BDD BEHAVIOURS – SKIN PICKING More than one third of people with BDD pick their skin. This relatively high frequency isn’t surprising, given that skin concerns are so common in BDD. People with BDD who pick are usually concerned about minimal acne, scars, or scabs, or such things as “large” pores, “bumps,” “small black dots,” “white spots,” “ugly things,” or other supposed imperfections. They pick to make their skin look better—to make it smoother, clearer, more attractive. They pop pimples, dig at white heads or blackheads, or smooth bumps. Some try to remove dirt, pus, or “impurities” from under the skin. While many use their hands to pick, pinch, or squeeze, others use tweezers, needles, pins, razor blades, staple removers, or knives.Picking with implements like these for hours a day can cause major skin damage. One woman picked an actual hole through her nose. Some people have go to the emergency room, because they pick through their facial skin into major blood vessels and need stitches. A colleague told me about a patient who picked so deeply at a pimple on her neck with tweezers that she ruptured her carotid artery, the major blood vessel to the head. She required immediate emergency surgery; the surgeon said that the picking nearly killed her.Even though skin picking can cause extensive skin damage, it’s important to realize that people with BDD don’t intend to mutilate themselves. Rather, they’re trying to improve how their skin looks. The problem is that the behavior is so compulsive that they can’t stop, which is what causes the damage.For some people, picking is a relatively inconsequential aspect of their BDD. But for most, the picking is in and of itself a serious problem; some consider it their major problem. One woman attributed her suicide attempt and psychiatric hospitalization to her belief that she had “ruined (her) face because of picking.” Two woman I know of needed psychiatric hospitalization largely because of their picking and eventually committed suicide.*98\204\8*
Archive for the ‘Anti Depressants-Sleeping Aid’ Category
RELAXATION TECHNIQUES, BIOFEEDBACK FOR STRESS BREAKDOWN TREATMENT: POSSIBILITY TO FURTHER STRESS BREAKDOWNMonday, December 27th, 2010
RELAXATION TECHNIQUES, BIOFEEDBACK FOR STRESS BREAKDOWN TREATMENT: POSSIBILITY TO FURTHER STRESS BREAKDOWN
Some of the relaxation exercise and biofeedback methods have as an underlying theory that feelings of tension under stress are a sign that the sufferer is physically unfit. The inference is that stress should not cause anxiety symptoms in a person whose body is physically fit from regular exercise, and who has his feelings under control.I reject this concept. It must always be remembered that anxiety response to stress is a normal alarm mechanism. Abnormal physiological states can lead to anxiety symptoms when the person is trying to deal with what might be otherwise a normal stress load. I fear that some people giving advice about stress management seem to believe that anxiety under excess stress can be reduced by their methods.The promise of some relaxation techniques and biofeedback methods, that they can dismantle the alarm reaction which warns us when we begin to overload the nervous system, seems at best ineffective, and at the worst, possibly harmful.I believe that abuse and disrespect for ourselves is part of the human condition, and I tend to view the proposed use of techniques which would free us from the penalty of overloading our nervous systems, as just another example of the human behaviour which tends to make us vulnerable to stress breakdown in the first place. The promise that modern biofeedback methods are able to combat stress, in my view, just leads people to think they can cheat the system, and get more and more work out of their over-stressed nervous systems without paying any price. In fact, attitudes such as these are the classical preconditions for progressing from stage one stress breakdown to stage two and stage three. I tend to see therefore, some of these stress management programmes as potentially capable of producing serious stress breakdown, if they are used in ignorance of the real function of the anxiety response as a warning signal of overload.
For the insomniac, if you want to fall asleep it is important for you to create an artificial THS. Hence you have to create a spotlight and focus this onto the non-threatening and non-anxious parts of your mind. The self-hypnotic technique described here is called progressive relaxation, which is a standard technique used in the induction and deepening of hypnosis. This technique has been used by many hypnotists, such as the late Ainslie Meares of Melbourne and John Hartland of England. In this section, this progressive relaxation exercise is modified for sleep facilitation and for entering the THS. This exercise involves focusing the spotlight on each part of your body in turn. Try to stay with one format of relaxation which will always work for you, rather than change the format every night In other words practice the same program of relaxation every night Perseverence with the same routine has a higher success rate in inducing sleep. At the same time, it is helpful if you have a clear image in your mind of how the model of sleep control in your brain operates. Once the arousal messages from the higher control diminish sufficiently, the sleep centre will take over and trigger sleep.
The THS is the psychological switch that shifts you from the awake state through to the sleeping state. We know ten commandments for self-hypnosis, and they are easy to follow but must be repeated every night.
One of the difficulties in the management of functional pain is that we find it very hard to accept the idea that the pain is in fact due to our nerves. We feel the pain; it hurts; it is a real pain. We are convinced in our mind that such real pain is not psychological in origin. We tell this to the doctor, but somehow he does not seem to understand. If he would only do some additional test we feel sure that it would show some organic cause for our trouble. We undoubtedly want to find an organic cause. Such is our scale of values that no one is very proud of himself when he has to explain to his friends that his pain is merely due to nerves. But there is more to it than this. The pain is so bad that we ourselves feel sure that it must be due to some physical condition of our body. This is particularly the case in psychosomatic abdominal pain. Our anxiety has affected the smooth working of our bowels. They contract in spasms, and often quite violently, and the part of the bowels in front of the contraction does not relax properly in the way that it should. The pain nerves in the bowels are stimulated and we experience real colic.
It is clear that the first step in the self-management of such a condition is the acceptance of the idea that the pain is in fact the result of our anxiety. By acceptance of the idea I do not just mean verbal agreement with our doctor. It is very easy to do this, and at the same time to keep our own reservations on the matter. No. We must accept the truth openly and without reservation.
There is a further point that needs explanation. We are often inclined to think that our pain should be directly related to the cause of our anxiety. For instance, if our anxiety is caused by a sexual conflict, as it often is, then we might expect it to show itself in pain in the sexual parts rather than in pain in the stomach. But this is not so. There are usually two factors: one is the conflict or conflicts which produce our anxiety; and the other is usually some incidental matter, such as past trouble in some organ, so that our attention is focused there in a way that has the effect of localizing our psychological pain in this part of the body.
«I am depressed. My mind is filled with morbid thoughts. Can’t face the day. Would just like to stay in bed. Not get up. Never get up. Never wake up again. Sometimes as bad as that. Can’t get going. Everything a burden. Getting the children off to school. He helps, but he does not understand. Sometimes tells me to pull myself together. That bites. It hurts me. He does not mean it. But it hurts me. All I am trying to do is to pull myself together. But I can’t. I just can’t. »
Depression has different causes. Sometimes it is the direct result of stress, but not always so.
In stress our brain is bombarded with an excess of messages so that it is not functioning as well as it should. We become aware that we are not coping properly with our situation in life. It is this awareness of our failure that makes us depressed.
«Have lost my cool. Edgy. Blow up about trivial things. Irritable. Just plain irritable. Used not to be like this. Irritable at work. Irritable with my wife. Poor dear, she bears the brunt of it. Scold the children for playing around like normal kids. It used not to be like this. There has been a change. And the change is in me. »
In stress, the nerve cells of our brain have become over-alerted by the excess of messages they are receiving. They fire off too quickly, and in inappropriate circumstances. As a result we are soon finding fault unnecessarily with those at work, bickering with our wife and scolding the children.
An unhappy consequence of this situation is that people withdraw from us to avoid our irritability. Workmates no longer suggest a friendly drink on the way home. Our wife spends longer doing the chores rather than sitting with us. And the children, without any conscious evaluation on their part, take to playing in another room.
“No reason at all. No reason at all. I know I am just as good as the others. Just ill at ease with them for no reason at all.
They are talking, joking, happy. They are all so natural. Feel I should say something. Think of something good to say. Can’t get the chance to say it. So butt in. But the subject has changed to something else. It just sounds stupid. Then more ill at ease than ever. I don’t know.
‘It breaks up. They move on. The ring of their jaunty footsteps echoes their light-heartedness. I leave. Then start brooding over what I’ve said. All the time knowing it is all so trivial.
‘The next day, and the day after, it crowds in on my mind. Life should not be like this.”
A high level of anxiety keeps alerting our mind and making us self-conscious. The self-consciousness increases our anxiety still further, and a vicious circle mechanism is established.
The answer. Secure enough to talk if we wish to. Secure enough to remain silent, if that is what we want. Inner security comes to us when our brain runs easy, interpreting the messages as they come to it.
“I love her. Really love her. Don’t doubt me on that. But something within me tells me, we must break it up. Why? I can’t explain. Can’t possibly explain. Living together three years. Still love her. Must be my love has changed. Somehow a feeling of emptiness. What is the purpose. What does it all mean? Sex, everything. It’s all good. Tried to talk to her about ultimate being. She didn’t understand. Just happily relaxed about it. Mildly amused. Is that good enough? Life together, but on a different wavelength. I must break it up.
‘But how? How can I break it up without hurting her? Sex last night. Something you could not surpass. That does not make it any easier. Keep the sex, and not her soul! That would be cheating. I don’t want that.
‘Final exams in two months. Should come top. What does it matter? End up nowhere”
His brain is muddled with idealistic introspection. He is likely to come under stress, and his examination results will suffer. I have seen other young people, girls and young men, caught in similar situations. ‘What is a degree? A piece of paper. I want more in life than that.’ Some have dropped out. In a year or two they have found that a degree would have been a help in furthering their idealistic aspirations in a practical way.
He would agree that we are all individuals. And he would readily apply this to himself. Yet he denies this same individuality to his girlfriend. He has not lived long enough to learn that love transcends individual idiosyncrasies.
Young people often forget the naturalness of it all. Love is for loving. It is a tender process. And is easily bruised, harmed or even destroyed by the bite of intellectual examination. If ever a man should just let his mind run quiet, it is he.
There are, however, practical considerations that can save some of the stress. If there has to be a break up, better by far that it should come about by a gradual drift apart, rather than some terrible confrontation and attempts to give reasons in words, which in this case are really no more than toys of the intellect.