The Speakmans & Dermatillomania – My Views


Photo credit: Яick Harris / Foter / Creative Commons Attribution-ShareAlike 2.0 Generic (CC BY-SA 2.0)

So I’ve finally gotten round to watching a recent programme on ITV* featuring a young woman, Charlotte, suffering from dermatillomania who sought help from the popular English therapist couple, The Speakmans.

I have to confess that until about a few weeks ago I had never heard of The Speakmans. Apparently they are a staples of daytime TV (regular guests on shows like This Morning) and Eva Speakman has a column in Reveal. They also have a huge following on Twitter (1.4million).

They kindly dropped me a line via Twitter inviting me to watch the show featuring Charlotte and I felt rather obliged to. Being that I didn’t know much about them I did a quick internet search to find out a little bit more about their background and expertise.

What I could gather from their website is that they appear to specialise in phobias and anxiety-related disorders.

Marmite?

They certainly seem to divide opinion.

You have some people who tweet rapturously about the Speakmans and others who plainly despise them.

Quite a few of the people who are against the Speakmans make comments about how they look, how they dress and their daytime TV appeal (which is often a euphemism for class snobbery) – I think this is quite unnecessary and frankly mean-spirited. What I’m interested in is whether they demonstrate respect for the people they are treating and whether their therapy does what they claim it to do.

Their way of speaking to people divides opinion. They are quite blunt at times. Whilst I tend to be more appreciative of that style of communication, I could see why other people might find them rude or patronising. For that reason alone I don’t feel that their therapy is for everyone.

Methods

A key part of their therapy seems to be family mediation and the Speakmans try to get the family members to resolve their communication difficulties especially around the area of emotions and showing each other that they care. That sounds like a reasonable idea to me, especially as families are the major support group for most people. I believe I read somewhere that if you have a good support group then it improves your chances for recovery. I don’t know though whether this was the particular reason why that was a key part of the therapy though. I had a feeling it might have gone a bit deeper than that.

Their methods can be rather unorthodox at times, and they had Charlotte poking a peach with shears at one point to try to jolt her into understanding the damage she was causing to her own skin. It was that realisation after that activity which was said to be the moment Charlotte was “treated”.

It did make it seem rather unbelievable, as I certainly know (and I’ve read medical books obsessively about skin disorders) exactly how much damage I’m causing my skin by picking yet I still continue to do it.

I have a nectarine in the fridge and I don’t think poking it with my tweezers will make me stop (much as I do have that optimistic streak in me).

The Speakmans were careful to point out to me (before I watched the show) that it was  heavily edited. So perhaps there was a bit more to it than what appeared on TV. However, that does then beg the question as to exactly how useful the show was for sufferers of anxiety-related disorders. After all, for various reasons, we are not all going to get to see the Speakmans.

Conclusions

In terms of takeaways the message I got was you need to figure out when you first started exhibiting the picking behaviours and link it to an emotional trauma that you had at the time. You then have to accept that you shouldn’t be re-living the trauma long after the original event. You need to let go and leave it in the past. You need to realise that what you are doing is maladaptive – have that breakthrough and you’re treated. Certainly there is an underlying message that ultimately it is the sufferer who is responsible for her (or his) condition – this could either be seen as offering their clients the responsibility to manage their behaviour, or blaming their clients by insisting that they were the ones who “bully themselves.”

It was good that the first part of the programme shows some the impact that the various disorders have on a person’s life. The fact that the show has got people talking about mental health conditions is a plus point. However it doesn’t give any guidance as to what the viewer who has the same(or similar) condition might do to fix their problem. No mentions of helplines or organisations in the end credits which is a big let down.

If the Speakmans do manage to successfully treat these people then power to them, but in terms of helping me with my dermatillomania, sadly it did not offer me any new and practical solutions. Instead it made me sad thinking about my own fragmented family and wondering if I would always be a fragmented person as a result. There would be no way, barring divine miracle, that I would ever be able to have a normal conversation with my mother, never mind getting to a stage where I could say that I loved her (I don’t and I won’t. )

So I fall back on to Cognitive Behavioural Therapy and hope that I won’t have to poke any peaches on the way to recovery.

*Apologies to my international readers, The Speakmans show is only available in UK regions.

The Words I Hear When I Look In The Mirror

Chester Bennington (the lead singer of Linkin Park) has been open about his battles with alcohol and substance abuse. It is said to be the inspiration behind the lyrics for Linkin Park’s 2001 hit song “Crawling”.

However I found a lot in the lyrics that I could relate to body dysmorphia (the general sense of unease); also the psychological and literal wounds caused by dermatillomania.

For the lyrics have a listen to the video above.

 

“There are wounds that never show on the body that are deeper and more hurtful than anything that bleeds.”
Laurell K. Hamilton, Mistral’s Kiss

Recovery – There’s Work To Do!

Mental illness has been part of my identity for so long, that now that a glimmer of hope has arrived in the form of Cognitive Behavioural Therapy for substantial improvement (and maybe, **whispers it** recovery), it’s just started to throw into the mix a chaos of thoughts about how I would transition over to being mentally healthy.

Also, it has dawned on me quite how much work I have to do.

I confess I hadn’t looked at that piece of homework the kind therapist woman gave me since the weekend. (Naughty!)

I have my next appointment not this Friday but the very next. I must commit to a couple of hours over this weekend.

This is how the whole process is going to work:

1) Reading I read up on all the CBT techniques and underlying concepts re anxiety, body dysmorphia, OCD and perfectionism on the sheet. There are some online exercises via these sites as well that I should practice.

2) CBT Skills Workshop There is also a one day course that I need to book myself onto which is a detailed workshop on CBT skills.

It was either this or spread out in shorter sessions over several weeks.

This is the better option for me as the place which holds this workshop is only realistically accessible by car (ironic when one of my OCD conditions involves driving which is so bad that I cannot drive right now). Its not so much of a deal for me to book a taxi as a one off.

3) One to one time I get 6 sessions of face to face time with a therapist, but we’ll probably spread it out over 12 weeks with me doing my homework sessions in the meantime.

4) Choose an issue  Realistically I can only choose one of my OCD conditions to work on and that would have to be my dermatillomania. This is because out of that and driving, dermatillomania* has the greatest immediate impact on me day to day.

I can choose not to drive, but it is difficult for me to choose to go to work with a dirty unwashed face. My rituals can sometimes take hours. They make me very late sometimes (notwithstanding the irritating troubles I get with public transport reliability anyway)

5) Exposure Therapy I am very nervous of this.

I will have to be able to look at my skin without having to carry out the ritual of feeling for  “dangerous” imperfections.

For some reason I have to do it. I simply have to.

When I find something that is wrong it must be picked until all the contamination is out there. If I don’t do it (according to my OCD brain) I will develop a very large infection which will spread all over my face and body. I will have to go to hospital where I will catch MRSA and will die. THE END.

My dermatillomania actually increases the chance of that happening! Not to mention the obsession with the gouged area having to look symmetrical when I’ve finished with it.

I will need to take a chance on what will happen if I don’t allow the ritual to take place. Build up to delaying the ritual.

There will be a lot of tears!

Aftermath

I certainly won’t be “cured” by the end of it, but I hope this will put me on a faster track to recovery.

My therapist thinks that my depressive episodes are a result of being overwhelmed by extreme anxiety and maladaptive responses to stressful events. Dealing with stress and anxiety properly will be the key to unlocking recovery.

I’ve got my work cut out for me for the rest of the year working on this and restarting my recovery habit project.  I’m going to be tackling aspects of what could be post traumatic stress disorder brought about by surviving child abuse. I will also be seeking a professional opinion to whether mild autism could be part of my make-up as well.

I do not seek any joy in collecting the “labels” – the purpose is to gain a deeper understanding of what makes me “tick”, so that I can practice what is optimal for my well-being and future development.

 

*Dermatillomania is now confirmed as a distinct condition from OCD. My particular variety appears to have much more in common with “classic” OCD in that I am picking as a ritual in order to “prevent” a very specific set of disastrous scenarios from occurring. From what I have read, a lot of dermatillomania sufferers are not even conscious at times that they are even partaking in the behaviours. I believe for that reason my chances of improvement through CBT will be much higher than for many dermatillomania sufferers who might be better served trying some other techniques (certainly Exposure Therapy is not usually the recommended therapy for dermatillomania). So if by chance it turns out to be a miracle cure for me the context needs to be appreciated. Also there is the factor of individual variability. And of course CBT might still be useless for me!

Mental Health on the Internet 27/7/2014

Blog of the Week

Somber Scribbler

I love love love the artwork on this blog which is used to illustrate the blogger’s recovery journey with depression. Please check it out!

Links I Love

  • Oh yeah! I love this purported therapy! Fresh bread has to be one of my favourite smells ever! Who knew that it was meant to be so good for alleviating depression?
  • I haven’t done yoga now for quite some time since my breakdown. A real shame as I found it very centring and calming. Click on the link to find out why.
  • So, there is a reason why so many people feel invigorated by a seaside trip.

Video of the Week

Whitney Thore reveals how she learned to learned body acceptance through dance:

Body Dysmorphia and The Photo Shoot

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TRIGGER WARNING: This post covers the topic of body dysmorphia with a frankness which could be distressing for some people. Please proceed with care only if you are comfortable with this.

It’s not the easiest thing in the world to try to explain what body dysmorphia is to someone who doesn’t know. It’s also hard to explain why it’s not simply vanity.

The simplest way I can explain it is that its when I perceive my body, in terms of subjective feelings, as something completely different to what the average person would perceive it as. It’s almost like I have this mega-zoom lens and the nice air-brushed version of me that others see becomes a living nightmare.

I see asymmetry, unevenness, pores, oddness, bulges, jowls, wrinkles, fat every possible angle I look. The bulbousness of my nose, the shine and dirt of my greasy skin occupy every thought from the moment I catch sight of myself in a mirror.

It was out of curiosity that (some time ago now) I decided to go to a local photographic studio (which specialises in makeovers) so that perhaps I could have an image or two that didn’t make me want to slit my throat in despair.

Arrival

A nice young woman came out, took my details, sat me down and handed me a glass of champagne and some biscuits. I was told to take a seat for a few minutes to relax and wait for my turn with the make-up artist.

I chewed a callus on one of my fingers nervously.

“I hope this won’t be a waste of time”, I thought. I looked around at the walls which were covered in large prints of extraordinary looking human beings.

I wondered if I would be the first person to be turned away for being too ugly to be photographed.

I also felt ashamed of the fact that I had skin picked really badly the previous week. I had some large scabs on my cheek which had only just healed. I had spent nearly two hours earlier that day carefully applying and re-applying foundation and heavily layering with powder to prevent any hint of shine. I was worried that the foundation would have to come off and my gross little secret would be out.

Make-up

Another impossibly pretty woman came over and introduced herself as my make up artist for the day.  Over to the make up station I went.

“So then, what are we having?” “We could do glam, girly, natural,…” “Pretty” I said, interrupting. ” I just want to look normal and pretty”. My eyes started welling up fearing that this was an impossibility.

“I have this thing. Body dysmorphia”, I mumbled. I also wanted to talk about my dermatillomania but that word didn’t exist for me then. All I knew was that I had this horrible habit which f**ked up my skin on a regular basis.

“I’m sorry but do I have to have my foundation removed?”

Make up lady looked at me. I think she told the truth when she said that I had done an excellent and seamless job with my coverage.

That’s the only good thing about having dermatillomania. You tend to get really good at doing your make-up. The fear of ridicule is a good motivator for learning make-up skills.

She patted some more powder over me and applied some blusher, lipstick, eye shadow and pencil. When those were done the fake eyelashes were put on to open up my small piggy eyes. At the end of it, I still felt conscious of my jowls and what I saw as the beginning of a dreaded “turkey neck” but I had to acknowledge that my eyes looked quite tolerable.

Lights, Camera, Action

I went on through to a changing room where I changed into diaphanous costume – one which I used for lyrical ballet. I might look disgusting but I felt good in that costume. Light, free, floaty and expressive.

I went through to the studio.

My photographer was a tall, photogenic Polish woman. She was bubbly and brimming with enthusiasm.

I normally take an instant dislike to such people as they tend to fray my nerves too much, but somehow she made the exception list. She had an extraordinary power of making me feel safe, even though I had only known her for a few minutes.

I obeyed all her instructions without question.

Turn this way and that. Eyes up, down, head this way or that. All interspersed with compliments which I couldn’t quite accept. I think I was in that studio a good two hours, although it seems a lot shorter than that.

Waiting

When I finished my exhilaration quickly turned back into nerves as I waited and wondered how the photos would turn out.

It seemed like a geological era had passed before they called my name again.

Time for the viewing

I got taken to another room – this one had a huge big computer screen. This time it was a man I was talking to. He was beaming from ear to ear.

“Yes, that went fantastically well! You’re going to be so thrilled when you see them. Now what package were you after?”

“Can I just see the photos first?”

“OK”, he said. His enthusiasm dampening down only slightly.

So it went. Photo followed by photo followed by photo followed by photo. “Make a shortlist” he told me. I gazed at the photos very anxiously. Most of them looked hideous. Buck teeth, fat nosed mess.

“Oh!” he said “you’re really going to like this one!”

Next photo appeared, the man grinned broadly again and watched me carefully to gauge my reaction. I almost managed a smile. The face was looked alien to me but in a good way. Asian pretty. I thought. My eyes scanned further down. Pleasantly lit defined shoulders, flat stomach.

Oh! just oh!

I stared in horror. BACK FAT. “That” I said, sharply “that, has got to go!”.

“But there’s really nothing…” his voice trailed off as he became sensitive to my obvious distress. “We can hide that part if you really want us to” he said softly.

“Yes, yes, please”.

Of the others which made the short-list I asked to see them close up, almost pixellated. I wanted some airbrushing to hide all the hideous imperfections.

However I did get to take away, in the end, a good half dozen images of which I wasn’t too unhappy with. One of those images appears in this post.

Thoughts

It will take some hard work to get me over this ridiculous illness. It makes me feel ashamed as some of the thoughts are blatant fat-shaming. I hate fat-shaming and I hate that my illness makes me fat-shame myself.

I just hope that someone out there reads this post, realises that body dysmorphia is an actual condition and gets the help they need.

As for me two weeks and counting until Cognitive Behavioural Therapy starts. I hope it will help me tackle some of these troubling thoughts and that at the end of it I will have learnt self-acceptance.

“I am not pretty. I am not beautiful. I am as radiant as the sun.”

UPDATE: I started writing this post yesterday, but I have to stop by to let you know that there was a last minute cancellation for my CBT therapist this morning and I got my appointment two weeks early! Amazing. I will blog about that sometime over the weekend. R x

The Importance of Self Compassion in Recovery


Photo credit: mararie / Foter / Creative Commons Attribution-ShareAlike 2.0 Generic (CC BY-SA 2.0)

So here I am – my progress on my recovery experiment almost entirely halted.

I’ve had an exhausting week, OCD, anxiety, fatigue – its all got the better of me and I just feel like curling up in a big cocoon for ages and ages. Not having to face the world or having to do a darn thing is wonderfully appealing to me right now.

I’m not allowing myself to get properly down about it though. I knew this might happen. In fact, I knew this would happen.

I’m not going to recover overnight. I don’t know if I can ever fully recover but I have some idea of what I want things to look like at the end of my journey.

  • I just want to be in control of my conditions and not have them control me.
  • I want to be able to see friends and not be self-conscious thinking that they are negatively judging my appearance
  • I want to find love again (or at least enjoy the process)
  • I want to be on top of my finances and finally buy myself a little house in the country
  • I want to buy myself a car and actually drive it without OCD stopping me
  • I want to feel energetic most days and actually look forward to the day when I wake up

I don’t think any of these things are a massive deal. They are achievable but they will take time.

They will take time and also the other magic ingredient self-compassion.

That’s why I’m letting myself have a free pass until the weekend. I’m free to skin-pick, wallow, and vegetate as much as I need. It’s not great for me long term, but for now I just need to have a day or two off to regain my bearings. I’m thinking I can start again on Saturday. I will have a restful Friday night. Yes. That sounds doable.

Self-compassion recognises that I am a less than perfect human being – not in the overly critical, body dysmorphic, OCD way – but in a moderate sense of “here’s some things you are good at, here’s some things that you are less good at and here’s some things that you are working on. It’s okay. It’s all good. You are worthy.”

Yes, a radical thought that.

You are worthy

A lot of us give ourselves such a hard time that we don’t allow ourselves the luxury of allowing these words to land.

I dare you – let the words land.

Feel it.

Know that you are enough.

R x

My Panic Box – Top Ten Items For When Anxiety Attacks

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After the embarrassment and distress of my panic attack on Saturday night, I thought about how I could avoid such an incident again.

I have already accumulated a number of coping strategies which help me with panic attacks – but these usually help when I have time to feel the anxiety levels starting to rise. In that scenario the rational part of my brain is still working sufficiently to reason my way through the situation even though it is very hard.

The problem with the incident on Saturday night was that it came on very suddenly with the loud thunderclap.

I just reacted. BOOM!

Rational brain rendered completely useless. The situation escalated very quickly to one where I was crying, screaming and rocking underneath a duvet. An undignified mess. I demanded immediate comfort but was denied.

A solution?

So, in my now more rational state of mind I did a bit of thinking.

How about if I could bypass having to think my way out of panic and had something instantly to hand? I could create my own emergency box full of goodies to sooth me those times when no words of reason would be able to reach me.

First thing’s first, I need an actual box – so I did a quick web search and found this. Adorable eh? I could never be miserable looking at that! In the basket it goes.

As for the contents, they went a little something like this:

1) Gizmo (see photo) He’s very cute and very huggable. I’ve had him for ages, but I never usually allow him out in plain sight. In an absurd logic, I reason that if a hot prospect stops by the flat and sees him (yes – just suddenly stops by – randomly, happens to be interested in me, not married, not violent etc) they will be put off and run scurrying back down the street again! May be I should have him out. If not, he can live in the box.

2) Chocolate Extreme times call for some exceptional chocolate. How about these from Hotel Chocolat? Expensive but none of it ever gets wasted. Its small enough not to constitute a binge if I eat it all either.

3) Perfume A small bottle of Angel (or perhaps a small atomizer filled some drops). Its probably my favourite perfume ever. Vanilla Chocolate heaven. Beautiful and dreamy!

4) A Wind-up Radio/Torch Power gone? No need for panic. An eco-friendly two in one means I get to listen to Radio One whilst having a some light.

5) A Book of Old Fashioned Ghost Stories (preferably a hardback). Curious that this should find its way into an emergency box, but I love Victorian fiction and most especially the gothic genre. The mood would be heightened by the semi-darkness . A short story or two shouldn’t overly tax any frayed nerves.

6) Bottle of Lucozade I don’t usually drink fizzy drinks. I’m perfectly content with the more traditional methods of caffeine delivery such as tea or coffee. However I do associate Lucozade with illness recovery at university (along with large bowls of grapes and rice pudding).

7) Large Scented Candle (& a lighter) I love candles and most especially the lovely fragranced ones you get from Yankees candles. I’m craving their Honey & Spice candle. I’m sure that would settle me quickly if I got to breathe in that luscious blend of sweet and spice!

8) Shiraz in a Glass Did you know you can get individual sealed plastic glasses of wine? Perfect for someone like me who is semi-tee-total (as in I normally drink only one or maybe two glasses of wine a month if that). I know that alcohol is a depressant and you shouldn’t drink it in that state but for instant calm (when you’re me and you’re body isn’t used to it) then it can have it’s uses.

9) Puzzle magazines I like the logic problems most of all. I used to really enjoy puzzle magazines as a child. These days I don’t get much time to do these any more, which is a shame as they could quickly while away the hours.

10) Face pack – I like those individual sachets you get from Montagne Jeunesse. Stops me from immediately skin-picking if I whack one of those on my face. Plus they smell nice and are quite relaxing to massage my face. I might try this one next to see if it helps fade some of my hyper-pigmentation scars.

So that’s it. I’ll start shopping for the missing items after pay day next week.

Obviously I won’t know if this idea will work until I get another panic attack. I know I can’t carry the box with me while I’m outside, but I think there is less danger for me outside where there is other people about, as there is a chance someone will help me (as has happened on a couple of occasions).

Indoors I have no one to help me and this is where I need the services of a Panic Box – like a First Aid Kit for mental wounding.

Do you have a panic box and what do you have in it?

 

“I must not fear. Fear is the mind-killer. Fear is the little-death that brings total obliteration. I will face my fear. I will permit it to pass over me and through me. And when it has gone past I will turn the inner eye to see its path. Where the fear has gone there will be nothing. Only I will remain.”
Frank Herbert, Dune