Dysmorphia

Today’s session was a hot mess.

It didn’t start out that way. I had my first shift of clinical affiliation today, so I went to session right afterwards in my scrubs. The therapist opened the hour by saying, “Nice scrubs!” and I told her I had a funny story about that:

When I found out I needed scrubs for clinic, I asked my classmate where to get them. She said to just order online, so I found a company I liked and ordered them from Amazon. My wife suggested a certain size, but once she left the room, I decided to get the larger size instead.

When the scrubs arrived the next day, I pulled them out of the box and held them up to myself. Wife said, “Do you think those will fit you?” and I said, “Yeah, probably.”

“Okay. Try them on.”

I did. They were admittedly way too big on me. My wife asked me if I’d genuinely believed those scrubs would have fit me and I said that yes, I really did believe that.

At this point she took a photo of me in said scrubs and we jokingly posted it on Instagram.

I relayed this story to my therapist and showed her the picture. I explained that in the photo I am wearing size large scrubs and the scrubs I was currently wearing were a size small. I also added that Wife and I felt that taking a photo of me in these huge clothes would be a good way to demonstrate the severity of my body dysmorphia.

She agreed.

Then she asked me how I felt looking at the pictures in the large scrubs. I said I understood that the clothes were too big, but I imagine it’s just because of different sizing or something. I told her that my decision to order a large wasn’t really about fear of buying the wrong size; I genuinely believe that is the size of my body.

“But the difference between large and small is sort of universal, right? Even if a large in one brand is different from a large in another brand, the difference from large to small is still rather substantial across a single brand.”

“Maybe. But it still seemed appropriate for me. I was shocked when the small fit me.”

This happens often. I will hold up a shirt that I know will fit me and turns out to be way too big once I put it on. Or I will hold up pants that I vehemently insist are too small and yet fit well. But once I decide in my head that a clothing item is too small, it will always feel small as I’m wearing it, regardless of how it actually fits on my body.

She asked if I ever veer from that constant distortion; if there are “two camps” that have opposing views. She said she imagined River was holding fast to the distorted images, but that perhaps myself (or other parts) can see our body more accurately?

I explained that sometimes, in very quick moments, I can see something besides a gross and fat person. There are moments when I catch myself in the mirror – perhaps in yoga or when passing an unexpected mirror – that I stop and think, “Whoa! I look good!” But then it all shatters within seconds as the self-hatred and body negativity settles back in to remind me of how disgusting and worthless I am.

She asked what I think pushes me out of the moment of reality and positivity into distortions and negativity.

“Fear, I think. I don’t want to let go.”

“What do you not want to let go of?”

“Distortions and disordered eating.”

“Hmm. You DON’T want to let go of distortions and disordered eating?”

“Well…there are ‘two camps’.”

We had been doing a lot of laughing and joking around this topic, mainly because I told the story in a deliberately amusing way. But at some point I explained that, joking aside, this is a serious thing that is very distressing for me. She acknowledged my statement and said that she wasn’t laughing at the nature or seriousness of the distortion (which I knew).

There was a lot more I wanted to talk about and I was started to feel uncomfortable with how serious the body image talk was getting, so I switched topics.

Which is when things started to get messy.

I still need to work that all out in my head, so I’ll save that for a later post.

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10 thoughts on “Dysmorphia

  1. jbuchana says:

    Interesting. My body image is that of someone smaller than I am. I’m constantly surprised when I look in the mirror and see how large I am, or when I won’t fit into a booth at a restaurant, etc. I mean, I know I’m morbidly obese (and have been gaining fast after a recent med change, even though I’m eating the same), but it still surprises me.

    Liked by 1 person

  2. Rachel says:

    I remember feeling this exact same way in the past; it just didn’t register that I was the size I was. There was something satisfying about it (in an unhealthy way) but also very sobering. That awareness is always in the back of the mind, isn’t it? This is all so difficult

    Liked by 1 person

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