Social Anxiety Archives

It’s hard for me to post this picture. But I am doing it because I feel like I am on an island.

Scars are quite common, I have sewed up many a laceration in my time as a family practice physician assistant, but facial scars are a different beast.

I didn’t understand this until I received one.

I have talked about my scar on this blog several times, I was too afraid and too ashamed to post the picture until today. This injury happened about two months ago,while surfing. I took the tail of a 40 lb. fiberglass long-board to my face. It was a total accident, but two months later I am left with a rather large and unsightly atrophic scar.

I will post this as well when I feel ready to face my own image.

Since my injury I have been hard pressed to find people with large facial scars. I am not sure if it is my BDD or just the fact that I have a facial scar and I compare my face with everybody.

When I do find somebody I spend the rest of our time together analyzing their facial scar, and it is not like I really care, but I want to know how they deal with theirs. Of course I would never say this out-loud it is something I do in my mind, behind the scenes.

I have been searching for emotional support, it is hard. There isn’t much support out there for people with facial scars. It is even surprisingly hard to find good, trusted information about surgical revision or laser treatments… Something I have been thinking more about lately.

All Aboard the Ugly Train: Passengers – One

People have been surprisingly cruel as well. I never saw this coming. I thought dealing with a facial scar would be a solitary journey. But no it is not, it involves a ride on the “ugly train.”

It is like a nightmare, and no matter how hard I try I can’t get off.

In last two months I have been repeatedly called scar-face, my scar has been endlessly critiqued, leading up to Halloween I actually had several people asked me if I “was going to use my face as part of my costume…” That one left me traumatized for the good part of the following weekend. Actually still does.

I have had people tell me they were surprised it didn’t heel better, that it was more “sunken” then they would have thought, that it was looking worse. I actually can’t believe people say these things. Many a conversation have been had with my scar in place of my eyes.

Now I find I can no longer look people in their eyes, because then I start to think about my scar. I am constantly scanning their gaze.

It’s Just a Scar

It is just a scar, it does not define me, it is part of me now, it is part of my face. Yes, I may be able to get some type of cosmetic surgery to make it better in the next 18 months, but should I have to? I am the one with BDD, if people only knew how these comments affect me. How when they make them I drive home suicidal, how I feel like a monster, how I am afraid to even kiss my wife or be around people who I know.

At first I was even afraid to see the reactions of my own children. They of course look easily past it, they see their dad, not a scar.

It gets old… The comments. There is an endless stream, I have become open territory on which others (I assume) can displace their own body image concerns.

My patients have been surprisingly kind and thoughtful, not one has hardly said a thing. Yet, in the medical community there is a belief I guess that you can fix everything. So when they see my new, infinitely less “beautiful” face, they say things. Horrible things. Really surprisingly horrible things.

All this, and I have skin issues already that are related to my BDD. They were in my mind before, nobody once said anything about my skin prior to this injury, yet I still hated it.

Now as I test my theories and my notions of my imperfections, they are confirmed. To a person with BDD this is particularly devastating.

Getting on With Life

I heard this poem today while on a run it is by Jon Blais who died of ALS. He is still the only person to have ever completed an Ironman triathlon with ALS.

By Jon Blais (August 1971-May 2007)

Live…
More than your neighbors.
Unleash yourself upon the world and go places.
Go now.
Giggle, no, laugh.
No… stay out past dark,
And bark at the moon like the wild dog that you are.
Understand that this is not a dress rehearsal.
This is it… your life.
Face your fears and live your dreams.
Take it in.
Yes, every chance you get…
come close.
And, by all means, whatever you do…
Get it on film.

I like this saying about life “not being a dress rehearsal.” The time I spend lamenting this is getting me nowhere. The more depressed I become, the more I hide from the world, the less I live. And this is time, the only thing I have, and I am giving it to those people who treat me badly. They don’t deserve it.

Starting to Live

I am using this blog to work through my BDD and this facial scar. I decided on my run today, while listening to this poem that I have had enough. Now I just have to figure out how to live like that.

Looking for support? Make sure to check out:

Changing Faces: An amazing community for those of us with facial disfigurements.

It has been a while since I have been out with a group of people that I did not know well.

This has been out of fear mostly, my belief that my facial deformity would be too distracting for others to accept has kept me home-bound.

Most of this is because of a scar to my face, a recent injury that I sustained while surfing. It ended in 8 stitches and a pretty significant scar on my left cheek. At least it was significant to me.

As I have mentioned before I have had BDD since I was probably 15 or 16. I had learned to control it, but this incident sent me overboard.

All my facial concerns landed on me like a ton of bricks. And until today this is where I sat, buried under the weight of it all, short of breath, wishing for my life back.

JUMPING IN

Until today I had worn a band-aid over the scar. People at work I could tell were wondering why I still wore this band-aid after several weeks. I told them it was still healing, of course they didn’t know it was my mind I was really talking about.

This made things only worse and over the last week more and more people started to ask me about scar and if they could see it.

I hid behind this band-aid, but unlike other scars or wounds people seemed to feel they had a right to ask me to remove my cover.

Strange I thought, I surely wouldn’t ask this of another person. But then again nobody knows what goes on in my mind.

DISROBING

So today I took it off. My family told me not too, even my wife felt I may not be ready, but I did it anyway. It caused me such anxiety that I found myself in a cold sweat.

But I knew that as long as I hid behind the band-aid I made it worse. I drew more attention to the imperfection.

The problem is that when it was covered I could deal. When I looked in the mirror and did my checks there was one more step to see the blemish. Just the action of having to remove the band-aid stopped my compulsion to look. So in this sense it was a protection.

But, it also prevented me from overcoming my worst fear. And that was the fear of people having to see me with this scar. Watching their eyes draw to it. Knowing that it existed was enough, knowing that others knew it existed was more than I could bear.

THE DELUSION

Immediately when I entered the room I expected people to gasp, but they didn’t. They hardly even noticed. I looked for their reaction all night, when the lights came on I actually went into where I knew it was the worst, I looked for their reaction, but it was non-existent.

Is my mind playing tricks on me or are these people just really to kind to say anything? I sit with this question tonight. And to be honest I am still not quite sure about the answer, or maybe I am too afraid to know the truth.

But at least I did it. I tested it and you know what I survived!

Some Tips

The mind will try to prove both the delusion as well as the reality. The only way to understand the difference is to test your theories of what is real. The problem with BDD is that it is hard to know what is real, to know if your thoughts are warranted or just a figment of your imagination. For me this night taught me something: that it is possible the images I hold in my mind are not real.
You have to get out into the world. The fear at times is overwhelming for me. But had I not gone out I would never have had this brief, yet important moment of healing. The delusions in my head would continue their loop.
Put yourself in fears way, it is the only way to heal, regardless of what you may think.