← The OCD Whisperer Podcast with Kristina Orlova
The OCD Whisperer Podcast with Kristina Orlova
175. Body Dysmorphic Disorder: How to spot the hidden signs with Robyn Stern, LCSW
00:31:29
Loading summary
Transcript45 lines
- [00:00]
A
Welcome to OCD Whisper Podcast, guys. If you find these conversations useful and helpful, please hit that subscribe button. And don't forget to turn the notification bell on today. With me, I have Robyn Stern, and we're going to be diving into her story with something called bdd, body dysmorphic disorder. But first, we're going to welcome her and we're going to find out a little bit more about her. Welcome to the show, Robyn.
- [00:20]
B
Thank you so much for having me, Christina. I'm really glad to be here.
- [00:25]
C
Hi, I'm Christina Orlova, host of the OCD Whisperer podcast. As someone who lives with oc, I understand the struggles firsthand. If you're here, you're not alone. Before we start, grab your free OCD survival kit at www.corresults.com to help you take control. That's K O R results dot com. Now let's dive into today's episode.
- [00:54]
B
I have body dysmorphic disorder. So that is why I reached out to you. I wanted to be able to come on this platform. I've seen a lot of your YouTube videos and they've been amazing. And I felt like this was a platform where I would be able to share my story as a clinician who also has lived experience with body dysmorphic disorder. So I want to thank you for having me and get and giving me the ability to come speak.
- [01:18]
A
Absolutely. And I'd love if you can share just a little bit. You mentioned a clinician. So tell us a little bit about yourself in terms of you run a private practice or you in a group practice or just kind of where are you at with your own profession?
- [01:31]
B
So I can't believe this, but I am nine years into my private practice. I run a solo practice, and I specialize in treating body dysmorphic disorder, ocd, body focused repetitive behaviors, and anxiety disorders in general. So it's just solo, just me, private practice. And it's been incredible. And I love, I love, it's a passion. And we always say, you know, you want a career that you love to do and not feel like it's work.
- [02:01]
A
I love that. I mean, I can't speak highly enough about that because I myself am in the same boat. And yeah, I really thoroughly enjoy it and love it. I thank you for coming on and wanting to talk openly about your own experience and your story. And I'd like to dive in by just asking, you know, before you knew that it was bdd, what did you think was wrong with you?
- [02:25]
B
So initially, when I think about my struggles which started probably in like late adolescence. I never asked my clinicians, like I would go to therapy, I went on meds around 15. I'm assuming they, it's always was in the realm of like anxiety and depression as a clinician now I know we need those diagnostic codes for super bills and all that stuff, but I, I didn't know. I never asked what they diagnosed me with, but I'm pretty sure those were the things. And to be quite fair, it wasn't really until college that I started to have thoughts that really resonated with what truly body dysmorphic disorder is and how it kind of shows up in a person. So I think growing up, you know, in adolescence, in my teenage years before college, I think it was, it showed more as anxiety. I think in looking back I could see where it was a self conscious about my image. But I don't think it was as clear as it was when it was in college.
- [03:32]
A
So, so yeah, so when you were at that time, right. Like against anybody listening, if they don't know and they're kind of in an experience, like what was going on for you then that you say, you know, you're like, well I was feeling this or I was thinking that. Right. Because again like you said, you had no idea. You don't have any of these words. I mean you, you're now a clinician successful when it sounds like, right. So you know all these big words and terminology. But if we put all that to the side for a minute and just go back, like time travel with me, what was, what was it like? Right. When you were going through life, what did you think? Did you think it was just some insecurity? Were you having thoughts, thinking, well, I guess maybe I'm just a little anxious or what, what was going on before? Kind of that point where you like, okay, something is really off here.
- [04:15]
B
So I was bullied, you know, from fourth grade to seventh grade about my appearance. And ironically that wasn't my, my area of concern with bdd. So I think I always had this like anxious, like I'm on eggshells, like people can judge me type of thoughts, but my real BDD thoughts and what I think others would resonate with was when I was in college, that was my first time just sort of feeling like I was ugly and I just remember feeling different and those were thoughts in my head and I remember just being like, okay, well this is just me, I'm ugly and I'm different looking than others and I can't like really put it into Words per se, obviously, you know, we all look different. I have curly hair, people have straight hair. Like, there's just various features that are different. And I don't want to say that all my friends looked alike because they did not. And we all came from different backgrounds, but I just felt like inherently different. And that's when I started noticing looking at the back windows of cars as I was walking from my dorm room to class and every car, I would sort of gauge an image. I didn't know what I was doing. It wasn't like a conscious, like when we're treating clients where it was like, okay, this is an intrusive thought I need. It was just like I was just constantly doing it. I did struggle with acne my freshman year. That was real. But I went on Accutane and my skin was better. But learning more about bdd, I wasn't able to ever see my, my skin as clear, even though objectively it got there. And so it was not just like my skin though. It was just this sense again of like, different, ugly. And then just my thought process of it was like, okay, I guess this is your life. This is how you're gonna go through your life. And you're gonna go through life and you're going to be different than every other female. Men because I'm straight aren't going to find you attractive. This may or may not affect your ability to be in a relationship. Friends may or may not want to be around you. And I just remember having those thoughts, but I never shared them. I wasn't in therapy at that point. I was just taking Paxil at the time, so I didn't have to share them with anybody. And I didn't. It was more. I was holding that and I don't know how. I don't think it was pervasive enough where it was like affecting my day to day because I was fully functioning, but it was silent there. That, that was definitely a notion of what I was thinking. And that was my mindset and my mind frame, like the frame of my mind for all of college.
- [07:19]
A
So what happened then? If you're going through that kind of sounds like quietly living in this internal process where you're, you're, you're having. Obviously it's impacting how you're, the beliefs you're having about yourself, right, and your own self worth. But what happened? What was the turning point that made you decide, okay, let me, let me go seek some help or at least explore what's happening here?
- [07:40]
B
So it was the summer before my senior year of College, which was 2001, I live in New York. I was interning in Manhattan, and I was like, I had this, like, very kind of surreal experience for me. I feel like I didn't get a lot of male attention. I got decent, like, but I was quiet. And so I never, like. I always said to myself that, like, I was a wallflower because I was made fun of. I never really wanted to put myself out there. I never wanted to wear, like, bright colors. I mean, I'm wearing black now, but, like, I love hot pink and red. I just wanted to fit in, um, because I never wanted to be made fun of again. And the summer going into my senior of college, I was getting a lot of male attention. And it was to the point of, like. It was like four or five guys that were trying to pursue me. And I honestly, like, looking back now because I've spent a lot of reflection time. I think it was a little bit overloading for my brain and was like, wait, what? This doesn't make sense. Like, you have these thoughts about yourself, and now you're getting a lot of feedback that's sort of like, disputing that, but what do you do with that? So that was, like, my first summer where I had, like, my first crush. He was older than me, like, this guy that I was dating. And it was, like, a really fun experience, different. And then it ended, and I took it really, really hard to the point where it was like, okay, what's wrong with me? Am I going to get over him? All I did, you know, I think we as, you know, young. Like, I was 20, of course, but he was. He was older than me. He was 30. And I had an actual. An actual physical. I don't want to call it deformity, but I developed folliculitis, which is, like, bumps under my neck. And I had gotten electrolysis because one of the side effects of Accutane can be hair growth. And I went for electrolysis, and I got it. And either she gave me poor aftercare, and I developed these whiteheads. And essentially, after spending this time in the city in the summer, I came home to have this experience. And then, like, I couldn't leave my house. And I was going in and out of the mirror. I was looking at it. I was physically repulsed by it. I was like, there's no way that I can go back to school like this. How can I explain this? When is this going to go away? And at that point, it was getting closer and closer to the time that I had to go back to school. So I had to make a decision that I was going to take a medical leave. And this is before social media. I'm 45 years old. So this is back in 2001. And you know, my friends just thought I disappeared.
- [10:26]
A
So did you like, stop talking to them altogether or you. Oh, you did. Okay, okay.
- [10:32]
B
There was no real. There was no texting. So like, you know, people had beepers people would use. Yeah. AOL Instant Messenger. There was the physical phone. Mental health wasn't really talked about then, so it wasn't like something I was openly going to discuss, nor did I fully understand that this was a mental health issue. So I. There was really nothing for me to say and I wasn't going back. So at that point I finally got on. I had gone off meds and then went back on and started having therapy. And I had went to the self help section in Barnes and Noble. We had all those beautiful bookstores and came across the book the broken mirror by Dr. Kathryn Phillips. And I don't know how I came across it. And I read it and I was like, wow, this is me.
- [11:32]
A
Interesting.
- [11:33]
B
And I was like, wow, I. This is like every thought. And then at this point, you know that I was housebound for a month, lost a lot of weight just because I of, you know, the depression that came along with it, the avoidant behaviors, the checking. I was like, this is me. And just all those like, intrusive thoughts and. And they share stories. And I had gone to a therapist at the time and I brought the book with me and I said, oh my God, this is what I have. And this was back in 2001, right around 9, 11. And she goes, no, you don't.
- [12:08]
A
Oh.
- [12:08]
B
And so at that point, at that experience, sort of the folliculitis cleared up. I went back to school my second semester, graduated on time because I had all my credits. Still had those thoughts about myself. Never talked about it, never really discussed it with my family. The family was always like big supporters, friends didn't really ask me where I was, which was great. So I don't remember what I said to them. Everyone's selfish at that age. So I don't remember like what was discussed or not discussed. I just kind of came back into the house that we were living in off campus and reengaged in college and that was that. And that was sort of my first experience with really being in the depths of what I would consider a full blown BDD episode where I was symptomatic.
- [13:04]
A
Yeah. I mean, I want to jump in for a second because, like, as you're sharing that, I can't help but, like, hear pieces of like, 1. It sounded like it was easy to kind of avoid and get through without anybody really knowing or hearing about any of it. Right. You didn't have to really say much to friends because like you said, everybody at that time is in their own head about it. But it's interesting that it doesn't sound like you even fully understood what's happening. You were just in this thing, like, I don't know, just have these thoughts and, and, and I want to know from you, like, what did you think was there? Like, oh, maybe I'm broken or what's wrong with me? Or just even not knowing what's wrong with me but wondering what's wrong with me.
- [13:42]
B
Or.
- [13:43]
A
Or maybe this is just a physical thing that will. I'll grow out of it. Or. Right. Because sometimes it could feel like. Or am I being vain? Or like, okay, there is this breakout going on, but okay, I guess it'll heal because, you know, I can imagine all that kind of stuff can be confusing. And then like, how do I share that stuff with somebody? Like, what. What am I going to ask or say?
- [14:07]
B
I think there's a few things. And I want to specify that this is not everyone's journey. And so when I speak to my story today, this is my story. And I honor everyone's story with bdd. My story was different in that I was really good, able to fake it till I make it, and the internal pain was there, but I functioned optimally. And I think that that is hard because there's many people that I see in my clinical practice that don't. I. I think the word defective resonated more with me. And that started way back when I was bullied as a kid. So I think I held that and sort of was like, well, you were bullied as a child. People are making fun of your looks. So it's not uncommon that you think you're ugly and disgusting and different because people treated you different. These were my best friends, by the way, that made fun of me when I was a child and did not include me. So I think my thought process was not that I was vain, was like, this is just you. And like, you are different looking. People told you you were different looking when you were younger. You are different looking. You're feeling that, you're having thoughts. You're getting some different feedback from people. I didn't get into a sorority, so there was that rejection in college, I rebounded well from that. But, like, I didn't have, like, a lot of boyfriends in college. I had some interest. And again, like, I think this very, like, heavy interest that summer, I just can only classify it as just overloading for my brain. Like, how do I experience that? Like, I was. I was getting some attention, but this, like, all of a sudden, like, I entered into the real world of New York City, Manhattan, and guys were looking my way and wanted to take me out. And I'm just like, wait, that's just like, not. Not.
- [16:12]
A
Well, you're all.
- [16:13]
B
Yeah.
- [16:13]
A
You're also in an environment that's so much more fast paced. There's so much going on in New York and that. That's such a weird place to be in. Right. Like, on the inside, I feel this about myself and kind of think that, you know, okay, there's a deformity, I'm ugly, et cetera. And then suddenly on the outside, completely different, Something is happening. I mean, that can feel intense. Like, how do you. How do I make peace with this in my mind? Like, what's going on here? It's confusing.
- [16:36]
B
It was, you know, like, I remember just like, it was surreal. Like, even when I was dating that guy for such a short period of time, it was like, weird. It was like, first of all, also, I was younger. I mean, I was 20. He was older than me by 10 years. And so he had, like, lots more experience in terms of, like, life and, like, going to these, like, fans. So it goes from like, feeling defective and ugly and different to, like, now, like, I'm being wined and dined in Manhattan. And like, it was just weird. It was a very surreal experience. It was a guy that was making attempts, like, like, he took the train back with me because I live on Long lived on Long island. And he was. It was just like, wasn't even. Just like, we dated. He was. In today's world, it's like, oh, my gosh. He actually, like, went out of his way to be kind and, like, did things. So it wasn't just like, the interest. He was also, like, in that moment, kind. Until we ended things. And ironically, we stayed in each other's lives. We reconnected at later point. I don't know if he even knew I had it or not. We connected at a later point in our lives, but it was very surreal. And I think that experience, the experience of all the male attention, the experience of me feeling that way I did about myself and then obviously having the, the acne Sort of on my neck, like, was like, just like a recipe for disaster. And I think the BDD was it. It blew up. It was undiagnosed for two years, but I knew I had it.
- [18:13]
A
Yeah, like, that book was a turning point. It sounds like, right? Like you, like, literally you're reading something going, this is literally on paper in black and white. Like, my thoughts, my experiences all spelled out there. And you're going, oh, my God, this is it.
- [18:28]
B
And that's where, like, it leads you to, like, you know, I think in general, and we talked about this before we came on of like, mental health in general. Like, we're clinicians, we're people, but, like, we're not God. And if you feel like you're not connecting with your. Your provider, keep searching. But I was young. I believed what she said to me. I went in, I. I had a lot of trust. And that shifted as I got older of the system, just medical system in general. And so when she told me I didn't have it, I believed her. I didn't have. I didn't know to question it. I didn't know to say, well, no, no, no, no, no. Like, let me show you this. Like, she shot me down. And then that was it. So my thoughts just went back to again, like, this is just who you are. And it got progressively worse. And that's when my mom's therapist was like, I think she might have this. And I don't think I ever shared with my mom that I had self diagnosed myself. I see so much later. And that led me to Biobehavioral institute and great act, where I was formally diagnosed in 2003 with body dysmorphic disorder. So my crash was in 2001 and my formal diagnosis was in 2003. Yeah.
- [19:50]
A
Yeah. I mean, how wild, right? Because sometimes, yeah, if you have somebody who doesn't fully know or understand what something is and it gets missed, I mean, you have to live longer with all of that. And I mean, what a blessing that you had. You had somebody who was like, wait a second. I think that that is this. And to your point, I think too, for a long time these. These things weren't really discussed, especially body dysmorphic disorder. I know plenty of people who, you know, have shared and said things like, well, I would. Didn't want to share anything because people would think I'm just vain or, you know, that I'm like, you know, focusing on something when, you know, they say they can't see it, but. Right. And there's always that but, and it's, it's, it's like, okay, well, whatever is happening outside is outside, but on the inside or how I'm seeing myself sometimes that can be so distorted and you really just, but you don't understand what's happening, so you have no way to make sense of it. So, so let's fast forward for a moment. So you've, you've got, there, you've got the diagnosis. If you can just give us like a little brief summary of, you know, what, what does it look like? Like if somebody's listening and they're like, oh, I might be dealing with this. What, what is the treatment? What's the therapy to get better?
- [20:59]
B
So right now it's still a little antiquated. So it's 2003, it's 20, 26, it's 23 years. And the therapy is still very much CBT, ERP, which is the original like gold standard treatment for, for, you know, ocd. As I've sort of gone deeper myself, I do feel that that's even, you have to do it. But I think there's much more to it that if you don't do. I feel that you can miss out on certain parts of recovery, as I'm sure, like we're seeing now with ocd, like inferential, like various modalities. I think, you know, professionally for me, I go much deeper into deeper psychotherapy because we've learned that there is a trauma component for people with BDD that we don't always see, see with people with ocd. And that piece has to be worked on internal core beliefs, like I told you, like feeling defective, feeling like ugly, unlovable. Those pieces have to be worked on. And those pieces are not necessarily going to be worked on when you just stop the compulsion. You have to explore that. You have to go deeper, you have to understand where do those come from, why are they there, how are they not helpful? And so BDD definitely has that OCD like base. But I always find that we go deeper within BDD for treatment. And you know, I think what's hard often is that there's not enough of us out there that really truly understand or treat bdd. And I will say from a personal lived experience, I often was treated with appearance related ocd and it's not. And it feels different. And I remember like my therapist like referring to it many times as ocd and it was like, yeah, it's not. Oh, it's not. And it's like, but what do you do when you know, like there's no one else that can really help you. So it's, it's sort of doing a lot of education, understanding you're not alone that there's so many people now that can provide that therapy that do understand it, that but do understand the nuances and treatment is available and that you don't have to feel this way and that you can get into recovery and you can begin to heal. And my biggest thing is living a value based life. And you can, you know, you may have struggles and what I call blips, you know, but so do people with OCD or any, anything in life, right. I think it's, it's sh. Shifting the mindset of knowing for me especially was like you can get into recovery but that doesn't mean you stay there permanently and you can have ups and downs and that's okay. That doesn't mean it pulls you right out of recovery. It's just part of life. And I think being self compassionate for people with BDD is super important because we're just innately very critical of ourselves and harsh, just even struggling with it. There's so much shame, there's so much misunderstanding. There is that sense you're being vain, especially in a beauty focused world.
- [24:19]
A
Oh God, yeah, right. I mean there's so much, if you think about it for men, women, for, for really everybody, for humans period, about beauty standards and requirements and changes about her or like 50, 000 times I see so many different makeup. I mean, I can't tell you how many times I see contouring. I'm like, for God's sakes, how, how much can you contour? I mean truly, how much can you really contour? Right? And so even simple things like that, that seem benign, but you put it together with something like this and there's just so many ways that this becomes, you know, like you said, like the perfect storm or all the right pieces together, right? And, and we are as humans judgy, let's not lie about that. Like we all, we all can be right. But like you said, you're bullied or you're picked on or there's other additional features and suddenly it's like, now what? Right?
- [25:10]
B
And it is hard. I think it's hard. I think it's, it's hard because, I don't know, I don't think we think when we think of mental health that it's about appearance, right? I don't think we think about that. I think we just often don't go there. And I don't I never in a million years when I first was having these thoughts, I did not think this was mental health. I thought this was just okay. This was residual of being bullied. This is just you, you are ugly. So this is your life and you're going to have to live your life being that way.
- [25:42]
A
Yeah, like, that's actually a very deep. Right. Like that, that, that I think runs to such a deep core of our essence. And having to. Even as you're saying that, like, that just feels like, oh, right. Saying, wow, I have to live my life with this thing that I'm just. I'm defective, I'm ugly. And this is. This is it. This is just the lot I was given and this is what I have to accept and this is how it's going to go. I mean, that just sounds really horrible and painful.
- [26:07]
B
Well, and I think that just speaks to what BDD, again, is like. Yeah, the loneliness factor. Right. So we're not. You're less likely to see people just going on and talking about it because it's super private. And I always tell people, be wary of what you see on social media because I don't know if they truly have the disorder because most people, they're not going to sit and go into the depths and pain of what they've experienced with this. Yeah, it's so private and personal. It's. You know, when I would go into the mirror or do my compulsions, it was, it was. There was so much shame, there was so much sadness, there was so much pain. I didn't want to share that with anybody. I. I get weary when someone's just like, oh, and I have BDD or body dysmorphia. And I'm like, that was definitely not. And look, everyone has a different experience. But in my nine years of treating it as in private practice, I've never seen one person show up that way.
- [27:11]
A
I bet. Right? I mean, yeah. Like, everybody listening here today, right? If you're really listening or if this resonates or this is you. I mean, yeah, I don't think this is a walk in the park. We just like, with ocd, we never talk about, like, oh, yeah, I can't wait to just clean my stuff up and line it all up.
- [27:27]
B
Right.
- [27:27]
A
If you're enjoying it and liking it, like, well, then good for you. Maybe you're a type A person. But that, that's not how this. These things work usually. Right. They're. They're, like you said, they're internally really, there's a conflict. There's a pain, there's a, there's a distress, there's like things are falling apart. I mean, having to get to a place where you think that this is just how you are and that's it, like this is your lot in life. It's just, that's, that's a really tough pill to swallow. So, you know. Yeah, I mean, I think for anybody, you know, listening to that or, you know, if you're carrying that kind of to your point is like, you know, maybe let's, let's go get some professional help and explore this because there could be something else going on here that that's being missed or you, you know, you had, you didn't catch yet that we can actually then work on.
- [28:15]
B
Absolutely. Because I have to say that it is beyond the physical. It really just affects you how you show up in all facets of your life and how you connect with other humans and how. I have a colleague of mine that says, how can you have a relationship with someone when you have a relationship with your body part? That hits what also hits for me, and I'm okay, I've spoken so much at this point is a very high percentage of people with body dysmorphic disorder are not married. I have my own thoughts on that as a 45 year old. I'm single, I was engaged twice, the same person, it didn't work out. I have my own thoughts on how relationships and I've spoken a lot about how relationships are with BDD and that's also something that has to be discussed in therapy and stuff like that. I think, you know, we see this with all mental health issues or people in general. Sometimes we just are not picking people based on what we believe our worth is. We see that more with bdd and so I think that's also what might lend us to either being single or maybe being in unhealthy relationships. So there's so much to unpack. But like what's so great is that there is help, right? And I think we're, we're still growing in the field, we're still looking in the field, we're researching, we're, we're, you know, trying to understand it. Is it something I wish I didn't have? Yeah, I don't know myself without it though. Isn't that so crazy? Even though those thoughts were in my late teens, early 20s, it's defined me for so long in the sense of like fighting with it, beating it, understanding it in such a way, giving back now to the community, helping people with it. There's a reason we all have something. There's a reason we all been through something. I wouldn't say I would have wanted it, but I have no idea who I would be without it.
- [30:13]
A
Well, I love that because in many ways our struggles, if you will, also shape us right? And shape our strengths as well as, of course, our challenges. Robin, I want to thank you so much for coming on the show, for sharing your story, and for folks listening if they'd like to find you. How can they find you?
- [30:28]
B
You can go on my website, rlsterntherapy.com and I have all of my, you know, I've spoken and I have all my information and contact information and you can always email me and reach out.
- [30:43]
A
Wonderful. Thanks for coming on the show.
- [30:45]
B
Thanks for having me.
- [30:49]
C
Thanks for listening to the OCD Whisperer Podcast. Remember, freedom from from OCD is a
- [30:54]
A
journey and you're not alone.
- [30:56]
C
Visit www.coraresults.com to explore self help masterclasses like Sneaky Rituals with Jenna Overbaugh or ICBT Masterclass with Christina and Abe. Don't forget to grab your OCD CBT journal tracker and planner while you're there. If you found this episode helpful, please subscribe, share and leave a five star review to help others find the podcast. Together we can make a difference. Keep going and I'll see you in the next episode.