Monday , October 3 2022

Panorama: The fear of reflection: What is my life with the obsessive-compulsive disorder


The author, Oliva Loving, suffered from a physical malformation disorder, also called a dysmorphic: this means a perturbed perception of the body itself and is characterized as an obsessive compulsive disorder. Affected people realize that they are bad or deformed – mainly this affects individual parts of the body.

Love led to a seeming recess in her face caused by a pimple she had at the age of 15, almost despairing.

According to "Ärztezeitung", too much anxiety can lead to great pain, depression and problems in social and professional life. Love has suffered more and more of the symptoms: In it, the course of the disorder was accompanied by intense obsessive ideas and actions, so she had to go to psychiatric treatment.

According to psychologist Stefan Brunhoeber, about one million people are believed to be in Germany.
At the global level, probably 0.7 to 2.4% of the population suffers from malformation. Men and women are affected by a similar reason of two to three.

In her blog post, Loving talks about how she lives with her dysmorphosis and obsessions, her treatments, and describes unsuccessful cosmetic treatment.


Last summer, I'm not allowed to go to the toilet alone without permission. Also, my cell phone was, except for half an hour in the evening, under a permanent lock.

When I was allowed to use it, I was under close scrutiny by my therapists who made sure I did not push Snapchat, I turned the camera on to the front or passed old photos, zooming in my face.

My former locations were the Institute for Obsessive-Compulsive Disorders (OCD Institute) at McLean Hospital in Massachusetts. At the time of my treatment, I had suffered from a so-called physical malformation disorder (KDS) for three years.

First obsessive compulsive disorder at the age of 15

At the age of 15 I developed my first obsessive-compulsive disorder. All my attention was focused on a little depression that had remained on my face after I injected a cortisone syringe into a pimples pimple.

Every fifteen minute I had to scrutinize my concern – without, however, a ritual of this act as it is called in the KDS terminology.

However, I knew a lot about rituals. In the seventh grade, I was afraid I could hurt my fellow men, for example with the power of arms (and stabbing my mother, for example) or with sexual harassment (and abuse of my classmates, for example).

At that time, I had no idea that these thoughts could be related to OCD. I was afraid to send to prison and I always feared that something would catch me and then I would "book" it.

I began to pray during the day and ask God on my knees to take away these terrible thoughts. From this assumption, soon everything that remained was kneeling.

Fears, obsessions, absurd rituals

At some point, I did not fall on my knees on a regular basis, but I began to bend my head forward in a kneeling bow and touch the ground with my forehead. At that time, I kneeled so often I had to wear a back support while I was struggling.

My violent fears eventually disappeared, but soon I developed new obsessions. At the age of 17, I began to notice the strong blurry shapes and dark spots in my field of vision. Immediately I realized the problem:

I saw the words mouches volantes, dotted translucent dots and threads that can enhance the field of view. Immediately it seemed to me that I might go blind and would not see or read again.

So I started spending most of my time in my dark home. Hidden in my dark closet I read books, I only went out into the street at night.

Then I started a treatment. In this type of treatment, patients with obsessive compulsive disorder are a scared stimulus for a certain period of time release – Suspended.

As soon as patients realize they are not going to die immediately, for example, when they board an airplane, hold a knife or take a vaccine, then these actions can be repeated in a controlled manner. In the end, the patient's fear of activation factors must disappear.

At that moment, I was afraid of the bright light, as it highlighted the points and threads in my field of view. At a time of treatment, I had to read my healer, who had previously seized my glasses of dark sunglasses, in the open air and in the bright light of the novel "The Hunger Games."

Treatment can only change our course of action

Eight years later, it is now possible for me to walk out in intense sun or drive my car. I can only recommend treatment treatment.

My therapists at McLean Hospital reminded me again and again that my stay at the hospital was not definitely designed to change my mind. Only our actions could change permanentlyhow our healers always reassure.

In the beginning of 2018, I enrolled in a postgraduate diploma in Creative Writing. Until this time, he received selective serotonin reuptake inhibitors for eight years. In addition, I also spent every free second of my days obsessed with my appearance.

Even when I was searching or reading, I was accompanied by a feeling of embarrassment that had settled beneath the surface of my thoughts. Sometimes it took me a moment to remember the reason for my discomfort. Really, depression on my face. But the feeling remained, I could not avoid my discomfort.

Everyday I sat for hours in front of reflective surfaces of all kinds, I sent photos to my friends and asked for their opinion. I compared pictures taken before cortisone injection with recent photos.

I talked to the strangers and asked them to look at my cheek for me, I said, "Do you see the place? Like, they see nothing?" When these people did not see it, I often became angry, as if they had deceived me in some way.

I was sure both my strangers and my friends were lying to me. But when they looked and said they could see depression, they gave me a bad mood that sometimes lasted for days.

Last summer I was supposed to work part-time as a teaching assistant in a summer camp I loved as a child. But at some point I realized I could not do that. Another day I could not pretend that everything was fine with me. I had to deal with the problem of my illness, no matter what.

In his fifth edition Diagnostic and Statistical Manual of Mental Disorders, an American model work in psychology, the KDS is characterized as a kind of obsessive compulsive disorder.

The International OCD Foundation (International OCD Company, author's note.), a person must first identify a number of specific symptoms to get a KDS diagnosis:

An obsession with the appearance of the individual, repetitive behaviors (such as continuous verification of the individual's reflection or permanent re-application of makeup), the case should also be of clinical importance (as indicated by the extent of the emergency) and a disorder diet should be a diagnosis can be clearly ruled out.

Eating disorders can cause similar symptoms

Although KDS has a lot in common with eating disorders of all kinds, the two diseases should not be confused. Dr. Katherine Phillips, who is something of a patient at the KDS setting, writes in her book The broken mirror: "Due to the relative differences between diseases, it is important to differentiate KDS from eating disorders and diagnose them separately."

Although patients with KDS may be concerned about their weight or height, their fears are usually directed towards the appearance of other parts of the body. Phillips writes:

"If a person's concerns focus on the hips, stomach or thighs but not on body weight in general and if that person does not experience markedly abnormal eating disorders or otherwise meets the criteria for eating disorder, then I will diagnose a KDS."

From my own research, I knew that KDS is a persistent and disease resistant disease. According to current knowledge, science assumes that even cosmetic surgery can not cure a KDS.

Dr. Phillips says the long list of ineffective therapies includes "surgery, dermatological treatments and other non-psychiatric treatments."

Beauty surgeries do not cure the disease

Many studies led by dr. Phillips suggests that 6 to 20 percent of people visiting a cosmetic surgeon are likely to suffer from KDS. Surgery can help temporarily relieve these people from their anxiety. Ideal fear usually reappears in altered form.

For example, a woman who convinces herself that she has a nose that is too long could soon turn her attention to her sparse hair after a nose.

On the one hand, of course, I understood this. On the other hand, I still wanted a cosmetic upholstery, an injection of the so-called skin fillers,

I informed myself of the potential of a cosmetic treatment.

The choices were Juvederm, Voluma and Restylane, the wallpaper that a woman had recommended in an acne forum. I went to the local cosmetic surgeon for advice. When my doctor offered surgery there, I got a panic attack.

Four hours of treatment every day

At the same time, I have applied for many OCD treatment programs. Two of these programs have also been specialized in patients with KDS, among others. In March, I received a letter from the Institute for Obsessive-Compulsive Disorders at McLean Hospital.

So, after finishing my masters, I moved to Orchard House, a white, three-story Victorian building that is separated by a narrow street from McLean's main building. Every day I was treated for four hours of treatment.

My healer persuaded me to look the face in my face on my phone's reflective screen for half a minute and from an extremely unfavorable angle. Then I was given the opportunity to turn my attention to something else like reading, cooking or writing.

During the first weeks of treatment, I just understood the meaning of this exercise. After all, I was accustomed to seeing my face's reflection from unfavorable angles. For years, I had done nothing else. How could he help me?

When I put the phone on the edge after such a session, all I could think of was the reflection of my cheek that had sank so deeply in my mind.

"Whether you can get an obsessive compulsive disorder possibly a post traumatic stress disorder?"He asked a friend from the OCD Institute, and he also had to deal with the unwanted illusions that showed him the killing and rape of strangers.

It was at noon, we ate a sticky white plate of rice at a table large enough for the eight members of the group.

I had to think of the fantasies of violence of my seventh grade, in dark shapes with a blue sky background, in my reflection on the front discs that flash from a car that fights.

It is about controlling our actions

My therapists at McLean Hospital told me again and again that the purpose of my stay was not to change my mind.

We could change our energies as they were told.

But the sustainable return of rituals can also lead to a change of thought.

Each week, we chalk the "Triangle of Cognitive Behavioral Therapy" into a table. The sides of this triangle stood for our thoughts, behavior and emotions. Only one of these three sides is responsible: our actions.

I was only able to check how often I looked in the mirror. And the therapists made it hard for me.

I often supported the therapist for my desire for plastic surgery. He reminded me that patients with KDS undergoing cosmetic surgery or otherwise changing their appearance may often regret the procedure afterwards or find a new part of the body to fix. He was sure it would happen to me the same fate.

I was better off to accept my appearance

I left McLean Hospital after nine weeks of treatment at the end of August. Although I still do not feel well with my appearance (which, according to my therapist, was not the goal of the treatment) I had reduced the number of my mirror checks from more than 100 daily to less than five.

I focused on the technique of life-oriented, a basic component of so-called ACT therapy (Treatment of acceptance and commitment, Note.). This is a central part of the treatment of obsessive compulsive disorder and KDS. I also got better to accept my own appearance.

Before McLean, I had always asked people for their opinion on my face. The brief relief I felt after each compliment was usually only a short while and soon gave way to a need for more.

One month after my treatment at McLean Hospital, I suddenly felt a cold panic. I got an appointment with the closest plastic surgeon. My brain has repeatedly sent me short messages, recalling that in such a troubled situation I do not have to make important decisions.

My Way to Clinical Beauty

But I ignored my doubts. One afternoon of Friday I arrived at the beauty clinic. There I had to turn on the light on my mobile phone and keep the light beam on my cheek so that the assistant can only recognize what I meant by "depression".

The patch of the skin, which the doctor said was not larger than the end of a pencil, was then blurred by an assistant with small purple dots. This created a constellation of colorful dots on my face.

Then put a cooling cream on the spot to leave us room for twenty minutes. When he returned, he offered me a ball against stress. I'm asking for a second.

He replied that, unfortunately, they did not have a second, but if I wanted to have a breast implant? For sure. In one hand I made the ball of anti-stress, in the other a coarse, slightly shiny breast implant.

"Just a little punk," he said.

At the time of injection, I took a deep breath and drove something out of my seat. Immediately it seemed to me that maybe this had destroyed the whole process and that the fabric of the wallpaper could already have been installed elsewhere on my cheek.

But the assistants did not show anything. Finally, the doctor took a step back. The nurses smiled at me.

"Does it look different?" I asked. They circled. I looked in the mirror. There was nothing on my face except the purple dots. I said this loudly and added: "That's probably the topic."

I turned my face and looked at it from a familiar perspective. The skin on my right cheek tightens slightly, so any inconsistency was immediately apparent. I could still see depression, but now it was much smaller.

For this little triumph I was rewarded and went to a restaurant where I ate a cheeseburger with a knife and a fork. We were very careful that the wallpaper could not slip.

Psychiatry instead of cosmetic treatment

But my general mood – and my rituals – did not change anything. Over the next few days, I checked my cheek from all corners. For no real reason, I went to my local bank branch a few days later.

A symbol attached to the entrance prompts customers to come and "personally meet the owners of your credit union." A small mirror line was attached beneath this promotional letter.

He always showed me my appearance in this mirror. If I were at a certain angle in the mirror, my face would be illuminated by two separate light sources and would be thrown in sharp contrast.

Evolutionally, I looked in the mirror.

Μετά τη λειτουργία, το μάγουλο μου έμοιαζε λίγο πιο ομαλό, αν και μπορούσα να δω μια μικρή τρύπα στο κεφάλι μου προς τα αριστερά, στην οποία δεν είχε εξαπλωθεί η γέμιση. Η κατάθλιψη δεν είχε εξαφανιστεί αρκετά – ένα αποτέλεσμα που με είχε βυθίσει σε μια βαθιά απόγνωση πριν από την McLean.

Αλλά έκανα εκπληκτικά καλά. Κοιτώντας βαθιά, αποφάσισα να αναθεωρήσω τις σημειώσεις μου από τις πολλές θεραπείες στο σπίτι. Συνειδητοποίησα ότι η λύση στο πρόβλημά μου ήταν ψυχιατρική, όχι αισθητική. Έχω αντισταθεί σε αυτή τη διορατικότητα για μεγάλο χρονικό διάστημα.

Ανησυχούσα επίσης ότι ενδέχεται να υπάρχουν άνθρωποι που θα μπορούσαν να προσβληθούν, κάτι που περιγράφω σε αυτό το άρθρο. Η ιδέα ότι μπορεί να υπάρχει μια γυναίκα τόσο ενοχλημένη από μια μικρή κατάθλιψη στο πρόσωπό της που χάνει χιλιάδες δολάρια σε πολλές ψυχιατρικές και καλλυντικές θεραπείες ίσως να μην ευχαριστήσουν κάποιους ανθρώπους.

Αλλά εδώ είναι το κολλητικό σημείο: Παρόλο που το KDS μπορεί να επηρεάσει το σώμα, το όνομα το ήδη υποδηλώνει. Η ασθένεια δεν είναι φυσική, αλλά ψυχική ασθένεια.

Γνωρίζουμε τώρα ότι οι διατροφικές διαταραχές δεν έχουν καμία σχέση με την ματαιοδοξία. Η ίδια στάση πρέπει να επικρατεί έναντι του KDS.

Είναι πιθανό ότι η εμμονή μου θα στραφεί σύντομα σε ένα άλλο μέρος του σώματος. Έχω δεχθεί ότι η ζωή μου θα καθορίζεται σε μεγάλο βαθμό από περιόδους υποτροπής και μεταγενέστερες φάσεις θεραπείας και ανάκαμψης.

Αλλά τα χρόνια μου χωρίς συμπτώματα ήταν τα πιο ευτυχισμένα της ζωής μου. Είμαι ευγνώμων για το ότι αισθάνομαι λίγο ανακούφιση, τουλάχιστον για τώρα.

Αυτή η δημοσίευση εμφανίστηκε για πρώτη φορά στο HuffPost ΗΠΑ.


Αυτό το άρθρο γράφτηκε από την Olivia Loving

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