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I recently came across this site and have been struck by everyone's honesty. Thanks to all who have shared. Like others, I've decided to use this forum to journal my progress. By putting it on this site it feels more substantial than simply writing in a journal. By anonymously writing here, I am able to feel a bit freer from the shame and to feel accountable for my future actions. Here's my story. I have been picking, primarily my face, for over a decade. Like many people, it started when I began getting pimples during puberty. Years ago, a dermatologist actually helped me see that my compulsive behaviors created my problems, and named my condition, which is acne excoriee. There are spans of time when my face is clear, but it appears that I always backpedal in times of stress. Mirrors and harsh lights are my enemy. Without them I probably would not even see the microscopic "imperfections" that I pick and squeeze. I also struggle with my cuticles/nails, but have recently been doing extremely well in that area of my body. I think that by trying to maintain beautiful hands, my face has unfortunately bore the brunt of my abusive behaviors. Ultimately, my shame and attempts at "covering" my work is the most damaging aspect of this condition. I am aware that what I see is often not noticed by anyone else, and that most people just slightly notice some pimples/marks. My loved ones are quick to point out that they see my attractive face and not my pores. While I cognitively know that this is true, it is hard to truly take it in. I have a hard time experiencing pride or joy in simply who I am, and base my self worth on my work and good deeds. My shame is also intensified by the fact that I am getting my doctorate in psychology, and "know" what I "should" be doing, which is getting help from a professional trained in this area. I feel like a phony and a hypocrite, as though I am a cardiologist who smokes. Most people would be shocked to find out about my picking and mental health history because I present myself as a confident and successful person well suited to being a psychologist. At this point I am on the fence about getting therapy, and justify my non-action with the fact that I am a busy graduate student. The truth, though, is that it is more because I am ashamed of seeing a fellow mental health professional at this moment. I have much insight about the connections between my thoughts, feelings, and behaviors. For example, I see the perfectionism that helps to drive my academic success is also making me miserable, and I take it out on my body. There is a huge leap between self insight and action. Today I'm trying something new. I am going to use this forum to write about my journey. I don't know how long I will keep it up. I also am going to attempt not to turn it into an academic exercise (because of my background I am tempted to send links/summarize research on dermatillomania). Instead, I will reflect on my internal experiences, triggers, and actions. My first step today is to throw out a mirror. I use it in front of my bedroom windows during the daytime to find any and all "imperfections." While I do need to focus on coping mechanisms for stress, I also know that altering my environment is going to a be a big part of my recovery.