Eating disorders disconnect you from your body, which is odd; ostensibly, that’s what they’re about. But they’re not about the body as a whole. They’re not about how it works. They’re not about functionality or strength. They’re about how the body looks and often, they’re about how it looks piecemeal.
When I look at myself in a mirror, I don’t take in the whole image. It’s broken down, fragmented, and warped. The warping has to do with body dysmorphic disorder, a condition which often shows up with eating disorders.
Eating disorders have lousy friends.
Body dysmorphic disorder directs the brain to focus on bits and pieces and perceived imperfections to an obsessive degree. Everyone has things about themselves they dislike. They think their nose is too big, their eyes too close together, or their ankles too thick. If you don’t suffer from an ED or BDD, however, you take that information in, give a mental shrug, and get on with your life. This is not how it plays out for those afflicted with BDD.
It is the dysmorphia that separates the body into component parts that you obsess over. The two parts I obsess about most are my thighs and my face, and the obsessions lead to behaviours which are harmful.
I’ve spent most of my life hating my thighs, convinced they were massive, disproportionate, and grotesque. Convinced I needed to hide them behind baggy jeans, long skirts, and enormous t-shirts falling well below my hips. In my mind, my thighs are utterly offensive and must be concealed at all costs.
I don’t wear shorts. Ever. My legs are not acceptable enough for that. I require coverups for bathing suits. God bless the long, wrap-around skirt. It took a long time for me to go out in public in a bathing suit without a long top. Even now I compulsively check and compare myself with the people and legs around me; my inner dialogue suggests I’m seeking evidence to support my self-diagnosed deformity.
I exercise my thighs compulsively, and not just during gym time. Squats are required anytime I stand still. Brushing my teeth? Squats. Preparing food and waiting for a pot to boil? Squats. Sitting at a desk? Get up and do squats. Need to use the bathroom? Sometimes, the routine varies; after I empty my bladder, I do jumping jacks.
I’ve often thought the thigh problem could be solved by the judicious application of a butcher knife. Just cut off the offending bits. The doctors could sew me up and at last I’d be perfect. I saved for years for liposuction only to be told by the consultant that it wasn’t appropriate or really necessary. I was convinced he was an evil liar and life-destroyer.
I’m working on believing my thighs are fine and normal but it’s a challenge. I’m not at the “positive affirmations about my thighs” point yet. I don’t love them. I don’t care if they’re strong. I don’t care that they carry me around. I want perfection or at least a lack of deformity and the fact that everyone tells me they’re fine and normal is irrelevant.
It’s hard live well when you hate bits and pieces of yourself.
I also obsess over my face. I obsess over the imperfections I see and it generates ridiculous levels of anxiety. The anxiety manifested in a self-mutilating tic decades ago. I would attack my face with pins, scissors, knives, and cuticle scissors in an effort to rid myself of the perceived imperfections and achieve acceptability. That the “deformities” – small white spots and random hairs – might be in my head and unnoticeable to the world at large was something I never considered.
In my case, BDD also leads to a loss of cohesion. When I’m anxious, I lose the ability to asses my appearance. In my mind it becomes warped and misshapen, almost cubist in its presentation. In my head, my face becomes skewed and obscene. I’m lucky in that I’ve been able to share this problem with a few friends and can check in with them when I’m spiraling up; they reassure me that I’m normal, that my eyes are not offset, and that my nose doesn’t track significantly to the right.
The long-term consequences of the BDD behaviours have been severe. I have serious scaring on my face. I have nerve damage to my chin and lips, enough so that my smile is skewed and I can no longer purse my lips enough to whistle or play my flute. Luckily, my thighs are still intact, though I remain un-enamoured.
It’s getting better. I currently have no open sores on my face; that’s a win. Open sores are an obvious sign of self-harm but they’re also a trigger. They’re an obvious imperfection and the BDD wants to cut them better, an idea that’s ludicrous but somehow seems to make sense when I’m engaged in it. I have decades of appearing in public with bandages covering my work. I picked coloured ones and told myself it was stylish.
When I was in residential treatment several years ago, I did some work with the art therapist. The goal was reintegrating my image of myself and learning to see myself as I actually was. The first thing she did was have me draw a picture of what I thought my body looked like, life size (the height was marked on the piece of butcher block paper). Next, I lay down on a piece of paper and the therapist traced my outline so we could compare the two. The discrepancies were amazing. Much to my surprise, I wasn’t even close to accurate. I assumed I would kill it. I assumed everyone was wrong in their assessments of my shape, size, and appearance. I expected the exercise to vindicate me. Instead, it was a punch in the gut.
How could I be so wrong about something so fundamental? My thighs were not enormous tree trunks. My waist was not covered in rolls. My upper arms were not pendulous. It was bizarre to look at a concretely accurate image of myself. Part of me believed the therapist had cheated and not traced me correctly, though the reasonable part knew that was unlikely.
This brought home the fact that my thoughts cannot be trusted. My beliefs about myself need to be met with skepticism. I need to challenge the knee-jerk thoughts and responses that arise from feeling like I’m a mutated and deformed freak.
Cognitive therapy helps.
Oddly enough, so does grooming self-care. When you hate yourself and attack yourself, you aren’t being kind. Self-care provides the opposite experience. You indulge yourself. You treat yourself nicely. You learn to appreciate the bits and pieces that make up your body.
I wish I could go back in time and undo what has been done but of course, that’s an impossibility. All you can do is keep moving forward and work on understanding the quirks that led to the maladjusted and harmful behaviours.
My first thoughts may never be kind but when you’re trying to recover, it’s the last thoughts and actions that tell the tale.
(More information about BDD can be found at https://www.psycom.net/eating-disorders/body-dysmorphic-disorder)