How can people stand to look at themselves
in photos, videos, mirrors?
My therapist wants to do video sessions so we can try EMDR. And I'd like to make YT videos about some of the things I have rolling around in my head, because no one reads articles anymore. And I'd like to be able to share photos with my friend. And I'd like to learn how to do makeup and stuff. But I just can't seem to get over this hurdle. I've been sitting here for the last hour trying to get myself to look in the mirror and my brain is just like, "No, we're not doing that."
I told my therapist I'd think about it, but idk if I can do it. I need the EMDR to do the video conferencing. I can't do it the other way around. It's like she's asking me to get better so she can start doing therapy. If I could do video conferencing I wouldn't have gotten a therapist, ffs. It's literally the reason I went to the clinic.
I used to hate seeing myself in photos or videos and I do not want to see any footage of me before 2012. I hope it's all been erased. I still don't like pictures unless I'm the one taking them, and I cringe when I see myself on video. I look too much like my dad and grandpa in pictures but not in the mirror, and I can't help but think about them when I see myself. I don't think I'll ever get over it even if I improve my appearance as best I can. I'm also very nervous in the gym showers. I haven't been bullied for my appearance since high school. It sucks and no amount of compliments or attention from other people seem to fix it.
I tried something about a year ago. I'd try to look as 'best as I could' as if I'm going out with someone I like, and then like do video journaling. Talk about stuff that worries or bothers me.
It took enormous effort to just say anything that made sense, because I'd have to be suppressing a lot of "EW I'M UGLY. EW MY VOICE. EW THE CRINGE" screaming in my head. I got through a couple of short videos in the end where I'm like talking about SA and being cute and vulnerable and stuff.
I first sent my best video to a friend I have that has literally never judged me about anything. So I knew beforehand she'd say something nice.
I ended up uploading it to my Facebook too (just 30 people there, none of them IRL people, a very predictable environment). I got a lot of likes and love reactions, which kinda made me feel okay about my face and voice for a bit.
I never tried that again though. It took a lot of mental effort, and also there's a "diminishing returns" to people being supportive and nice if they don't care about you. There's sort of a novelty to vulnerability that makes people respond supportively and encouragingly (if that makes any sense). However, if I like try to do these videos every week or something, they'd start seeing it as pathetic or manipulative (depending on how vulnerable I act).
There's also the option of not showing vulnerability at all and just hiding it, but then there's a risk of someone being (unintentionally) mean or say something that completely destroys my self-esteem. I'd never consider doing a YT video. People are just too mean on the general web.
I try to avoid my photo being taken in general because I look so ugly. If someone does it anyway, I try to detach from it. I've also try to overemphasize my flaws in my own head so I'm never shocked by any photo of mine. I know exactly what freakish things to expect and look for in my face. If it ends up looking a little better, I can feel a little relieved. No sure if that's very healthy though.
Anyway, I'd recommend the video journal thing at least once if you've never tried it. You also may need to be thinking of someone specific you'll be showing it to, who wouldn't be critical at all and always supportive. Doing videos for myself alone never really worked for me. It just made me feel worse because I wasn't trying hard enough I think.
& Best of luck with the therapy :heart I didn't know you started that. Hope it's helpful.
I don't really like sharing my image with other people because then they have opinions or form opinions. I don't have much of a problem looking at myself in mirrors though, although I don't look very closely most of the time. I have a mirror behind my PC monitors so end up seeing myself often in that.
It's possible to make YouTube videos without showing yourself, though obviously most people don't.
It's really difficult to make YouTube videos. On my new channel I don't show my face, but still record myself speaking and I hate listening to my voice. It's also really feminine/high pitched. I used to show myself years ago. It's less important if you do gaming related stuff, if I wanted to branch out at any point I'd probably have to show myself really but I'd really rather not. I literally put no effort into bothering with my appearance and want to be disembodied. There really isn't much I can do about my appearance and that makes creating a brand that I don't hate difficult.. I don't have anything to say at the moment though. I keep wondering why I can't find YouTubers I relate to much and it's probably for the same reason I don't make videos really.
That's also why I'm not really attaching anything meaningful to what I'm doing on YT atm. I doubt I'll ever get anywhere partly for this reason. It's kind of just limited/impersonal and essentially it's just acting. I don't have much of a self to express anyway though.
But yeah so I basically don't have any advice. I guess it's just like something you have to force yourself to do when there's stuff you want to do. I also have anxiety issues recording YouTube videos it was a lot worse the first time I did it like in 2009 that took so many takes for a couple of minutes of video. But then every time I leave the site and come back I have to relearn certain things and I'm still not comfortable on my new new channel and have to stop and start a few times. It takes a while before I warm up because it's like talking to yourself but at the same time it's not because I've had entire long conversations with myself where I had less anxiety. It is a lot easier if you script it though but I tend not to.
I don't know because I never do but if you were video chatting with someone there might be a way you could just look at them and not yourself? Looks like you can do it in zoom:
if the problem is mostly you seeing yourself that could help.
Wish I had actual advice to give. I know (well more or less) how big a deal this is for you. I'd hate for this to discourage you even further but generally speaking seeing yourself in pictures and videos is a lot worse. My immediate family members know they're not supposed to film or take pictures if even by accident I'm going to appear on them. The rest of the family, they get 'I believe cameras steal your soul', lol, insist, I insist in the opposite direction.
It's gonna be incredibly tough if you can't handle mirrors though. Except... I'm thinking maybe on the video call thing you can turn off your own image or something, so you don't see it but she does? Don't know much about it, never done video calls. Just thought it might be worth investigating.
I think ive gotten to a point where i just accepted my appearance and my flaws. It still cringes me but i dont get down about it for days anymore. I just accept what i have been given and try my best to be the best version of me such as working out and being in really good shape.
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I would go with gradual exposure without delving into the psychology of it at all. Purely behavioural solution. Keep large brain out of it, it will only get in the way ;).
Mirror (do all this while noting anxiety scores on a piece of paper):
1. Look in a mirror with a piece of paper stuck on it covering your face. Look at it for an hour
2. Cut the top part of the paper off so you can see your hair. Look at it for an hour
3. Cut more paper off...
progress to looking at photos of you in.
1. Take a selfie on phone. Dont look at picture. Repeat every minute. Do for hour.
2. Take selfie on phone. Look at picture. Repeat every minute. Do for hour.
3. Pick the best selfie.
4. Send selfie to best friend
Important to log anxiety scores throughout and be mindful. Your brain will throw out all manor of convincing arguments as to why you shouldn't be doing this. You will believe it, probably, but commit to doing it anyway and just get through the tasks, and try to score anxiety as honestly as possible.
I have learned (doing zoom meetings), my mind reverts to a super critical version of me, to try to get me to quit (i.e. "this is useless, it wont help, this isn't going to help my problems because ...xyz"). I can be convincing, I would expect you can be equally as convincing, but for this you would need to suspend all of that and just view as mechanical exposure task.
Might help if you view as experiment.
I think for you Tru, this is something you would gain sooooooo much from though if you could do it, and I would looooooove to one day see you making vlogs and videos, and join me in a zoom conference or co-run a zoom support group with me or something!!
I went through this today (after a weeks illness), my angry inner child had a bit of a temper tantrum during a zoom meet, I've been slacking on the mindfulness so I let it carry me a bit. But am planning to get involved with the recovery college doing some actually useful topics for them lol ;). It's constant though, the excuses and justifications my mind fires at me throughout this stuff.
Thanks, guys. I really appreciate the replies. :)
@Saeta Yeah, reassurance doesn't seem to help people much, if at all. There's always a way to discount what people are saying. I got teased a lot for being pale when I was a kid, and then starting in hs for having long hair (which almost everyone hated, lol). But that's not really the issue. I know I'm ugly (for a male) by conventional standards (women were never interested in me) and I'm mostly able to live with that. The problem is a bit more complicated because I'm trans. By feminine standards of beauty I'm spectacularly ugly. And those are the only standards my brain really cares about. I mention some other stuff below.
@Myosr Thanks for the suggestion. I might try a voice journal. I've recorded my voice a couple of times for my friend for special occasions, but I can't bear to turn the camera around so I'm in the picture, lol. It's a bit more than just being ugly; my gender dysphoria is involved, too.
I'm not really worried about people being mean. I know what people are like, and I know what people think about people like me, and I've been called just about everything at some point already. I know what kind of comments to expect and the high dislike to like ratios from watching other people's videos. My self-esteem is pretty good, all things considered. Being called "ugly", etc., won't surprise me nor would it really upset me. I just don't like to be seen. My mind seems to think that not being visible protects me in some way, and losing that protection is somehow connected to my fear of being in photos/videos. I'm not really trying to be vulnerable (maybe people will see it that way, anyway); the kind of stuff I'm thinking about making is more factual or theoretical.
I've been doing therapy for the better part of a year now. I don't think it's helped yet, but it's nice to have someone to vent to. Maybe the EMDR will help. If I can force myself to do it.
@Persephone The Dread Yeah, the "forming opinions" is a big part of it for me, too. I feel like, if you're any flavor of trans, how you look has a big impact on how people interpret your words and actions. And I'm much more concerned about that than being ugly per se (though I hate that, too). "Because you have this kind of body, you don't really think/feel that, it's not really genuine, your personality is all just an act, etc." Not sharing photos/video probably doesn't actually help me at all, because people know what I am, but by sticking to text I can fool myself into believing the real me is coming through on occasion.
Idk anything at all about making videos (and why would I? lol). But I'm not concerned about the production quality or having fancy effects. I just feel like I should be putting something out there. Idk how many other people there are like myself who feel like they have no representation (maybe there aren't any, haha). And because many people's arguments stink. But I don't expect to have many followers and I'm not trying to make any money. I'm doing it for personal reasons. I'm sure I'll be redoing the same videos dozens of times, though, because I totally suck at speaking.
My therapist suggested hiding my image during video conferencing, but, like I said, it's about a lot more than the way I look. Just knowing that another person is seeing me is a lot of the problem.
Thanks, @zkv . :squeeze Yeah, mirrors are a problem for me, too. They're a slightly different problem, but connected.
When I share a picture/video, my mind is normally panicking about the fact that someone is seeing my picture. And it completely messes me up and I can't think straight. But when I look in the mirror I get a different chain of events. For starters, there's a weird sense of alienation, like the person in the mirror isn't me but a stranger and they're watching me, which creeps me out. (And maybe that's because I never look at myself.) And then there's this kind of intense rage, because I'm angry at my body for destroying my life (my poor body, lol; I know it's just a bag of chemicals, and never meant to cause me any harm, but that's how I feel). And this awareness of how my body has destroyed my life sends me down the suicidal ideation slip 'n slide until all I want to do is kill myself. So I avoid looking in mirrors to avoid this chain of events as often as possible. I get the same chain of events by looking at pictures or video of myself on my own, but during an actual conversation (like with my therapist) I think the freaking out about being seen would dominate, not the self-destructiveness.
@Hussle I'd like to get to that point someday. I just don't know how to do it.
@SplendidBob I was right with you until step 2:
You might be right that going into the psychology of it all won't help. You can probably figure out the psychology from the stuff I wrote above, and it's obviously not rational, and I already know it's not rational. So maybe exposure is the way I'll have to go. I just don't know how to break the--1. see self, 2. hate self, 3. kill self--chain. Forgetting about the existence of my body as much as humanly possible is how I maintain whatever little sanity I have left.
I think being on any kind of Zoom conference is outside the realm of possibility at this point, but it's a nice thought. :b
For me it was about learning to detach myself emotionally from what I was seeing. I used to look at myself in the mirror, or in a photo, and it would trigger all the horrendous memories of bullying and abuse that I experienced simply because of the way I looked. It would remind me that my appearance had barred me from any kind of relationship, or physical intimacy and I would feel a visceral sense of anger. I would look at my body and would hate it for what it had done to my life. Judging by your comments it seems like you are going through something similar, a sense of association between your body and the pain you have been through. Worst of all for me was that I had read so much about how the key to getting better is to start seeing yourself as beautiful and I felt guilty that I couldn't. Of course the reason I couldn't was because it's nonsense. I am not beautiful.
I only started to get better when I began to look at myself more objectively. I am ugly I would say to myself but what is it that makes me ugly? What is distinctive about my appearance? I began to analyse my own appearance in great detail and the emotional despair I felt when looking in the mirror was replaced with intellectual curiosity. I became fascinated and curious about my ugliness. I felt like I was analysing a weird painting, or poem. I turned it into an academic experience instead of an emotional experience. And I started to accept who I was. I was ugly but it was interesting because I was also different. People gave me abuse for me being ugly but that didn't make me a monster. I deserved a life. I didn't deserve to have to hide myself from other people. Because why should I hide just because I don't fit any conventional measure of beauty? Admittedly this approach may have only worked for me because I am such a weirdo.
I know for you it's way more complicated then just feeling ugly and I realise you may have received more abuse than I ever have. And I am sorry. Sadly anyone who is trans is liable to get that. But I do get pretty regular abuse from strangers on the street so I at least have some kind of sense of what you have been through. I hope that one day you reach a point where you no longer feel like you need to hide anymore. Take care.
I don't mind seeing myself. Many years ago, I made many hours of video of myself as a form of video diary and I never had a problem watching it even though I know I'm hideous to other people. My main issue is having other people see me.
Not sure if anyone suggested this already, but maybe you could use an avatar -- be an animated cartoon character or something. After all, it's the internet! Some friends and I were once going to don dinosaur masks and do a weekly show on politics, "Jurassic Talk" -- never did get around to that, come to think of it.
@truant from either or all directions, or maybe placing multiple layers of semi transparent paper / fabric over the mirror, and removing one / two at a time. Could set up using a window to see how clearly you can see something face-esque behind at each unveiling, then set up enough on the mirror so you know you cant see yourself, and you can do it from safety.
So long as each step is gradual enough for you to be able to handle that step while being in the, ideally 3-6/10 anxiety range, that's perfect. You can go higher, and the sad truth I have found is you have to sometimes (been hammering away at 7-9/10 tasks for a while now, but if I had any other way id be down at 5-6, because its very hard to cognitively defuse from).
me: "I now shall invite the anxiety that is a yellow blob into my stomach where I feel it, and make room for it. I accept you yellow blob of anxiety"
9/10 anxiety: "get me the **** out of here I'm literally going to die, and I am not just a blob, I'm a pus worm and I'm spreading through your entire body"
me: "It's fine I've made room for you, I accept you, I shall let you float away like a leaf on a stream"
9/10 pus worm: "not when you are dead, you wont, ****er. Turn off zoom"
lol. It does sortof help, maybe drops anxiety scores down 1-2 points or something ;) - but i think yeh, 5-6/10 anxiety at each step is for the best. But if you do this and log scores, you might find your estimations are off (high). Happy to brainstorm with you on this one if you want :) to make it as bearable as possible.
Yeh, the psychology, I feel this is one of those things where its possible to carefully design it, to graduate the exposure slowly enough, that it makes the perfect candidate for a graded exposure hierarchy. I also know that your brain is a good one, like mine, and if you try to understand your way out of it, you will be stuck forever, because your mind will come up with unlimited ways to deflect you, like wot how mine does. I see exposure as a rather intellectually unsatisfying clumsy brute of a thing, but a thing that works very well if exposure can be carefully controlled enough, and the individual has the courage (and support) to stick with it. Its with a sortof reluctant sigh that I end up having to use it on myself though, not least because its just so god damn disappointingly mechanical.
Its like building a computer to beat the best player in the world just by throwing more processing power at it. Its just so ****ing inelegant and unsatisfying, but at the end of the day when any mobile phone cant be beaten by anyone in the world its time to throw in the towel and just give up lol.
Its also a little bit like knowing you have to eat a **** cake, and the only way you can down it is by cutting it into slices lol. Ho hum.
But thinking of you, and hope its something you can overcome, or overcome enough :hug. (totes believe you can, btw).
Well, I did it. I ordered a webcam off Amazon. I'm not sure I'll use it, and I might regret spending the money, because I don't have a lot of it, but I guess I'll find out.
@Alleviate Suffering Yeah, that "everyone is beautiful" nonsense drives me crazy. I can't convince myself of something that isn't true. But if you reject it, you're made to feel shallow and superficial. So not only do you have to deal with being ugly, you get told you have a rotten personality and people tell you that you're creating all your problems yourself with your lousy attitude. Gee, thanks, I feel so much better now, lol.
Interestingly, I take that "intellectual curiosity" approach toward my life in general. I have to, because it's so psychologically painful. I have to frame my own experience in a way that makes the relentless tide of **** seem "interesting" and "novel". Sure, my life's terrible, and no one would want to live it, but hey, no one else is having these experiences, and that makes them "special". All the "value" of my life comes from it's "uniqueness". If I stopped existing, then this particular version of hellworld would cease to exist and that would be a loss (somehow, in some way) to the universe. When all your experiences are painful, you have to turn to aesthetics. "This is terrible! But I have to admit, it's kind of interesting. What an adventure!" <- This is literally how I have to approach every day of my life to keep from self-destructing, since I have nothing to look forward to. (That got kind of dark, but hey, that's interesting, too, isn't it? Lol.) I've tried this with my appearance, observing it with detachment as an object, but tbh when I look in the mirror I feel like I'm in Jacob's Ladder and there's only so much interestingness I can take before I feel like smashing something.
Thanks for the reply. :)
@WillYouStopDave Did making the videos help you mind the way you look less? Or did you feel that way when you started?
@Curmudgeon64 I have thought about using avatars for YT videos but I don't have the technical chops for that. I know next to nothing about video editing, let alone animation. And I'm not at all artistic. I can't afford to hire anyone to do that kind of thing, either.
@SplendidBob Yeah, idk, I'm not disputing the design, but it sounds like an awful lot of work, lol. I'd have to buy the paper. And then look at myself in the mirror to even attach the paper. I feel like I'd just end up not doing it because I can't be arsed. I'm not good with things that require a lot of preparation or planning at the best of times, and these days I'm happy if I get pants on in the morning. Like, if I were capable of starting and continuing a process like this, I would be capable of getting off my *** and writing every day, too, and then maybe I could afford to buy pants to put on in the morning, and I'm just not. I have a lot of trouble motivating myself to do anything these days. I think the kind of interventions you're talking about demand a level of commitment that itself depends on feeling like you have the ability to make your life better through your own efforts. And I've basically lost that feeling. My goal every day is no longer self-improvement, but finding a way to not kill myself. And that's about all I can manage. I do keep everything you say in mind, though, so thanks. :squeeze
No. I never had a problem with seeing myself on video or in a mirror or whatever. I don't judge myself that way. But I would have never shown them to anyone else because the idea of being judged by others is what bothers me.
I think for me, its just time and growing older that has allowed me to reach the point where i am. I realized that life is really too short too keep worrying or being brought down by my imperfections and flaws.
If I could have used all that time in my life where I would spend hours/days nitpicking and analyzing my appearance and used it in other areas more productive I would have but my mindset back then probably would not even bother to hear this.
I still have moments where I revert back but only for maybe a fleeting few minutes compared to months and months even years.
Like when I see myself on camera, I'll start to focus on how big my head looks.
My head size has been a source of insecurity in my teenage years and was heavily and severely bullied for it and those moments remain ingrained in my memories till this day. I developed severe body dysmorphia and a whole bunch of other disorders as well as depression due to it.
These days, I just marvel at its size hahaha. I mostly laugh about it now. I think it helped that my body filled out a bit and working out also helped me look more proportionate but Ill still get comments once in a blue moon but the insecurity or thoughts about my head arent as severe as they use to be.
I mostly have other grievances about my appearance now and my head size is probably at the bottom of my list but even then, thse. grievances dont bring me down as much and I have focused less on my appearance and focused more on being productive.
It was just a matter of learning self acceptance and learning to focus on and control things that I can actually control and improve things about myself that I can work on.
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Idk. I tried using the webcam for an online class but after using it the first day it was too much cringe to do it again. The main reason is because I noticed I looked really angry through the camera (I didnít feel angry though), and felt like it was offensive for others to look at or be exposed to that.
I got my webcam today. Anxiety was pretty gut-wrenching, but I've been psyching myself up for over a week now and I forced myself to figure out how to use it. It's sort of funny because I know I'm ugly, so I expected to be hideous, but I didn't expect to be this hideous, lol. I'm actually quite a bit uglier than I thought I was. I guess because it's been a while since I've looked and people get uglier over time. I have some pretty notable facial asymmetry and did some Googling and, honestly, the only people I can find online who are uglier than I am are people with facial deformities from birth defects or injuries. I'm a meme waiting to happen. Especially if I start presenting more feminine. I'll need heroic levels of determination to be seen in public en femme. I'm basically every trans woman's worst nightmare realized. Yay me!
I'm not really sure what to think about it. On the one hand, if I were to make YT videos about being ugly, there would be an actual ugly person making videos, instead of average/attractive people with BDD who just think they're ugly, and maybe that would help someone feel less alone or better about themselves (I'm not sure how, though). On the other hand, I doubt I'd get more than 5 subscribers, so who'd ever see the videos? I'm also afraid that if I do make videos about trans issues anti-trans activists will use my image/videos for hate propaganda, since I'm basically the kind of person everyone is afraid of. ("Do you want this man going into a restroom with your daughter?" I can imagine it now...) I don't want to make things worse for trans people by putting my face out there. I'm almost a shoo-in for one of Blaire White's videos if she ever gets wind of me, lol.
What I really want to do is kill myself, but I don't think I can get assisted suicide for being ugly. But ... damn, I really should. We have to draw the line somewhere, lol.
@WillYouStopDave When I see my body, I see the source of all my problems. Pretty much everything can be traced back to the shape of my body. So not having any kind of strong reaction to it would be like having no strong reaction to any of my problems. Which would be nice, but, yeah ... hard to get there, lol.
@Hussle I'd really like to get to that point. I have a very asymmetrical face/head because my jaw is misaligned. It's sort of kidney bean-shaped from the front. I have a large skull, too. (I have trouble finding hats that fit.) But I have dozens of problems with my body. A lot of the problem is that when I see my body I'm reminded of why I have to be afraid when I leave the house. With gender dysphoria, you basically either stay in the closet until the depression kills you, or you transition (and somebody else kills you, lol). Since I can't pass I have to worry about my physical safety. And most of my symptoms revolve around that (insomnia, nightmares, hypervigilance, phobias, panic attacks, etc.).
I've always done my best to ignore my body and focus on the things I can control, which is why I turned into a book nerd, but it's always created problems for me. (Like, it took me a really long time to find permanent employment, and I think a lot of that was because I'm not exactly customer service material.) And appearance just gets more and more important. I can't effectively promote my writing because I can't put up photos of myself, or do interviews, or share stuff on social media. So I can't compete with all the writers who can do that (since writing is part of the entertainment industry and that's how you make fans).
@Mlt18 I don't look angry. I look very anxious, though, because of the way seeing myself makes me feel. I can't really smile because my teeth are really bad (my two front teeth are fake and they're cracked/stained because I can't afford to replace them). So the best I can manage is a closed-lip smile. I know that other people don't like to look at me, and I feel bad about that, too.
I'm not sure. A lot of people actually enjoy taking photos and videos of themselves, and they usually seem to me to be people who aren't very self-conscious, which I'm the opposite of that basically. I had a lot of anxiety about my appearance starting from when I was a teenager and was very fixated on certain features which I felt were flawed. And it's not like anything's really improved, but I guess over the years I've at least come to understand it, and in my case acknowledged most people don't really care about how you look beyond a passing observation.
Reading about body dysmorphia (not saying it's this but still relevant) has helped me understand my aversion somewhat since there seems to be stuff I relate to, as essentially it's a bias where you process things visually in a piecemeal fashion rather than gestalt, which leads to getting fixated on features and difficulty seeing how everything can sort of work together even if an individual feature looks odd in isolation. There also tends to be heightened aesthetic sensitivity, which is good to apply to the arts, but not necessarily to your own face. I mean human bodies aren't always aesthetic (especially depending on cultural context, since what's conventionally attractive, or marketable attractiveness can vary) and they weren't designed just for that anyway. There's also a lot of self-consciousness and obvious predisposition to anxiety and obsessive compulsive traits which I definitely have. And then the question that I kept seeing in BDD forums of 'am I really ugly or do I have BDD?' And the answer is you can have one or the other, or both at the same time. BDD isn't so much about what you look like but how fixated and distressed you are. It's also possible to be just really, really unphotogenic.
I have managed to desensitise taking photos and videos of myself in private, but it's still difficult to show others. And if i take a break from it for a while it's still hard to start up again. Mirrors are a little easier I guess because I grew up with a lot of mirrors at home, and now I like them as a decoration thing. In fact even my phone case has a mirror on it so I can check myself, but it's not like I do it that much. I'm very aware of things like angles / lighting / focal length as well, and so I'm not that surprised by how different some people can look from one setting to another.
Fwiw I think you'd be great on a youtube channel.
@Rains I've seen that before, that BDD is about how distressed you are about a physical feature, not about whether or not the feature makes you ugly, and some therapists probably treat it that way, but I'm not sure that it's technically true. From the DSM 5:
If the preoccupation is unreasonable, then medication can help because the evidence that the person is basing their preoccupation on is self-derived (it's not coming from other people, who pay no attention to the "defect" at all, but from the OCD fixation). If the preoccupation is reasonable, then medication doesn't seem to help because the evidence is based on real feedback from other people (ie. the person is actually being ostracized). If you are legitimately "ugly" then they usually treat for depression and anxiety instead of BDD/OCD; the coping strategies are different. (I'm very far from being an expert, though.)
This was really good, btw:
In my case, I think not passing creates reasonable distress. If I were cisgender and I felt this strongly about my appearance, that would probably be unreasonable. The jury's still out, though, and my OCD may be playing some role. I've talked to my therapist a lot about my appearance issues and she's never raised the prospect of BDD, so I get the impression that she considers my fears at least somewhat reasonable. I think it all just gets filed under sequelae of gender dysphoria.
I don't think my YT videos will be very good, tbh, haha. I don't think I have the right traits to be a "personality". I mostly just feel pressure to get my ideas out there. But thanks. :)
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