Time Heals All Wounds

I was about to finish up for the day when my client Heather walked into my office noticeably upset. She was wearing large sunglasses that covered most of her face even though it was a cloudy day.   I could still see tears on her cheeks. Each time she tried to tell me what was wrong, the words would catch in her throat

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     Heather is an attractive, 36 year old woman with a good career and a devoted husband.  She has a very busy life, writing content for magazines on personal health and wellness.  One of her favorite topics is body dysmorphia.  Heather knows the topic intimately because she’s suffered from the conditions since she was a teenager.

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     Body dysmorphic disorder (BDD) is a mental health disorder characterized by an excessive preoccupation with one or more perceived defects in your physical appearance. The flaw may be minor or imagined, but the person with BDD is unable to see it that way. Instead, they spend hours each day worrying about their appearance, comparing themselves to others, and trying to hide their perceived flaws.  

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     Heather’s symptoms started many years ago when she was bullied in high school. The focus was her nose.  A group she referred to as “the cool girls” would call her Captain Hook Nose even though Heather had a normal size nose.

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     Heather was mortified and hated going to school.  She would use shading makeup to minimize her nose and never stand so that anyone could see her profile.  She had surgery when she was 18.  That worked for a while but then the self-hatred of her nose returned.  Her second surgery was when she was 29.  Heather’s condition was not unusual.

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     In her best-selling memoir Prozac Nation, Elizabeth Wurtzel recounts her own experience with body dysmorphia. As Wurtzel tells it, "I was obsessed with my appearance and convinced that I was hideously ugly. I spent hours each day examining my face and body in the mirror, picking out every flaw I could find. I would avoid social situations because I was afraid of being judged by others. I even considered plastic surgery, but I knew that it wouldn't make me happy. My problem was not with my appearance but with my mind.”

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     The reason Heather had come to see me on this particular day was to talk about her best friend Jamie.  During one of their heart-to-heart sessions, Heather had told Jamie about her nose and the two surgeries to try to fix it.  Instead of telling Heather that there was nothing wrong with her nose, Jamie started to laugh and make jokes about it.   Heather asked her to stop, but Jamie said she was being too sensitive.

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     Heather couldn’t believe her best friend would betray her trust.  She couldn’t believe she had misjudged this woman.  Heather blamed herself for not recognizing Jamie’s limits. She wanted her to be what she wanted her to be.  Heather thought she could change Jamie into the kind of best friend Heather wanted.  But she couldn’t because that’s not who Jamie was.

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     I understood Heather’s pain and started telling her about the warning signs of a toxic friend.  Sometimes there are physical reactions that signal trouble: tightness in the chest or shoulders, a sudden chill, queasiness in the stomach, a feeling of weakness.   

 

     As I talked, Heather sat there nodding her head until finally she said, “That’s exactly how it is with us.  I keep telling myself she’s my best friend but every time we get together, she makes me feel terrible.  My default mode is to blame myself. I’m tired of doing that.”