According to the DSM, the “official” mental health diagnostic guide, body dysmorphia . The involves an excessive preoccupation with some real or imagined physical abnormality that causes “clinically significant distress in multiple areas of functioning.” I’ve always admired the DSM’s pretension of having definitive criteria. What the hell is “clinically significant”? Who the hell knows? This is the same manual that contains “Math Disorder” – which means that you suck at math. I don’t know how much weight to put on anything in there.
But the “real or imagined” criterion has come to fascinate me, especially as it relates to this disorder. Almost everyone has some physical attribute they would change if they could. Most Americans say they would like to be thinner, and many people have minor grievances with the universe for giving them some other flaw- a big nose, a receding hairline, a birthmark, etc. Body Dysmorphia is something a little bigger than that. A professor once explained it to me this way: if Marilyn Monroe had a clinical case of body dysmorphia, she would leave her house in a ski mask every morning because she wouldn’t want anyone to see the giant mole that took up half her face. A younger prof would have gone with Cindy Crawford, but you get the idea.
At the same time though, many of us have encountered people who have ideas about their appearance that border on the insane. A common remark you’ll hear from a person with this sort of milder body dysmorphia-if they have the insight to see it- is that when they look in the mirror, they don’t see themselves as they probably are, but as someone who looks very much like the person the world probably sees, just with a GIANT nose or HUGE ass. When I heard that, I always thought that they meant that more metaphorically than they do. And I only really realized it when I discovered a mild body dysmorphia of my own recently.
My left front tooth has been slightly discolored since I was about 9 years old. In fourth grade, I was playing in the playground and I bit the curb with my upper teeth full on – American History X style. The left front tooth was broken in half and the bone over my mouth, which holds a lot of teeth in place, cracked. That loosened my teeth, and I needed a set of braces temporaraily to make sure I didn’t lose them. When the braces came off, my teeth had been saved, except for that left front one. I needed a whole series of root canals and crowns to save it. The tooth stayed, but it was tinted to a grayish-blue for the rest of my life.
I was self-conscious about it. It didn’t help that one of the favored ways of mocking me for the remaining 5 years of grammar school was to sing “don’t step on my blue suede tooth.” Hilarious. I heard that song all the time, and after a while it just rolled off me, even though it burned at first. Year after year I heard that God-damned song. When I first got to high school, in that brief period at the start when the middle school social rules still applied, I got laughed at about it. A lot of the time it was muttered near me and not said directly; but I heard it.
Dentists didn’t help either. Whenever I saw one, they would marvel at how discolored it was, and they frequently offered me expensive cosmetic solutions for it. I was tempted sometimes, but I always passed. After that early part of high school, I just came to terms with it. I didn’t like it, but there it was. Eventually I made friends and had girlfriends and everything was pretty much normal. When I had serious relationships later on, I asked how they were able to ignore it. They all said it wasn’t that noticeable. Some even said that they only really noticed it when I mentioned it.
That was sweet of them, I thought. They were clearly lying. It was a white lie, of course, but I knew the truth. It was pretty bad. The women who dated me, and the one who eventually married me, obviously saw something else in me that made my blue suede tooth unimportant. As I got older, and openly mocking someone became uncool, the only time it was ever really pointed out to me was by dentists. And they never hesitated to let me know just how bad it was. To hear them tell it, you would think my tooth was so very, very dark. Depending on the lighting, it was navy blue or battleship grey.
Recently, I went to a dentist who told me the post holding the tooth in place was sliding out of place and beginning to rot. The tooth would fall out unless I got it re-crowned. It would be very expensive. On the plus side, though, I would finally be rid of that tooth. I would have to do it eventually, since I was becoming a therapist and people are often weirded out by ugly teeth. I’d need to get rid of my grayed tooth in order to make sure clients felt at ease. So the time had finally come.
A couple weeks ago I had it done. As soon as I got out of the dentist’s office I looked in a mirror, and I was taken aback. It didn’t look that different. Sure, it looked a little better, but I wasn’t looking at a whole new me. That’s when it hit me. My wife, my close friends, my ex-girlfriends- they’d been telling the truth. It wasn’t that noticeable. After I got out of that chair I knew that the old tooth was gone. Nothing short of roofies could make me forget that it was impossible for the Evil Blue Tooth to still be there. So, when I looked in the mirror, knowing the tooth was gone, I was able to see my mouth as it must really have looked all those years. My belief that my tooth was a dark, navy blue hue was a complete delusion.
But I know what I saw. For thirteen years I saw that dark blue tooth every time I brushed my teeth and every time I looked at a photo. I saw it. Of the five senses, sight is the one we almost never doubt. You cannot see what is not there-or so we think. When people with body dysmorphia say they look into a mirror and see something ugly looking back, that is what they are seeing. With their eyes. It’s not that they see what is really there and blow it up in their minds. They see something that is absolutely not there. They hallucinate. Every day. I’ve been having a hallucination multiple times a day for thirteen years.
We think we are rational creatures incapable of seeing things that aren’t there. Our desire to believe something cannot fool our eyes, and we won’t see something that isn’t there just because someone else tells us it is. But for thirteen years I did just that. I believed the things those little monsters said to me so completely that my mind dictated reality to my eyes. Years of certainty and “evidence” only reinforced my ideas. Obviously, my tooth was discolored. Those children had exaggerated that, and the more they exaggerated it, the bluer my front tooth was every time I looked at it.
I am 32 years old. Insults made in fourth grade still stung enough to carry my imagination away from me. I’m not the healthiest person psychologically speaking, but I’m hardly a mess. I am an otherwise sane person, which is why I was so shocked when I looked in that mirror and I saw what had been staring back at me for just a little over a decade.
Is it that big a stretch to think teenage girls and women who watch Gossip Girl and look at Cosmo begin to see obesity when there is none? Is it hard to believe that people come to remember abuse that never really happened if they get told that it did by a trusted therapist over and over for years? People confess to crimes they didn’t commit all the time because they are terrified, strongarmed, starved and kept awake so that the cops repeating that they know you did it over and over begin to convince you that maybe you did.
Normal people hallucinate all the time. You probably do. The world you see is the world you have been told is there. Reality is actually a lie you tell yourself. How big a lie varies from person to person, but everyone is living in a world that they are making up. The Matrix was truer than you think.