend it.
He had a break out on browsing online for fixes. He wanted to explore the why? of hairloss some more. Millions of hours ..not enough. He came completely unstuck. He found the Indian female doctor who had written studies on Dutasteride for hairloss was a fake. She had been convicted of forging her own credentials. He believes he took the drug on her advice. This is most likely another story. The web is chock full of scam websites acting like forums to peddle advice to the anxious ridden hairloss worried. It is a billion dollar industry. He was gullible to the stronger better line of thinking. No care about sterility when you are in your twenties. This storytelling in the search for the certain answer must be at the hub of all OCD/BDDs. You are just trying to stop the doubt from returning. If you really know the why? of it...then the reasoning is that the wheel of intrusive thoughts will stop.
But it is never like that. The stories are strongly defended as though the ego in creating them, will completely fall apart, if it acknowledges the thoughts are from the imagination.
So the story that you get complete loss of hair moving from Dute to Fin goes on. Some one said it..No everyone says it. It must be true,is it true? Just tell me, you have never told me. Write it out so I know. See you can't, you don't know. Did you ask my brother? What did he say? But can that be true? How would he know it doesn't? People say it does, I have read it loads of times.

Yes, you learn never to open the debate with a storyteller. There is no resolution.The defence of it against all logic is too strong. I just had to state that it was part of his illness and not debatable in the end. I wrote out a guideline for dealing with the stories. They are going to come. They are part of your BDD. They are your illness. They cant be debated.
It is a loser battle to try and bring any logic into the OCD cycle. The thoughts can only be deleted.
It is like the amygdala fires an alarm and immediately a drop down menu of stories opens as a reflex. All the stories are in grey but a click on with your cursor opens them up and a myriad of pop up windows explodes in your brain. Why?why?why? If I only know why? it will stop.
But it just keeps going in a loop. The wording of the questions can be exactly the same each and every time. It all can run on autopilot, logic went MIA or was paralyzed by the first shot in the battle for the brain.
I have tried many times on the forum to lock heads in a battle of storytelling versus logic. I never did win. The stories are tightly held and defended by the ego with the full strength of will. They are right and if right, then not ill at all. The distress and limited life, perfectly normal.
The stories provide the context for the fear and unknowing. Without them, the illness has no basis.
Fragmentation of the ego. The energy has to go somewhere. It needs to enter the living body to give vitality to the doer. Mindful action that can be of value to life. Marg

My son has obviously objectified himself through this illness. He is an object to gaze on and find fault with but it is not to get attention. Objectifying didnt have its origins in his need to find value because of some lack of affirmation. He was loved unconditionally and does know it. So how does he now have a fragmented sense of self? How does he see himself as both object and subject in his own body?
Today, I think we all suffer from some degree of objectification. We need to access whether we are out-the-door ready. Hair, clothing just right. Make up for woman and even high heels for some a mandatory accessories for that plum job. And men no longer are exempt. Designer underpants get to the target market as though the guy without the abs will be OK if he gets the jocks right. How many sexist ads and TV shows have men parading topless, hairless and bronzed? So society has a hand in making us all self conscious. However, I dont think this accounts for how BDD is born?

I think we are dealing with a very distinctive substrate in my son's case and probably in most cases too. It is that OCD brain. My son, from infancy, drew emotional comfort from his body sensations. He could comfort himself by holding the edge of a satin blanket. He would stroke the cool silk material. Later his visual sense developed. He saw pattern and lines and responded to them emotionally. A stepping on the cracks game, turned sinister when he felt compelled to get it right and return to the start if he got it wrong. He responded to the look of a mistake on the page. Maths became something best avoided. Once teens hit, the responsibility of hair hit hard. Products lined the bathroom cabinet and getting the look right, the responsibility, that morphed into the BDD of today. He became emotionally invested in the look. He objectified himself and has never stopped. The fear of getting it wrong felt as shame and unworthiness.
So when you give over your living body to the thought that it is merely an object, you stop the flow of that life. Your swimming and suddenly you think your hair looks wet and awful, you will stop swimming. So that is what happens in an obsession. Your mind creates more and more thoughts that objectify your essence. Your living body loses its energy and focus. It has no direction when it has been deprived of its energy. All energy is locked up in thought. The body then must be only felt as a big lump of useless. A heavy, clumsy, ugly, ashamed glug. It is going no where other than bed.
So in the peak of an exacerbation of OCD or BDD, you are likely to be this lifeless blop barely moving from the bed. You are no longer fully invested in your subjective experience of life....your living doing active body but are now living like a corpse, the object. You have become almost totally objectified. Your thoughts never moving much beyond the assessing of how to achieve the perfect fix. Being good enough to look upon will give you a life back worthy of living. That is how the story goes. We are living in this phase of almost complete objectification at the moment.
So in recovery from BDD,we need to understand the need to give up compulsions, tame the intrusive thoughts and reclaim a life by valuing ourselves as doers rather than lookers.
It might be nice to imagine ourselves as David Beckham. But he has pressure on him and what does he really stand for. We don't really know him as a man. What does he tell us about living well? Maybe the Dalai Lama or The Pope have that inside heart that when we think on them, opens up for us to release the pain we have trapped inside.
I hope we find the way out. Best wishes to you all. Marg

As my son's reliance on compulsions to ease the anxiety has reduced there has been a spike in intrusive thoughts. It is all day. 80% are still on hair loss, 10% on body hairiness and 10% on his wife. I asked him for a breakdown of how his thoughts were going. By talking about them, I reasoned he might be actually distancing himself from them. But there is a fine line to triggering and yet again I crossed it.
After triggering a panic, he goes to bed and puts his hands wrapped in the top of the blanket to stop touching. With this high level of emotion present it seems hard to get going with anything like mindfulness. He doesn't understand what to do as he doesn't own a chore and is not invested in helping out. Trying a hobby seems a way off and reading anything than news grabs or celeb updates doesn't hold his interest for long. Basketball watching serves to create that blank trance like state that is thought absent. Alcohol does the same thing.
My friend likened these thoughts to a runaway wheel. I like the analogy. They just keep coming and are so difficult to find the brake for how to stop them. Theory says you should welcome them and just divorce the feelings from them. Separating thoughts from feelings just isn't easy when the feelings create panic.
I tried tapping yesterday. I can see it would work for those who were well into their own healing and just wanted to release the regret of past hurts through forgiveness. It seems a very calming, caring thing to do for yourself. Even the act of writing out your own chant to tap on is an excellent tool for letting go of the past. The problem, as I see it is that you have to be well enough to have perspective. The very nature of BDD, I liken to a lying disorder. The doubt, fear and catastrophizing cycle at every stage creates such emotion that reasoning fails. The problems are created through that timid soul finding an outlet in imagination. The solution lies in a transformation rather than working logically with the past to find the blame and wounds. Don't get me wrong, there are blame and wounds but they are not the cause of my son's BDD. He took the blame and gave himself more wounds than would have ever been done to him. Why is his timid soul feeling so broken and not whole?
Marg

He mentioned again his thoughts on suicide. It is a part of this illness to opt for the way out when you fail to find the solve you want or need. It is part of that teenager mentality to want another quick fix. He still isn't in a recovery mindset that recognizes what he wants might not be a doable. The question to really ask is, "What he can do?"
The goal needs to be to accept and love yourself unconditionally. Your body and its look,is part of the accepting. Filling your life with what you need really links into that thinking on what you can do to make your life better now. I suppose I am asking him to surrender in a fight. It is like a give up for the teenager and a suit up for the adult.
Taming the teenager is a long way off. He likes to bait me into defending my position. He will say stuff like, " I am going to be a slave to a hat for life." " I am a slapstick."
Of course he ropes me in yet again. I tell him he sounds ridiculous exaggerating and he then allows himself the opportunity to raise the screaming and let out the build up of emotion. I suppose that was why he said it in the first place. Just another way to vent. I know I have to listen to how upset he is more effectively. But once the door opens, he can never down escalate to resolve so a scream seems inevitable. I am finding it hard not to get jumpy around him when he starts on his topic. He always reaches the unsolvable issues and then can't understand why things cant be solved as he needs. Emotions start getting unmanageable.

Even though this illness has a strong biological component, I am still seeing the need for the illness symbolically as a way of remaining focused on a hurdle that holds the person from the freedom of adulthood. All the petty cares of comparing looks and wanting a perfect look are miles away from a life focused on paying the bills, getting up for work, filling the fridge, or doing a spot of exercise.
Adults have to mind filter the rubbish away so they can get the job of life done. But for a BDDer that mind filter doesnt work.

I had thought that only a trigger event in the teens had started my son's BDD. Apparently, I was wrong. He has recently told me that he would sit in the back seat of the car being driven to school and hate on his father's horseshoe hair line from the back. He was thankful with his thick hair it wouldn't happen to him. He was probably around 8. So he valued hair first and then his hair was devalued with the girlfriend's comment. That set up the template experience for the amygdala to follow. It sends a panic anytime he feels his hair maybe the subject of devaluing. That devaluing makes him feel inadequate and helpless. So if he is in any situation that also triggers feeling of inadequacy and helplessness,one could expect BDD will flare. That is how his genius has let him express it.

Healing has got to arrive through love. He will need to forgive himself of his own judgements about hairloss. That is a societal thing. The idea that it is a choice best avoided. There 's some appeal to valuing yourself as an aesthetic object. You don't have to value that doing of stuff that matters.

I hope we have a better day and learn a bit more bout the journey out. Marg