Mirror, Mirror on the Wall – Body Dysmorphic Disorder

I actually started writing this with every intention of doing a Sunday post, but wouldn’t you know, I got distracted and ended up doing something entirely different. So here it is for Monday.  Since this is something that is constantly on my mind and has been the subject of my latest therapy session; let’s talk about Body Dysmorphic Disorder. I’ve talked about dysmorphia before but not about the extent of the disorder.

So what is it?

Body Dysmorphic Disorder (BDD) is a kind of mental illness or somatoform disorder where a person is exclusively concerned with their body image. It manifests as excessive concern and preoccupation with a perceived defect of one or many physical features; or even vaguegly complains about appearance in general to the point where it causes psychological distress that (and this is important) impairs either occupational or social functioning, or both.

Snow White had it easy.
I’m going to reiterate this because as something that I’ve noticed a lot with self-diagnosing … you can run through the checklist of criteria for any disorder and say ‘yes’, ‘yes’, ‘no’, ‘yes’, ‘yes’ to any number of qualifications and on the surface it may look like you’re a good candidate for the illness or disorder, BUT, and this is a big ‘but’, if the problems do not create a SIGNIFICANT problem of functionality in some form of your life for an EXTENDED period of time, you may not actually have the disorder or illness, just passing symptoms of it that may be something else entirely. Being generally self-consciousness does not mean you have Body Dysmorphic Disorder. Being a cutter with mood swings does not make you Borderline (Yeah, I’m looking at all the pre-teen emo attention whores out there).

For years, starting in middle school, high school, and college… I could not go out in public. I could not do anything in a crowd of people. I would lock myself away in my room, wear baggy clothes (fortunately skater goth was a look that worked with my sense of style), and refuse to see anyone because the thought of anyone looking at me, seeing the “flaws” that I perceived induced a paralyzing anxiety. And I do mean panic attack, hyperventilating, dissolving into a puddle of self loathing kind of social anxiety. I could make myself go to work and school, but I would bundle myself up in shapeless clothes, avoid any kind of social contact, and steal myself away as soon as it was done.

BDD can occur to a degree that causes severe emotional depression and anxiety, and even may lead to the development of other anxiety disorders, social withdrawal, or social isolation. It sucks.

I remember having plans for events that I’d been looking forward to for months. For weeks I’d be even more strict about my diet and exercise so I would feel in control enough of my body to go out and enjoy myself. I would get all dolled up and decked out. Then an  hour before I was suppose to leave I would freeze. Literally on the threshold of my house, incapable of moving another foot out of the door because the thought of going out in public where people could see me felt like the world would come crashing down around me. I’d cancel my plans at the last minute, disappoint my friends, disappoint myself, strip off all the pomp and fancy and hide in bed for the rest of the night.

Like many mental disorders it’s caused by a variety of different things and is different for each person; biological, psychological, and environmental factors can all contribute. Maybe you’re predisposed to this kind of mentality, have suffered mental or physical abuse, or emotional neglect can be the cause. As you’d probably suspect, dysmorphic symptoms usually begin in adolescence or early adulthood when it’s common for self-criticism of a persons appearance to begin. From here it goes further than just criticism to an atypical aesthetic standard created from some internal perception of beauty or perfection between the persons ‘actual self’ and the ‘idea self’. What a person actually sees versus what you want to see.

However, what a person actually sees may be entirely different from what actually is.

According to the DSM patients are so overly concerned, or convinced, that they are misshapen or deformed in some way, despite all evidence to the contrary. Patients are generally concerned about some aspect of their appearance or with the possibility that they have some deformity. The specific “deformity” depends completely on the person. Maybe their facial or scalp hair is not right, maybe their nose is too big, their breasts are uneven, or their eyes are too far apart. Seeking help is actually common, but not by a psychiatrist. Because the person is so convinced that this is a legitimate problem they’ll go to their primary physician, dermatologist or even eventually to a cosmetic plastic surgeon. After being examined the physician usually finds no abnormality at all, or if one is present, it’s so trivial that no one would ever notice it. Reassurance does nothing though.

“Only a small minority recognize the groundlessness of their concerns; the vast majority are more or less convinced, and in a significant proportion the conviction becomes a delusion. Patients are often in torment over their “defect,” and the majority repeatedly check themselves in mirrors: in some cases such “mirror-checkers” may be so distressed by what they see that they may avoid mirrors, or cover them up. Most patients avoid contact with others, and a minority become housebound; ideas or delusions of reference may appear.”

I’m a mirror checker. Oddly I often avoid looking at my face, but I constantly check other aspects of my body that I perceive as out of proportion or that need to be hid. Constantly. It’s a compulsion. With me it’s my upper arms, thighs, and jaw. I have a very specific idea of what I need to look like and any deviation from this is a monstrosity.

Therapist has commented on more than one occasion that I have a beautiful figure and that my clothes are very professional and flattering (I go to session straight from work). I’m a master of disguise. A chameleon. I know exactly what I need to do to hide my flaws, create the illusion that they aren’t there, and appear in a way that is acceptable to the environment that I am forced to interact in. I wear a very specific cut of pant, I wear tailored jackets that emphasize other features and draw the eye to other areas like my tiny waist. It’s all a matter of tricking the eye of the beholder into seeing what I want them to see. This is often how I manage my Borderline issues as well. I draw the eye to positive attributes that I want people to focus on and gloss over the areas that I need to keep in shadow.

When I was younger my dad used to accuse me of vanity. He would see me looking in the mirror and say something like ‘you’re beautiful, quit checking yourself out’. Sort of a compliment I suppose, but he never understood. It’s not vanity. It has nothing to do with being vain. I hated how I looked. I NEED to see what other people see though. I need to be prepared for how others will look at me. What they will see with their own eyes. I needed to make sure that I was taking care to only show them what I wanted them to see. I needed to make sure I was perfect so there would be nothing to criticize.

“People with BDD say that they wish that they could change or improve some aspect of their physical appearance even though they may generally be of normal or even highly attractive appearance. Body dysmorphic disorder causes sufferers to believe that they are so unspeakably hideous that they are unable to interact with others or function normally for fear of ridicule and humiliation about their appearance. This can cause those with this disorder to begin to seclude themselves or have trouble in social situations. More extreme cases may cause a person to develop love-shyness, a chronic avoidance of all intimate relationships. They can become secretive and reluctant to seek help because they fear that seeking help will force them to confront their insecurity. They feel too embarrassed and unwilling to accept hat others will tell the sufferer that he or she is suffering from a disorder. The sufferer believes that fixing the “deformity” is the only goal, and that if there is a disorder, it was caused by the deformity.” (Thanks, Wiki.)

This is certainly how I think. If I could just fix these 3 things, everything would be perfect. If this was just a little more streamlined, if that was just a little more toned, if that was just a little more concave, I could be the marble statue I’ve always wanted to be. Roommate doesn’t believe this. She thinks that even if these things were “fixed” then my focus would just shift to something else.

Last session Therapist asked me to name 5 words that described how I view myself. 1) Ugly, 2) fat, 3) uncomfortable. I couldn’t’ actually think of two other words. I’m 30 years old, though I look like I’m 22. I’m 5’3”. I have a 24.5” waist. I’m athletic. In college I would be stopped on the streets by modeling recruiters. Professional photographers routinely seek me out at the many costuming events I attend to post for them. No, I’m not bragging. But since I’m maintaining a relative anonymity and won’t post my pictures on this blog I’m relaying my experiences to give you an idea of the massive discrepancy of what I see and what others do. Therapist looked like I broke her heart when I told her those words. I just don’t understand how others can see me and see someone that is attractive.

Another important thing to note is my weight obsession. Body Dysmorphic Disorder and Eating Disorders are not interchangeable. In fact, a preoccupation with weight and the development of eating disorders is something that is specifically taken into consideration in diagnosis. If a persons symptoms are better accounted for by another disorder: weight concerns are usually more accurately attributed to eating disorders: then BDD may not be the problem.

My eating disorder is incredibly psychologically complicated. In regards to BDD it’s almost opposite. I developed this disorder as part of my attempt to control my flaws. But there are many other facets to it as well; like my need for structure and control, as an attempt to fill the void of loneliness that I can’t otherwise fill at the moment, etc. So I’m one of those with both.

In fact, co-morbidity is common with BDD.

         76% will experience major depressive disorder at some point
         36% may develop agoraphobia
         32% are affected by obsessive-compulsive disorder
         But the most common disorders found are Avoidant Personality Disorder, Social Phobia, Social Anxiety Disorder, and Dependent Personality Disorder
         Eating disorders are also sometimes found in people with BDD.
I’m curious about the Avoidant and Dependent Personality Disorders. It makes me wonder if there isn’t a higher ratio of Borderline Personality Disorder with Body Dysmorphic Disorder as well.
Here’s the part where I list the symptoms and expressions and see just how neurotic I am!


Common symptoms of BDD include:

         Obsessive thoughts about (a) perceived appearance defect(s). <~~~~ And how.
         Obsessive and compulsive behaviors related to (a) perceived appearance defect(s) (see section below). <~~~~ I can  hardly wait
         Major depressive disorder symptoms. <~~~~ Gee, let’s think…. Yeeeaaah.
         Delusional thoughts and beliefs related to (a) perceived appearance defect(s). <~~~~ So I’m told, of course it could just be that everyone else is wrong.
         Social and family withdrawal, social phobia, loneliness and self-imposed social isolation. <~~~ Years, and years of this. Though admittedly I’m working hard despite my ridiculous anxiety to push through this, it is still always in the background of my mind bullying the happy thoughts off the playground.
         Suicidal ideation. <~~~~ Been there, done that.
         Anxiety; possible panic attacks. <~~~~ Possible? Can you say understatement?
         Chronic low self-esteem. <~~~~ Not that I’d let anyone see this.
         Feeling self-conscious in social environments; thinking that others notice and mock their perceived defect(s). <~~~~ I wish I could be social without people looking at me.
         Strong feelings of shame. <~~~~ I just want to be perfect.
         Avoidant personality: avoiding leaving the home, or only leaving the home at certain times, for example, at night. <~~~~ When it’s harder to see me.
         Dependent personality: dependence on others, such as a partner, friend or family.
         Inability to work or an inability to focus at work due to preoccupation with appearance.
         Problems initiating and maintaining relationships (both intimate relationships and friendships). <~~~~ It’s hard to be close to someone when you don’t want them to look at you.
         Alcohol and/or drug abuse (often an attempt to self-medicate). <~~~~ You can’t worry when you’re passed out.
         Repetitive behavior (such as constantly (and heavily) applying make-up; regularly checking appearance in mirrors; see section below for more associated behavior). <~~~~ Mirror mirror on the wall ::SMASH::
         Seeing slightly varying image of self upon each instance of observing a mirror or reflective surface. <~~~~ This is maddening.
         Perfectionism (undergoing cosmetic surgery and behaviors such as excessive moisturizing and exercising with the aim to achieve an ideal body type and reduce anxiety). <~~~~ I just want to be perfect, and redundant.
Note: any kind of body modification may change one’s appearance. There are many types of body modification that do not include surgery/cosmetic surgery. Body modification (or related behavior) may seem compulsive, repetitive, or focused on one or more areas or features that the individual perceives to be defective.

Compulsive behaviors

Common compulsive behaviors associated with BDD include:
         Compulsive mirror checking, glancing in reflective doors, windows and other reflective surfaces. <~~~~ Vanity is its own problem, but has nothing to do with this.
         Alternatively, an inability to look at one’s own reflection or photographs of oneself; also, the removal of mirrors from the home. <~~~~ We literally have a hall of mirrors.
         Attempting to camouflage the imagined defect: for example, using cosmetic camouflage, wearing baggy clothing, maintaining specific body posture or wearing hats. <~~~~ It’s really not that hard.
         Use of distraction techniques: an attempt to divert attention away from the person’s perceived defect, e.g. wearing extravagant clothing or excessive jewelry. <~~~~ You can see what I want you to see.
         Excessive grooming behaviors: skin-picking, combing hair, plucking eyebrows, shaving, etc.
         Compulsive skin-touching, especially to measure or feel the perceived defect. <~~~~ Hey, maybe I just like how my jaw feels.
         Becoming hostile toward people for no known reason, especially those of the opposite sex, or same sex if homosexual. <~~~~ In my defense, my hostility towards other people is usually because they’re dicks. And I’m irrationally angry.
         Seeking reassurance from loved ones. <~~~~ If I sought reassurance they’d know there was something wrong.
         Excessive dieting or exercising, working on outside appearance. <~~~~ 6 days a week, 15 hours in the gym, constantly monitoring everything I eat… Excessive? Nah.
         Self-harm <~~~~ I like to think of it as keeping myself on track.
         Comparing appearance/body parts with that/those of others, or obsessive viewing of favorite celebrities or models whom the person suffering from BDD wishes to resemble. <~~~~ Who doesn’t compare themselves to others.
         Compulsive information-seeking: reading books, newspaper articles and websites that relate to the person’s perceived defect, e.g. hair lossor being overweight. <~~~~ Maybe I just like to be in the know.
         Obsession with plastic surgery or dermatological procedures, often with little satisfactory results (in the perception of the patient).
         In extreme cases, patients have attempted to perform plastic surgery on themselves, including liposuction and various implants with disastrous results. <~~~~ Holy crap, if I ever get this bad I’ll just have myself locked up.
         Excessive enema use (if obesity is the concern). <~~~~ Um, Ew. Just, ew.

Now I certainly recognize a lot of these symptoms in myself but I don’t know if I attribute them all to BDD. Some of clearly a byproduct of my Borderline Personality Disorder or aspects of other problems I have. Where’s the line though? Often these things overlap and collide like a maelstrom of emotional turmoil.

Surprisingly in my research I found that this actually affects men and women equally. It sounds like it would be another ‘female problem’, but apparently not. As many as 1-2% of the world’s population might even meet the diagnostic criteria for a diagnosis of BDD.

My final thought: Not just in physical appearance but in every aspect, I’m obsessed with how people perceive me. Not because I have some need to be complimented or anything like that. But I need to know how others see me, what they think, so I can gauge how different it is from how I think of myself. 

Lucid Analysis – Trials in Therapy – The Body Issue

I know I usually do this on Friday, but I was a little, busy, yesterday ß—- Secret.

I like to think of my session on Thursday as I Hate Everything but I’ll do it anyways. And by everything, I really just mean my body.  I’ve been bumping up my workouts like mad, started a food journal again to track everything I’m taking in, and I’m still not seeing the results I want to see as fast as I want to see them. But let’s face it, if it didn’t happen yesterday it’s not going to be fast enough for me.

I’m freaking out about putting on weight because I’m trying to kick a really bad habit. Maybe habit isn’t really the word so much as addiction. I’ve been addicted to diet pills for longer than I care to remember. I hate them, I need them. I stopped taking them. They’re a major crutch for me. I don’t overdose on them, but I take the max possible. Every day. The same times every day. If I don’t, or I miss a dose, the panic starts. The thought of gaining weight is terrifying to me. The thought of taking these pills for the rest of my life disgusts me.

I hate talking about this stuff in real life. Guys don’t like to hear you obsess about your weight or pick apart your flaws, I don’t like to show that things like this bother me. When you see me in person I’m confident and I have a very “I am the way I am, if you don’t like it, get the hell out of my way” attitude. Which isn’t all an act. I don’t care what other people think of me (unless I’m very emotionally attached), I care what I, me, think of me. And I’m not happy.

Therapist wondered what triggered this because I don’t usually harp on about it. I talk about my bulimia often enough, but I don’t usually tear myself apart to her out loud. She actually thought that I didn’t have these thoughts very often. ::blinks:: I OBSESS about my body.  
I’m sick of it.

My health is really important to me. I am worried about the affect these things will have on my healt. I just got so disheartened when Psychiatrist put me on the drugs that made me gain weight. I won’t even see him anymore. I see his PA, and I like her a lot better. I worked so hard to get my body to a place where I was truly comfortable with myself and in ONE MONTH he destroyed that for me. I’ve been struggling ever since. 

And what’s ridiculous, is no one else sees it. Everyone tells me that I have a killer body, but it’s not what I want. Even when I got my tattoo, it took a lot for me to post the pics of my body, b/c to me, I am over weight in those.

Homework: Pull out my pencils, pens, and/or paint, and draw how I perceive my body to be.

I have a completely distorted view of myself and I’m not sure how to fix this. Therapist absolutely can not relate to this at all though. She’s the kind of person that’s always had to work to GAIN weight. Boo hoo. So she wants to get a better idea of the difference between what actually is and what I see in myself. 
Regardless of all this body image weight phobia I’m doing something that I need to do for me. I kicking this addiction.  It’s been about 3 weeks already. I think about it every day. Not opening up that bottle is still really difficult, but I’m doing it.

And despite all these bad thoughts, and these overwhelming feelings that I should be hiding myself away so no one can look at me, I’m still going out. I’m still working to put myself out there. Hell, I’m still dating! In fact I had a date with Tech Boy right after my session.

So, we haven’t had sex yet (not to be confused with not doing a lot of other stuff though haha). This actually freaks me out. He hasn’t pressured me for it at all. I don’t know if it’s because his ankle is still broken or what.  It makes me paranoid though. Even though he’s like super cuddly, eye contact, really into everything I say… wtf? I have to say, he is a Borderline’s dream to sleep with. Let me tell you how much I love waking up next to someone like him. If I even try rolling away from him he pulls me back and wraps his arms around me. And then says he could stay like that all day. So I guess all in all things are going relatively well there.

I’m still struggling with how much I can trust him with. I have such a hard time trusting anyone, especially men. I know there are some decent ones out there, they just haven’t been very prominent in my life. Sorry guys. I’m still struggling with how much I should invest too because I don’t know how right we are for each other. Then again, sometimes I think I could fall in love with anyone.

Alright I’m a little drugged up at the moment, so I honestly can’t think straight. I have no focus. Spin spin spin.

I think I’ll go make Honey Lavender Biscotti and Buttermilk waffles for Roommate.

I love food. I hate food. There is no in between. 

Lucid Anlaysis – Trials in Therapy : Healthy Seperation?

Therapy was neither good nor bad yesterday. Mostly we talked about how distraught I am that my co-worker is leaving. He’s seriously like THE PERFECT PERSON to work with and have as a mentor. I’ve never really had a mentor like that before and the experience is invaluable. Therapist thinks I’m in shock right now from the suddenness of the announcement. It’s clearly triggered my rejection and abandonment issues. Ultimately she does think this will be a good opportunity for me to grow in healthy way. I’m angry at myself for allowing myself to rely on someone. I’m angry at him for up and leaving. My gut reaction is to pull back and put as much emotional distance between myself and the entire situation as I possibly can. Therapist thinks I should do the opposite.
She thinks that instead of pushing away I should take the time I have left with him and get to know him better on a personal level. Get closer. I told her that sounded scary. Why would I want to invest MORE emotionally when I know for a FACT that they’re going to leave?  Isn’t that like emotional masochism?
She says ‘no’. This is a normal process in life. Jobs change, people move, and since there is no aspect of this that is my fault it’s unlikely that I will internalize it as something to punish myself with. Plus, he’s a mentor. He’s been a positively influential role model in my life and that is precisely the kind of healthy relationship I should continue to cultivate. I know him, his wife, his kids, even on a social level. Just because he is moving physically does not mean the personal/professional aspect and bond that we have created will disappear. This will be an excellent opportunity for me to experience a healthy a separation and work to maintain a connection throughout the process of changing locations, not abandonment. Therapist actually believes that this is affecting me is also a good thing. It means that I’ve begun to internalize someone. It’s something that’s extremely important for someone like me that has a complete lack of object constancy. I don’t believe that he’ll remember me once he’s gone, and I don’t understand how I can still be a part of his life if I’m not around, but if there’s anyone that I think will welcome remaining in contact, it would be him. We’ll just have to see. I’m taking it one day at a time, and frankly, trying to avoid thinking about it.
My goal is to learn as much from him as possible so that I gain even more confidence in the job that I have so that I do not feel so lost when I no longer have a mentor and role model to rely on. Therapist thinks this is actually a very good plan.
We talked about this more than I wanted to.
She asked me about Tech Boy and Friend. How things were going with them? Things with Tech Boy are going really well. He’s going out of state this weekend so I won’t be able to see him, and I have something I’m doing with Roommate next weekend so I don’t think I’ll be able to see him then. This is creating a massive amount of anxiety in me. I told him I hope he has a lot of fun at his event this weekend though I kind of wish I could see him. His reply, “It’ll be a blast, but we’ll hang out soon, I promise.” So that’s at least a little reassuring. I’m just afraid that two weekends in a row is going to be too much. I can’t shake this mentality that if I’m not giving myself in some way sexually than he won’t maintain an interest in me. On the one hand, if that’s true than he’s just another jerk and I shouldn’t bother, but I also know that I need to feel like I’m doing something, providing something, taking care of something, for other people in order for them to need me. I need to know there’s a reason they stay, otherwise I don’t understand how there will be anything to hold them to me. Like me for me? Just for my personality? And because I’m apparently a good, loving person? Psh. Whatever. I don’t believe it’s enough. I need to DO something to make someone stay.
I know he likes me though. It’s really not hard to make me feel good or reassured. I see him at work quite a bit, but as a group we all have breaks at the same time and spend them down in the shop together. I was really busy yesterday afternoon (and honestly feeling really self-conscious to the point where I couldn’t stand the thought of being where people could look at me) so I skipped break. Right afterwards he texted asking me why I didn’t show up. Aws, he missed me. He texts me randomly so I know he’s thinking about me. And lately it’s become a habit to text each other right up until we’re falling asleep and tell each other good night. It’s adorable.  
Things with Friend have been improving too. I still have a lot of anger and resentment, BUT, it’s definitely diminishing. There are times I actually feel fully engaged in the ridiculous conversations we have. Romantically my focus has almost fully shifted to Tech Boy, so I don’t have the same kind of obsessive ruminations that I used to. His wife still makes me sick to my stomach but I expect that will always be the case. She’s an ugly person. And it’s still a thorn in my side that he would prefer to be with someone so hideous over someone like me. Whatever buddy, his loss.
Did I mention Lady Friend got ahold of me? On Halloween she was travelling and texted me around midnight saying that, “There are so many things here that remind me of you. I just wanted to see how you were doing and try to reconnect…” I was really surprised. I ended things with her very abruptly and just stopped talking to her. I was a complete mix of guilt and relief for weeks, but I felt paralyzed to even read the e-mails she sent me. I still haven’t read them. But she got ahold of me anyways and I would like to see her and catch up. Here’s something that I think is a Borderline issue. I actually don’t think we ended badly. We didn’t have any big fights or anything, I just couldn’t do it anymore and kind of, disappeared. ::hugs:: ::kisses:: “I missed you”. Gone.  The chemistry wasn’t there for me at all, but she really is a wonderful person. Some part of me knows this wasn’t an appropriate way to end things, but it doesn’t seem terrible to me either. I drop off the face of the earth with people all the time. I wonder how this will go.
My body dysmophia is killing me though. I want to see everyone. I want to be with everyone. I want to go out and do things. But I can’t stand the thought of people looking at me right now. It makes my skin crawl. I quit smoking, for real this time. It’s been a few weeks and unfortunately I have gained like 5lbs. I’m absolutely disgusted with myself. I’m kicking up my workouts and reinstating the food diary to keep track of everything I consume. Surprisingly, I’ve been in much better control of my bulimia. I don’t even remember the last time I threw up! ::pats myself on the back:: I also gave up one more major addiction (one that I haven’t mentioned before) but that’ll be a post for another time.
Therapist completely forgot to ask me about the Homework she set for me last week but I’ll share my answers with you anyways.
Homework: What positive things have I taken from my relationship with Friend?
         I’ve seen that it’s possible to find someone that I share so much in common with.
         I realized that even after having so many devastating relationships it’s still possible to open up and connect with someone.
         I have someone to watch endless amounts of bad horror with.
         There is someone out there that understands and appreciates my wacky brain.
         For all the emotional ups and down, pushing and pulling away, he never left, never threatened to leave. Shows me that it is possible for someone to stay regardless of how much I lash out or am hurting. For all the emotional turmoil he has been a stable presence.
Homework: What do I envision for a healthy relationship?
         Mutual respect.
         Someone I am comfortable being with and sharing with.
         Not being afraid to be myself.
         Not being afraid the other person will leave if I go out with or make new friends.
         Someone that wants to be with me, not other people also. < —— This is a change.
For the Healthy Relationships question I feel like there should be more. I just don’t know what a healthy relationship looks like though. I keep wanting to list things I want in a partner or am most attracted to in a partner, but even thinking about some of the things makes me wonder if what I look for is healthy at all so I don’t put that stuff down.
Relationships are hard.
Therapist thinks I’m making amazing progress though. It’s not like I’m all recovered or anything  but my responses and reactions are steadily becoming more appropriate/less extreme and I’m beginning to think about things differently. And she continually reassures me that I’m a joy to work with. No joke, therapy is not easy. Some days I can be in a great mood, and leave therapy feeling very heavy hearted. Some days I can be in a terrible mood and leave therapy feeling worse. I always leave therapy feeling more aware though, and like some part of my burden has been lifted. Less confused. It’s not easy confronting your issues on a weekly basis. It takes effort but I really think it’s worth it.
Sometimes writing this blog is hard. So many people, Borderline or not, are not very self-aware and do not often analyze themselves or their motivations. Every day I write this blog I’m forced to face some aspects of my history and my disorder. I’m hyperaware of my problems. On the one hand this is good because it reminds me daily how I need to tailor my mask and my actions to fit into my environment in an appropriate manner. It forces me to look at my life, consider where I’ve been and where I want to go. On the other hand sustaining such a heightened sense of Self is exhausting. I over analyze everything. It does seem to be paying off though.  

Did you see that? – Hallucinations, Distortions and Hypnogogia

I have so much I want to post all at once =( I completely forgot to post my Lucid Analysis from therapy this week (stupid busy at work this week and I didn’t have time to post Monday so now my whole schedule is thrown off). I may do that tomorrow because it was a rather insightful session. 
So continuing on with the Associated Features of Borderline Personality Disorder.
(B) Some individuals develop psychotic-like symptoms when under stress:
          Body image distortions, ideas of reference
          Hypnagogic phenomena  
Hallucinations: I can’t personally speak for hallucinations. I have never had this problem except for one time and an experience involving Absinthe, but that really has nothing to do with BPD. Friends wife has, on occasion, experienced bipolar related hallucinations. They can be visual, auditory, or sensory. Unless you consider that bugs crawling on your skin sensation a hallucination when there aren’t any bugs there. I’ve had that before, but only after I found an actual bug crawling over me and was a little ooged out.
Body image distortions: I’m not even going to expound on my issues with body image and dysmorphia. You can read about it more here. In terms of self-perception I have almost no concept of how I physically relate to another person from a physical measurements point of view. People and myself are measured by their presence in my mind. If I don’t have any respect for you, you can be 6’7” and 300lbs but you’ll register as someone nonthreatening and therefore smaller. If you’re someone I do have a great deal of respect or caring for, in my eyes you will seem taller.  Additionally, my perception of myself (has nothing to do with this), I just always think I am bigger than I am. No, not in an “I’m so fat”, kind of way. I need to physically stand side by side someone looking into a mirror to get an accurate idea of just how discrepant our sizing is. Otherwise I feel like I’m of a proportion similar to them or that their sizing is more ideal than my own. I don’t think I’m describing this well, it’s hard for me to convey. It’s a sense that I am not proportionate to those around me.
Ideas of Reference: involve people having a belief or perception in which irrelevant, unrelated or innocuous phenomena in the world refer to them directly or have special personal significance: ‘the notion that everything one perceives in the world relates to one’s own destiny’.  
Not my issue. I pretty much believe my place in this universe is innocuous in itself and I don’t believe in destiny at all. I am in control (or should be) of my own future.  To me this is something of a paranoid feature and my paranoia just doesn’t extend that far.
Hypnagogia is the transitional state between wakefulness and sleep (i.e. the onset of sleep).
I find this one rather fascinating… among its many names, it’s also referred to as the Borderland state. Fitting, eh? I have a lot of hypnogogic phenomena.
Transition to and from sleep may be attended by a wide variety of sensory experiences. These can occur in any modality, individually or combined, and range from the vague and barely perceptible to vivid hallucinations.
Sights – sensory features of hypnagogia are phosphenes which can manifest as seemingly random speckles, lines or geometrical patterns, including form constants, or as figurative (representational) images.
 I can’t figure out if this means with eyes open or closed. I assume closed because it’s the state between wakefulness and sleep. For me I have like this awful web of black tar that coats everything behind my eyes. It’s utterly bizarre. I just had this sense last night. I remember thinking it’s been quite a while since I’ve seen this.
Tetris Effect – People who have spent a long time at some repetitive activity before sleep, in particular one that is new to them, may find that it dominates their imagery as they grow drowsy, a tendency dubbed the Tetris effect. When the activity involves moving objects, as in the video game Tetris, the corresponding hypnagogic images also tend to be perceived as moving. The Tetris effect can be tactile as well.
I don’t really get this one, but it seems neat.

Sounds – Like the visuals, hypnagogic sounds vary in intensity from faint impressions to loud noises, such as crashes and bangs (exploding head syndrome). People may imagine their own name called or a doorbell ringing. Snatches of imagined speech are common. While typically nonsensical and fragmented, these speech events can occasionally strike the individual as apt comments on—or summations of—their thoughts at the time. They often contain word play, neologisms and made-up names. Hypnagogic speech may manifest as the subject’s own “inner voice”, or as the voices of others: familiar people or strangers. More rarely, poetry or music is heard.
I don’t know if I hear anything in particular when I’m hypnogogic, but I’ve been told I talk in my sleep. Clearly and often.  My Roommate, Friend, lovers, family have all told me that I talk in my sleep. As far as I can tell it’s most often at this point of bordering on sleep. Hey, it’s better than snoring I guess (which I’m told I do not do). 
Sleep paralysis – Humming, roaring, hissing, rushing, zapping, and buzzing noises are frequent in conjunction with sleep paralysis (SP). This happens when the REM atonia sets in sooner than usual, before the person is fully asleep, or persists longer than usual, after the person has (in other respects) fully awoken and causes them to be unable to move their body and limbs.
It’s not permanent, but it can certainly be a little disconcerting. I’ve never had this but some friends have mine have mentioned it.
Lucid Dreaming – This is  my favorite. Lucid dreams are dreams in which you are aware that you are dreaming. In a lucid dream, the dreamer can actively participate in and manipulate imaginary experiences in the dream environment. Lucid dreams can seem real and vivid. There are a couple different kinds and I experience both:
A dream-initiated lucid dream (DILD) starts as a normal dream, and the dreamer eventually concludes it is a dream.
A wake-initiated lucid dream (WILD) occurs when the dreamer goes from a normal waking state directly into a dream state, with no apparent lapse in consciousness.
I love dreaming. The dream world is one of my favorites to occupy. To feel your body moving through a world foreign to the one it’s actually settled in, it’s, trippy. Lucid dreaming can be cultivated by anyone really, not just those with PDs or some mental taxation. I highly recommend it.  
None of these are specific to or exclusive to Borderline Personality Disorder. Not by any stretch of the imagination. However they’re often triggered by stress and anxiety and being Borderline pretty much means you’re more prone to these triggers than average.

Bordering on crazy at the Con

Sith Twi’lek

This past weekend was my Sci-Fi Convention. I’m a complete and utter geek. This has been established. I am unabashedly geeky.  Saturday was kind of ridiculous. Got to the Con around 10am. Friend and I were doing our Star Wars thing. Dark Lord/Lady of the Sith. He is my Master, I’m his apprentice. Think of it like Darth Sidious and Darth Vader. Sidious is the Master. Vader is the apprentice. Anyways, we have our own personas, not some pre-fabricated existing Star Wars characters. I have no awkwardness about Friend anymore. Well, mostly. I still can’t watch him being cute with the wife. It’s just uncomfortable. But she wasn’t around for our day/night so it wasn’t a problem. My costume came out really, really well. This was supported by the fact that I could not go 5 feet without someone stopping me, or me and Friend, to take pictures. I was approached by at least 5 professional photographers, one of which wanted to do a photo shoot with me in the future. Neat. This was amusing, until it wasn’t. I just wanted to check stuff out and maybe buy some things (which I didn’t b/c the dealers floor sucked this year). Ran into a creepy club guy I knew, I wanted to smack him. Ran into a guy that I can only tolerate for about 5 minutes, but he KEPT talking, wanted to throttle him. By the time late evening rolled around I was starting to panic with the shear amount of people that wouldn’t leave me be. Friend and I hid in an auditorium during panel just to escape the hoard. After this I took off, could no longer deal with the crush of the crowd. Too much fluxuation is exhausting. I even managed to Control my dysmorphia. This I feel, is one of my biggest accomplishments this weekend. All in all though, a very successful experience.
The next day I mellowed out the costuming to something pretty and cute. Did a 50’s style rockabilly swing dress with thigh highs with a back seam. Admittedly I did this to tease Friend. It’s a fetish of his and I intentionally hit his buttons to amusing effect. Especially since he knew I had probably gotten these for him when we were actually messing around. Which I did. Watching him squirm, not be able to touch gave me a little spike of pleasure every time I caught him looking. I’m mean, maybe a little manipulative. Idk. Call it what you will. We actually had a really nice day lounging about and talking with people we knew.
Until the karmic retribution kicked in. I was sitting around the lobby with all my closer friends. By the end of the Con and break down was starting who do I see? Boring-ex. This in itself wasn’t bad. He’s completely forgettable and uninteresting to me. I ignored him. What made me a little mad was, the only reason he would have volunteered to work the Con would be to poke at me. This was the first year I hadn’t volunteered for the Con (I always volunteer because I am friends with everyone that runs it). He never even went, vehemently disliking it, until I dragged him to it last year where he still didn’t have a good time and actively complained about the volunteer director. He was working where I always did. It was obviously to bother me b/c. I fought the urge to lash out and tell him how dick he was. I was more pissed at the lady that let him volunteer, because she knew he was my ex. The stupid thing was, I didn’t really care. I just wanted to flip out. He was being a dick, intentionally poking at me, trying to bother me, which it really didn’t and I still wanted to smash his head into the ground. But hey, maybe he’s had a change of heart and loves the Con and isn’t a wacky boring stalker? What did bother me… was seeing Evil-Ex. I knew he’d probably be here, but miraculously hadn’t seen him. It was only about an hour before I was going to leave so I’d completely relaxed figuring it was safe. Nope. I haven’t seen him in over a year. Not since I moved out of our house. I don’t think it was the seeing him, so much as I was taken completely by surprise and not prepared for it. My stomach jumped into my throat and I needed to get out. (Friend) Good, relaxed, almost happy even (I’m honestly not sure I know what this feels like), (B-ex) annoyed, wrath, amusement, indifference, (E-ex) panic, nauseous, panic, anger, (myself) revulsion, anger at myself for letting him get to me, depressed… all in the span of about 15 minutes. Not together mind  you. I don’t do emotions simultaneously. I cycle, rapidly. One to another. I left, grabbed my wine, and went to Friends to not be alone. Curled up on his couch, depressed, binged at dinner, vomited immediately after, curled back up with my drink until it was time to go home and go to bed. It’s so hopeless sometimes.
What amused me was I had dreams with Boring-ex in them last night: We were at some house together. He was doing work. I was ignoring him. We kept our distance. He kept inching closer though. Doing that thing where you want to make someone aware of your presence to inspire a reaction, but not interact. I noted him there, but went about whatever. Finally I was sitting on the couch drawing and he sat right next to me. Crossed his leg which made him hit my drawing pad. I lost my shit. Screaming, completely enraged. Wrath personified: Which is exactly what I wanted to do earlier that day and repressed the urge. My subConscious said no, you needed to do this. Not just needed to. FUCKING needed to. That’s what I get for repressing my urges. They come out anyways and disrupt me when I’m resting.
Along these lines, I’m actually getting sick of my medication. I know it’s supposed to help me Control myself. In general I haven’t been having such extreme mood swings. Not that I haven’t still been cycling, and exceptionally angry, but not so explosive.  The alcohol and the bulimic crap don’t speak well for my impulsiveness though. I can’t seem to get ahold on those. Meh. I just can’t tell how much the meds help me. When I’m fine, I’m fine and maybe it’s the meds. But when I’m not, I still do the stuff I’m supposed to be fixing. I know there’s no quick fix for this. It’s going to take a long time. A lot of work. It’s hard to see so far down the road when I’m so stuck in the right now.
Edit: Just found out I’m in one of the local papers for my Sith costume! Neat. I am really proud of how it came out. Especially since I made 90% of it by hand.

Body Dysmorphia

Lack of Control. Destruction of my sense of self. It all translates into a perceived physical manifestation. For me this is body dysmorphia. What you see, is not what I see. I’ve been told over and over what wonderful shape I’m in, how great my body is, how beautiful, how this, how that… and I smile politely and say ‘thank you’. If I’m having a particularly good day, I may even believe the compliment. Or I should say, I do believe that whomever is telling me these things believes it, I, however do not see it. If I’m not having a good day, the voice in the back of my head finds ulterior motives for such compliments. Especially if they come from men – as a means to get into my pants, or get something else from me. I know I don’t look so good, how could someone else really believe what they’re saying, they must want something. Maybe it’s a little paranoid.
You may see someone pretty. All I see are my flaws. I can’t see myself as a whole picture most days. I see pieces in a shattered mirror, amplified, multiplied until that’s all that is in focus. If everything isn’t perfect, the whole picture is flawed. And nothing is ever perfect unless I am in control. Control of my body, my body image, is key. If I can control what I eat, how good my work outs are, they manifest physically into a very lovely physical result. My hard work is rewarded with results I can see and I feel wonderful for the accomplishment. If I slip a little, indulge just a bit too much, I see it the next day, amplified grotesquely. All I can do is obsess over what I must do to correct what I’ve done to myself. All the while hiding from those around me so they won’t see my shame in what I’ve done as my anxiety rages out of control. How I’ve lost control.
Everything is about control.