Living and Dealing with Body Dysmorphic Disorder

Body Dysmorphic Disorder (BDD) can manifest itself in myriad ways. Sufferers of the condition have a distorted view of how they look, which can lead them to compulsively check their appearances in mirrors, or, conversely, avoid reflective surfaces completely. Obsessive skin picking, seclusion, and cosmetic surgery are also common amongst people with BDD. These behaviors can shut sufferers off from the world and trap them in a cycle of fear and self-loathing. In the most extreme cases, BDD can lead to suicide.

Despite the odd celebrity confession, it's still a "new" condition in terms of understanding and public awareness. It was only recognized as being on the 'obsessive-compulsive spectrum' related to OCD in 2013. One in 100 people in both the US and UK are thought to suffer from the disorder, although it is likely this number is higher. Experts in the field tend to agree that Cognitive Behavioral Therapy (CBT), along with anti-anxiety meds, are currently the recommended starting point for therapists and doctors to go about treating it. But there's also a "human problem-solving process" that's been with us a while longer: manifesting and facing our vexations through art.

Two artists taking the raw material of their fears and obsessions and turning them into photography, performance, and film are Liz Atkin and Leigh de Vries.

Atkin, who works mainly in photographic self-portraiture, has been affected by compulsive skin picking since the age of eight, when the condition gave respite from the anxiety caused by conflict in the family home. She trained originally in dance and drama, but it was through a study project where she was asked to record her body that she began to think about her condition creatively. "I had to confront the illness head-on when I started a masters degree in dance when I was 29, and it was then that I realized I could use the illness and study it in terms of a movement pattern in and on my body. I had no idea that was going to turn this disorder around… it was life changing."

Beginning with a flat-bed scanner, the only image capturing device on-hand, Atkin began to record her own image, using whatever was nearby—milk, hair, glue, paint—to create new images. The surfaces and textures of her body and surroundings fascinated her, so she decided to "go in" for more detailed examinations of these parts of her body she obsessed over.

At the first Body Dysmorphic Disorder Foundation Event at London University's SOAS Building earlier this year, Dr. David Veale, one of the UK's leading experts in the field of BDD, held a discussion on how self-portraiture could help in the treatment of the condition. One of the recent findings he brought up was how a person with BDD or OCD has a different reaction to anxiety than a non-sufferer. Essentially, when the limbic cortex/fight or flight centers of the brain are active, a BDD sufferer will attempt to deal with the fear by switching on the part of the brain that deals with detail. In order to become or feel "safe," the brain of a BDD sufferer will focus in on something—hair, skin, legs etc.—as the source of distress, and obsess, hide, or mask, in an attempt to feel better. Or, in the case of Dermatillomania (skin picking), the act itself will induce a soothing, trance-like effect. This tuning in on detail is something that Liz Atkin's work on her skin picking captures brilliantly.

De Vries is a musician and artist who had been plagued with negative thoughts about her appearance since adolescence. "In all the projects I worked on up until this point, I was putting out how I wanted the world to see me. But because of my BDD, weeks before a photo shoot, video shoot, or going into the studio to sing, my BDD would really attack me on multiple levels. It got to a point where I isolated myself in my house for a few months—I didn't even make contact with anyone. Then it came to me: 'Why don't I express this through my art?'"

De Vries came up with the video and audio installation Exposure—The Broken Reality Tunnel, a walk-in, two room box that features two videos of her walking around Manchester town center wearing a prosthetic face piece, created by make-up FX expert Shaune Harrison. The two video rooms are connected by dark tunnels, where the voices of de Vries and other BDD sufferers talk about the condition. It's a darkly beautiful construct that reflects the feeling of being trapped with your thoughts.

"I wanted to create the monster I perceived myself to be and physically wear it in public to create some mending in my mind by having the actual experience," says Says de Vries. "When we have something in our mind, versus the physical, the version in your mind is way worse. Shaune and I worked through a mood board of what I thought I looked like. I imagined I looked like someone with Elephantitis, with huge growths coming out of my face and body. The closest we got was a huge tumor growing out of my face. I had the idea to work with secret cameras—I wanted to capture my own journey of isolation but also make a social commentary on how people react to people with deformities. We had these great secret cameras called pivot heads, on glasses that have full HD and motion, and I had a little button camera on my blouse so we had three camera points. It was possibly the scariest day of my life so far."

Neither artist has sought professional help for their condition. De Vries has been in contact with other sufferers via social media, and also through working with the Body Dismorphia Disorder Foundation. For her, the work itself creates relief. "It's quite beautiful in that way, that by revealing my darkest secret, I'm with it in a compassionate way and instead of being ashamed, I'm proud. I feel revealing the chaos means I feel closer to people and people feel closer to me—it's kind of like this weird way of saying 'I'm fucked up.' And people then say 'Oh my God, so am I!'" Likewise, Atkin talks about how the process of creating art mirrors the "tuning in" and focused relief of skin picking ("It's the same "hit" making art—using fingers, scrutinizing my body"). When, during a tough period in her life four years ago, Atkin did approach a doctor for the first time, they advised her that she was already engaged with what therapists would call advanced, breakthrough stages.

Both Atkin and de Vries want to use their work to help others. They are involved in outreach programs, particularly youth groups—as these are conditions that usually begin in adolescence—and art therapy. Atkin has done talks about her condition and is intending to do more outreach work here when she returns from her fact-finding mission to the US, which she is paying for via crowdfunding. "The USA is many years ahead in terms of awareness and research for skin picking and hair-pulling disorders." She has also been invited to show her work at the UCLA Medical Center and University of Southern California.

We all pick at ourselves—and on ourselves—from time to time. And we're all susceptible to negative self-image. When our minds take us to dark places, it's good to have art to show us that we're not alone. Liz Atkin and Leigh de Vries have shown us that art doesn't have to be conventionally pretty to be beautiful. And neither do we.