What it’s like to video call when you have body dysmorphic disorder [article]

Most of us have been on plenty of video calls over the past twelve weeks, embracing this new communication medium with open arms.

Articles on what to wear to your next Houseparty hangout or how to dress for a virtual date are ubiquitous, and you only have to look at the flurry of quiz screenshots littering Instagram on a Saturday night to understand just how at home (excuse the pun) many of us are feeling with this new way of communicating.

But it’s not all peachy. We’re seeing the emergence of content focusing on handling anxiety during conference calls and dealing with burnout from virtual socialising (for which a new term has been coined: “Zoom fatigue”).

I suffer from body dysmorphic disorder (BDD), described by the NHS as “a mental health condition where a person spends a lot of time worrying about flaws in their appearance.” I do strange things like re-apply blusher multiple times a day, avoid having my photo taken and always take the seat at the restaurant table that doesn’t face the mirror.

I also can’t bear to use changing rooms and when I’m sitting at my desk at home, I’ll open my wardrobe so the built-in mirror is hidden. (That way, I can’t see myself while I work.)

Every single day is plagued by anxious thoughts and habits. How do I look? Do I look OK? How do they think I look? What are they thinking about my nose? It’s a steady stream of negative thoughts invading my consciousness.

And it’s exhausting.

So you can imagine what happens when you throw video calling into the mix. A medium that forces you to come face to face with all your perceived flaws on camera; a medium where you can’t tell who’s looking at you; a medium that forces you to feel around in the dark for social cues that, in normal life, would be simply a given.

Seeking solidarity from likeminded individuals, I decided to reach out to fellow BDD sufferers via Reddit. I spoke to seven individuals to hear their thoughts on video calling with this disorder. They have all been forced to video chat more because of lockdown.

I asked them a series of questions about their thought processes before, during and after a video call, and if they’ve adopted any safety behaviours to deal with the discomfort.

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Preparing for a video call: the lengths we’ll go to

It’s typical for sufferers of BDD to develop coping mechanisms and safety behaviours. This could be anything from avoiding mirrors to avoiding social events altogether.

My coping mechanisms for video calling involve brushing my hair and re-applying blusher and powder before the chat starts. My brain tells me I look better with rouged cheeks and unknotted locks. In fact, my BDD lens tells me I’m pretty much a different person to the one I was before I applied anything.

I’ll also spend a considerable amount of time adjusting and testing my camera to check the angle is as flattering as possible. Despite this, I’ll still end up covering my face in the bottom corner with a post-it, peeling it back every so often to check how I look.

The Reddit users I spoke to have similar habits when it comes to preparing for a video chat.

DL is 28 and has had to use Skype more since the lockdown. He’s “paranoid” about his backdrop, and so makes every effort to ensure it looks as good as possible.

“I’ve set up an innocuous area in my house since COVID-19 started so I can “look” more natural. The one thing I universally do before a video call is to gel/style my hair. I feel like I look really bad if I don’t.”

He says he feels judged on his appearance in social situations and is therefore always striving “to look perfect.” DL also finds spontaneous calls particularly anxiety provoking.

“I prefer planned calls. If someone calls randomly I have to scramble and sometimes I hang up if I’m not ready. I really hate random calls of any sort.”

Another user, CJ (17 years old), also insists on brushing her hair before a video call starts. She’s having to take her school classes over video while the pandemic is going on.

“I brush my hair thoroughly and stare at myself through the laptop camera before going on the video call,” she recalls.

BDD sufferers tend to focus on one particular aspect of their appearance. We’ll scrutinise our perceived flaw and do anything to draw attention away from it when out and about. This could be wearing a hat to hide a scar, using makeup as a cover-up for spots or making sure our noses can’t be seen from the side on.

For OW (19), another Redditor, video calling has them obsessing over their cheekbones.

“I have an obsession with them to the point that I need to let the whole world know I have them. It’s not because I am being cocky because of them; it’s more of an insecure thing.” As such, they need to make sure they’re in the correct lighting before the call starts.

And BDD isn’t something that’s only prevalent among millennials and Gen Zers. I also spoke to R, a 47-year-old teacher who dreads video calls. She leaves her glasses off if she has to be on video, but for the most part, tries to avoid being seen at all costs.

“I have lied and said my camera doesn’t work. Really, I have covered it up with duct tape. It wrecks my day to see my reflection or to see a picture of myself.”

It’s normal for BDD sufferers to avoid mirrors and any other reflective surfaces (even seeing old photographs can be triggering). What can I say, welcome to our twisted, hyper-aware world.

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Behaviours during a video call

As you can imagine, there’s not much respite from anxiety during the video calls themselves. In fact, for many of us it gets much worse than the initial anticipation and prep.

One thing that’s recurrent throughout the chats I’ve had with Redditors is that we’ve all adopted coping mechanisms for when the video chat has started – whether it’s muting ourselves, leaving the camera off until we’re told to turn it on or covering the part of the screen where we can see our faces.

“I tend to mute myself and if possible turn off the camera until someone instructs me to turn it on,” says CJ, while K, another 17-year-old, admits “I usually cover the area of the screen where I am on, so I don’t have to look at myself.”

Seeing ourselves on video is completely different to looking in the mirror. Despite the fact we’re able to rationalise the fact it’s the same person with the same features looking back at us, our faces look completely alien – almost unrecognisable – and we feel even more scrutinised, like ants under a magnifying glass.

“Video calls make me incredibly self-conscious not just about my physical appearance but also my mannerisms and facial expressions. It feels quite performative, you feel like you have to constantly be aware of how you look. Most of all I hate seeing my face in the pop up window so always minimise it whilst talking. I feel like my face can be scrutinised whilst on video call,” says another user, AH, 23 years old. An unemployed graduate living at home, she doesn’t have to do video calls too often.

Another user, Z, is in her early 30s and has been going on video calls for work purposes. Before lockdown, she hated the idea of them and wouldn’t answer even to family members when they called.

“During the video call, I feel uncomfortable and anxious. I cannot wait for the call to end. There is also no way I can look at myself on the screen because I know if I do, I would become hyper focused on what I see and begin to scrutinise and analyse my appearance.”

“When I see myself on video, everything looks worse than how I am used to seeing myself in the mirror. I feel like I am warped and not normal. I’m also worried that others would see what I see. Thoughts of self-hate will then come rushing to the surface.”

When your head feels like flypaper for worry and anxiety, it’s unlikely you’ll perform to the best of your abilities during a video call. You might find yourself missing out on vital information because you’re too busy fretting. Unfortunately, for many of us it feels like something we’re supposed to just “get used to.”

Z feels like there’s a lack of consideration for anxiety sufferers who may not be comfortable with this method of communication.

“The more I see this, the worse it makes me feel about myself and living with BDD. The feelings of alienation and not being understood only increase when you are made to feel like you don’t have a choice or aren’t given any other option.”

Our worries and assumptions

For BDD sufferers, the focus is always inward instead of outward. Our minds are chockful of all sorts of assumptions about how we’re coming across and what other people are thinking.

We also find ourselves stuck in a toxic comparison loop, drawing parallels between how we look compared to the other people in the call.

“I feel uglier than everyone else on the call and worry that some may be taking screenshots of my face or recording the chat to make fun of how ugly I am,” says CJ.

We can invent hypothetical scenarios and become lost in them, trapped in a ghastly tornado of imaginary thoughts.

“I feel like I look gross and I also have a lot of obsessive thoughts on what parts of my face need to change. Even though I can’t see myself I can’t help but think that I look bad,” echoes K.

For AH, it’s the potential comments about her assumed “abnormal and hideous” features that make her anxious.

“I find video calls particularly triggering as people can often make innocuous comments that nonetheless trigger my BDD. For instance, whilst chatting with a relative over skype, my camera kept freezing and I was told by this relative that it wasn’t a good look. Offhand comments like these can be detrimental in the context of BDD and can trigger endless ruminating.”

Meanwhile, for OW, the fear is specific to his features: “I get nervous about my lack of masculine features that I have gotten through genetics. I get scared the person doesn’t see me as a man. So therefore I am not going to be taken seriously,” he says.

It takes more than just repetition to break these negative thought cycles and to be “tornado-free”. The solution, the golden ticket to freedom if you like, is self-acceptance.

Until we’ve learned to accept ourselves and our perceived flaws, the cancerous comparison loop shall continue and video calls will still remain a source of anxiety.

“I think I will keep feeling uncomfortable until I’m able to accept myself. I feel if you don’t like how you look, no matter how many times you see yourself, you will always feel the same way unless you’re able to change your mindset,” echoes AH.

“The problem with all of us suffering from this disorder is it does not get better with the habit of doing something more often. There is a fundamental problem that we need to address first and I think that comes through therapy. After the main issue is addressed I think all of our lives would become a tad easier and happier,” says OW.

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Keep working on yourself

There’s no magic potion to drink that’ll have you audibly yay-ing at the thought of video calls. And from my experience, beating yourself up about why they shouldn’t be a problem isn’t going to make you feel any better. The key to making them manageable is self-acceptance.

Write down a list of your achievements and your positive traits. Get used to reading them out loud on a daily basis to try and detract from all the perceived flaws you think you have. You could even stick the list on the wall above your computer screen as a reminder during difficult calls.

Whatever you do, don’t take screenshots during the call. (Nobody, not even Beyoncé, can look divine in a screenshot, especially if they’re mid sentence.)

 Do try and find an angle that works and makes you feel slightly more comfortable about your appearance. If you need to, cover your image in the bottom corner with a post-it note and try not to look at it during the call. Sometimes, ignorance is bliss (though this takes a whole heap of self-discipline).

Last but not least, strike up conversations with other BDD sufferers through social media platforms like Reddit or official bodies like the BDD Foundation. In such unprecedented times, it helps to talk to others about what you’re going through and can help you feel less alone.



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