Transcriber: LI YISI Reviewer: Sebastian Betti
Raise your hand if you have a social media account.
Most of us.
And raise your hand again
if you have scrolled through images and compared yourself.
Maybe sought reassurance on the way you look.
Many of us.
Thank you for your honesty.
Comparing yourself and seeking reassurance
is one of the most common safety checking behaviours
of someone suffering with body dysmorphic disorder.
Have you heard of the metaphor for your mindset in that
you cannot control the waves,
but you can control the oars of your own boat,
meaning that thoughts flow through your mind on a constant flow,
but you can learn ways to master your thoughts?
How in control of your thoughts are you?
I'm Jim Gunn and I'm a consultant, psychotherapist and body image expert.
And I’m seeking to campaign
to raise awareness of this serious mental health condition.
within this digitally evolving world.
Specifically, how it feels to have body dysmorphia,
how we can identify this disordered thinking
and how you can help or influence others towards recovery.
Let me take you back to 2014.
I just checked in to my room.
I was on a wildlife reserve in India.
It was late at night and sweltering hot.
You know, that clammy, humid heat.
And my hair was sticking to my face and my clothes were clinging to my body.
So I drew the curtains, took my clothes off,
splashed my face with water and lay on the bed.
I could hear a sound of a faint buzzing of a mosquito darting around the room
which was attracted to the light outside.
My mind began to wonder that
the light might attract a tiger sauntering around the reserve.
So I took a deep breath and I went to the door.
Slowly, Intrepidly opened it,
checked both left and right,
stepped out onto the porch,
hit the switch, then shut the door,
bolted it and jumped into bed.
In the morning, I woke to a knock on the door.
It was my guide to take me to the welcome meeting.
This is me outside my lodge.
Lucky number seven.
In the main building, there was a large auditorium like this one full of guests,
and I made my way to the front and found a seat.
And there was this man by a large projector screen,
and he started talking enthusiastically about their new technology that
they had night vision cameras strapped to various trees around the reserve.
And he was about to show us
the footage of last night's nocturnal activity from outside each lodge.
In that moment, my body froze.
I realized I had been completely naked on the porch.
My mind went foggy.
My cheeks began to blush. My throat went dry.
My heart started pounding.
My whole body was shaking and my hands went all clammy.
The terror of public exposure.
I watched as his mouth glided over lodge number seven
and continue on to lodge number eight.
My video footage wasn’t shown,
but that fear of public exposure, of rejection, humiliation,
and those physiological reactions of adrenaline rush:
pounding heart, trembling hands, ready to fight, flight or freeze.
This is the feeling that body dysmorphia sufferers have most of the time.
What’s your India story?
What would you do if you felt in that hyper-aroused state for most of the time?
And if you sought reassurance, you just felt worse.
Dysmorphia comes from the ancient Greek word,
and it means a fear of being or becoming misshapen, deformed or ugly.
And it was first clinically described 132 years ago
by psychiatrist Enrico Morselli.
Back in 1891, based on his study of 78 client cases，
he posited this wasn’t a rare disorder,
and yet 132 years have gone by
and it is still hugely underdiagnosed and under-recognized.
And yet it’s more relevant and more prevalent today.
Only a month and a half ago this year,
the tabloid press reported of a young 30-year-old female
working as a teaching assistant not too far from here,
that was suffering with body dysmorphia and died by suicide.
It’s really critical.
It has one of the highest suicide rates of all mental health conditions,
greater than depression or anxiety.
So we should know much more about it.
It can affect anyone, any age, race, gender or socioeconomic status.
Scientific research estimates
2 percent of the adult world population has body dysmorphia.
That’s 115 million adults
2 percent, that’s 1 in 50.
Here in the audience today,
you could be sitting next to someone with this disorder
or it could be your sister, your brother, your friend, your loved one.
More research needs to be done.
But it is thought that body dysmorphia has a multifactorial causation.
So it could be childhood bullying, teasing,
shaming or abuse or maltreatment,
or a family history of the disorder or cultural factors or societal pressure.
So it’s really hard to predict
who and why some individuals will develop body dysmorphia.
Now, when I came back from India, I returned to an abusive marriage.
I didn't have the guts to leave him because we had two small girls.
One day I found myself just walking into a women's refuge to volunteer.
But I had become so fearful of everybody I couldn't do it.
The manager gave me a knowing look and asked me into her office.
How are things at home? She asked.
And like someone switching on a tap for the very first time,
my true thoughts flowed out like unstoppable water.
You need to get yourself a solicitor and get yourself a therapist, she said.
And for that advice, I’m entirely grateful.
And with that, I found myself a brilliant therapist.
And it was during one session that I had my light bulb moment that
for most of my life I had felt inferior and rejected due to my appearance.
And this was more to do with my mindset.
It was to do with my self-perception of self
and had little to do with my actual external physical appearance.
And I had the power to alter my mindset.
I later joined a body dysmorphia support group
where I felt understood for the first time in my life.
I left that abusive marriage.
I got residence of my children.
And I retrained as a consultant psychotherapist,
and I developed the BPC method for body dysmorphia.
And it uses a combination of psychotherapy to address the past,
behavioural therapy to address the here and now,
and coaching to address the future.
And I teach this BPC method to large groups on a regular basis.
Let me invite you to answer a question.
Do you know what the top five phobias are?
Spiders. Spiders. Sharks. Anyone else?
Glossophobia. Thank you.
According to push doctor, a new gov.
Gloucester Phobia, the fear of public speaking
is the second highest phobia of all.
So public speaking greater than flying spiders, crowds.
So imagine someone living with body dysmorphia
standing here today to present a talk
that is not only photographed but videoed and posted online.
Despite those familiar feelings of that time in India,
I have body dysmorphia
and I am living evidence that it is a recoverable condition
with the right treatment and support.
Who in your life needs your support and what can you do to help?
Now.
What is it they need right now?
Could you offer them a listening ear to help them feel understood?
Could you help them create a self-management plan
or curate their social media to less triggering sites?
Could you help them find tailored therapy or go to their doctors for medication?
Engagement.
Could you help them join a structured support group
so they can feel understood and validated?
It can be an online support group
so you can attend with your cameras off.
Wider Awareness.
132 years have gone by,
and we now have the technological advances
to connect worldwide
Using this, can you think of ways
to better inform schools, universities, doctors, hospitals
to better understand this serious mental health condition
that is both treatable and recoverable?
Before I was a therapist, I used to work in digital transformation.
And I remember a time when my colleague wrote down some notes on her paper pad
and then looked at it and swipe left to delete it on a paper pad.
So we need to allow ourselves time to adapt to this ever evolving world.
And wouldn't you agree? Post-Pandemic?
There's an expectation to be visible all the time.
Most of our study or work life is spent on video conferencing
in our leisure time.
We’re on social networks
where there’s an expectation to take a picture or a video of ourselves.
If you meet up with a friend,
you know somebody is going to take a photo and post it somewhere
and we have photo editing and filter apps to present the best version of reality.
It’s our new normal.
But if you had deep anxiety about your appearance
and you were trying to live in this new normal of life online,
it can be really hard.
So it might be easier to avoid online interaction,
or to withdraw socially or even to push people away.
Social networking is about social connectedness
and we seek public acceptance.
And yet body dysmorphia is often misunderstood as vanity,
and minimized by unhelpful comments such as
“Just pull yourself together and get over it.”
or “just come off social media.”
Many of my clients will take an average of about five months.
That’s about 22 sessions,
before they feel able to turn their camera on and be seen online.
Have you ever tried to give up something as New Year's resolution?
Only by willpower alone to know it’s not enough?
Well, for body dysmorphia sufferers
trying to stop those intrusive thoughts or compulsions by willpower alone,
it’s extremely hard.
And wouldn’t you agree,
the more you try to stop a thought,
the more it comes thick and fast against you.
So if you weren't informed about the symptoms of body dysmorphia
and you just felt really awful about your appearance,
you might be more likely to seek to correct your imperfections
by going to see a cosmetic surgeon or cosmetic dentist or dermatologist
than a psychiatrist or psychotherapist.
Body dysmorphia begins in late teens
and it’s sometimes misdiagnosed as something else,
like OCD or social anxiety or an eating disorder.
Scientific research suggests that it can take up to 15 years later
before somebody goes to see a therapist.
Many of my clients are in their late 30s and early 40s.
Something mistaken as vanity can start to have serious implications.
People with body dysmorphia have a higher chance of
unemployment, divorce, substance misuse,
a higher chance of suicidal thoughts, self-harm, eating disorders
or other implications due to their repeated surgical interventions.
As with all mental health conditions,
it would be so much easier if it was visible like a broken arm in a cast.
So if we can’t see it, how are you going to recognize
if someone you know is suffering in silence?
Distressing thoughts and feelings can affect
a compulsion towards maladaptive coping behaviours.
The sufferer might get stuck in a cycle of an intrusive thought,
creating a distressing feeling,
creating a compulsion to carry out a safety checking behaviour.
So I devised this acronym to help describe the repetitive behaviours as
a result of those intrusive thoughts.
And I’d like you to think of someone you know
who carries out these actions repeatedly
or might use some of these language.
Mirror checking.
I’m so repulsive. I need to check in my pocket mirror.
Oh, my skin is awful. Let me check again.
My nose is all wrong.
Oh, everyone's going to think I'm so vain. I keep looking in the mirror.
But that’s not how I feel. I feel so ugly.
No one’s going to understand.
Or I’m just going to avoid mirrors altogether.
I’m so repulsive.
I’m just going to avoid them.
Inability to feel assured.
Look at these perfect images and I just feel so rubbish in comparison.
I point out all my flaws to my partner, but they just say I'm lovely.
They can’t see what I see. I know I’m grotesque.
They just don’t understand.
I don’t know why they’re with me.
They’re probably going to leave me with someone way better.
No photos.
I’m so gross. I don’t want any photos of me.
I don’t want any permanent memory of me.
I don’t want to be in that group photo.
I’m so ugly, I’ll ruin the entire photo.
Or I’m not going to post a selfie
because people are going to comment how disgusting I am.
Or I’m going to take 100 photos and filter them and edit them
and maybe one will be okay.
Disguising self.
I’m so vile.
I don’t want to draw any attention to myself.
I want to keep my body language small and shy away.
And I’m not going to make eye contact.
Or I want to hide my face,
maybe a thick fringe and heavy makeup or glasses or a scarf.
My body is so disgusting.
I’m going to wear dark and baggy clothes and try and blend in with everybody else.
Social withdrawal.
I'm just too fat and ugly to meet up with anybody.
People are going to look at me when I go out.
I feel safer at home.
I just can't face that birthday party, that wedding, that funeral.
I know I’m avoiding all these significant life events
and I feel so lonely,
but I just can’t do it.
Excessive grooming.
I need to pick up my skin.
I need to pluck my hairs. I need to do my hair just so.
I need to do my tanning or skin lightning.
I need to perfect my makeup.
I know it takes me hours,
but if you stop me, I’ll just get irritable or upset.
Traits.
Such as perfectionism, excessive list making.
Hoarding or procrastination.
I just feel so worthless.
Maybe if I try harder and please others, maybe I’ll feel lovable.
Do you resonate with the BDD mindset
or recognize someone with these traits?
We've looked at how it feels to have body dysmorphia.
How you can identify this disordered thinking
and how you can help others towards recovery.
With a new mindset, recovery is possible.
Thinking of that hotel room in India reminds me of the quote by the Dalai Lama.
“If you think you’re too small to make a difference,
try sleeping with a mosquito.”
Thank you.