Dear Dr Jules
I have a large birthmark on my face and I don’t like to go out anymore because I feel people are constantly staring at me, or even worse, they try not to look and they turn away. Can you help please?
I feel your distress as I read your question. Sadly, we are brought up equating perfection in appearance with goodness and success. We only see certain body types in children’s stories and in the media. It is always the slim princess who gets swept off her feet by the handsome prince, while dolls are impossibly thin with pretty painted faces. As we grow up and get more exposure to the media we are then bombarded with images that fulfill the current standard for perfection, always slim, toned and beautiful. Of course these images are digitally altered before we see them, reinforcing the ideals that not even the models themselves can attain. It is rare for us to see positive role models who fall outside of this norm: people who are carrying more weight, who are differently abled physically, or who have something unusual about their face such as a birth mark or a noticeable scar.
In therapy, I focus on helping people to differentiate between whether the problem is their appearance which must be fixed before they can move forward with anything else in life, or if it is their preoccupation with their appearance that is the problem, i.e., is what you see in the mirror what you feel about yourself? Once the client can accept that the issue is an emotional and cognitive problem, then we have something solid to work on.
As we grow up we have external and internal influences on how we feel about ourselves. The external includes things that other people did to us, such as bullying, teasing, staring, humiliating, rejecting and medical interventions which may have been expensive and painful. The internal are the resulting thoughts and beliefs we develop about ourselves that we repeat in our head over and over, or images of ourselves that we play out in scenarios in our minds that are distressing. Both of these are like audio tapes and DVDs that we keep playing, even though they are painful. Unfortunately, the constant repetition only serves to reinforce those old external influences in our mind.
Think back, did you get bullied or teased as a child over your appearance? When you remember your younger self, does it upset you to recall what that child went through? If so, some inner child therapy could be helpful, where you comfort that child and remind it that children are often cruel but without the ability to understand the repercussions of their actions. You may have had constant experiences of teasing or negative reactions that have reinforced your negative feelings about yourself, and that have built up over time until you can’t get those thoughts out of your head, and then your defense system starts to break down and you become caught in a negative cycle of expectations and beliefs, leading to low self-esteem and a sense that perhaps you don’t even want to leave the house.
Here is the key: don’t let your body image become the bully that continues to chase you around now, because that is what those old internal tapes and DVDs are – the bully that is still chasing you and humiliating you. Think about how much time each day you spend checking your appearance, or focusing on your perception of other people’s reaction to it? What do you think other people are thinking about you, what do you fear in their reactions? For example, do you fear they won’t like you or won’t want to interact with you? All of this is the continuation of the external and internal influences on how you are living your life now.
What we want to do in therapy is to help you change those old tapes and DVDs, and to learn to keep your attention focused outside of yourself so that you are less preoccupied with your appearance. Some people might have a problem with how you look, but remember that the problem is theirs not yours, and their questions might be exactly what you would be wondering if you saw yourself for the first time. As you make progress, I hope you come to experience your uniqueness as something to celebrate, in all aspects of yourself, such as your character, your achievements and your appearance. Those who know and love you do so because of who you are, and that is what matters.
I recommend finding others with similar experiences to yourself, and networking with them. It is really important to know that you are not alone and to see what has helped others to cope. A couple of good websites I found are: http://loveyourmark.com/meet-beverley/ https://www.changingfaces.org.uk/
Overall, don’t let your thoughts about your appearance develop into something more serious such as a preoccupation that stops you from living your life. Find the help you need to move forward and get out into the world again.
If you are feeling stuck with your life and can’t see a way forward, or if you are distressed about your appearance to the point where it starts to occupy your thoughts, then counselling can be helpful in providing support and a non-judgmental space to explore your options and make positive change. For a free consultation and to access the counselling service consider contacting Dr Jules in person