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My online friend has - I think - BDD. How do I help?
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I've been chatting to a person online for over a month now. We are the same age however he is in another country. We have anxiety problems so we help eachother out and give eachother advice and stuff, but I've started to pick up on the fact he may have BDD (Body Dysmorphic Disorder). He is an extremely good looking guy but he is always calling himself ugly and doesn't believe me when I tell him he's handsome. He criticises his appearance daily and says he can't look in a mirror because he can't stand looking at himself. It's really getting him down. He is always talking about a famous model and asks me to tell him that the model is better looking than him. I refuse to answer because I don't want to hurt his feelings, and he can pick up on this because he always says to me "Why don't you just tell me I am not as handsome as him?". He said he wants to be better looking than the model because he would feel happy about himself because the model is adored by everyone.
It's kinda upsetting me talking to him because I feel helpless. He is a good guy but very sensitive. He doesn't want to see a counsellor and can't talk to his family or friends. I'm running out of ways to comfort him.
Any ideas?! What do I say?
It's kinda upsetting me talking to him because I feel helpless. He is a good guy but very sensitive. He doesn't want to see a counsellor and can't talk to his family or friends. I'm running out of ways to comfort him.
Any ideas?! What do I say?
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Other than encouraging him to get an assessment and relevant help, I doubt there is much you can say or do to help him.
You can't change things for him - he has to do that.
You can suggest where he can get information - look at Mind's website for that - but then focus on chatting about other stuff away from his problems.
Remember this is an online friendship and that is very different from a face-to-face friendship. Often, in online friendships, there are lots of gaps and the temptation can be to fill in those gaps with wishful thinking.
http://www.mind.org.uk/information-support/types-of-mental-health-problems/body-dysmorphic-disorder/
http://www.mind.org.uk/information-support/tips-for-everyday-living/online-safety-and-support/
I was just about to post something similar. Women are not just attracted by looks, personality is more important and a guy who is obsessed with comparing himself to a model would be a turn off for me.
I agree but I would ask him if someone had been criticising his looks, perhaps when he was growing up? There must be something behind this.
He has social anxiety (that's how we met) and obviously going to a doctors or something isn't easy for him. He is definitely not attention seeking or trying to manipulate me. He helps me out with my problems and I try help him. I'm just feeling really helpless that all I can do is try and type out words of encouragement all the time.
I will send him the links that you sent Scottie and I will try persaude him to meet a professional but I'm worried about him.
http://www.anxietyuk.org.uk/get-help/what-kind-of-treatment-is-best-for-me/cognitive-behavioural-therapy-cbt/?gclid=CMyT6o-mn70CFZHJtAod4AYASw
Cognitive therapy is widely used nowadays for anxiety, depression, and disorders involving cognitive distortions, such as severe self-image problems.
I think you are doing the right thing by not colluding with his questions about looking as good as someone else.
As other posters have said, how someone looks, and how they are perceived by others, is a very subjective matter. So maybe you can ask him why looks matter so much to him? Also, does he impose the same kind of judgement on others? If not, why does he feel he should look so much better than other people? I.e. what’s wrong with looking ordinary? Would he only go out with a girl that looked like a film star? Etc, etc. Without getting into an argument, challenge the thinking behind his worries in a way that encourages him to rationalise them.
Meeting with a therapist is not the same as a social encounter, and perhaps you can impress that upon him. It’s a meeting with a purpose, and with cognitive therapy the relationship between client and therapist is based on a working alliance where the agenda is open and clear, i.e. it’s not about endless open-ended questions that make you wonder what the counsellor might be digging for in your unconscious mind, which of itself can create anxiety. Cognitive therapists are like friendly mentors who work with you on the problems that need sorting out.
You probably have a good level of empathy with him because you suffer with anxiety yourself? However, separating empathy from identification can be tricky when you have similar problems. Perhaps you can agree a pact between along the lines that you will challenge and push yourself sometimes, if he will? The B in CBT is the action side of making changes.
Sorting out how you think about things is part of the change process, but in most cases change means taking action. Which in CBT is often done in very small steps. So for example, if someone avoids going out because they might meet someone they know because this would cause them anxiety, they might be encouraged to take a short trip out and speak to someone they don't know - just the one person, and no more than saying: 'good morning'. When they feel comfortable doing that, then it might be a slightly longer trip and the objective might be to speak to two people, and so on, building up contacts as confidence increases. Later on, the trips might get longer, and might involve a short conversation. The idea being to just nudge the boundaries out a little further bit-by-bit.
Unlike classic psychoanalysis, cognitive based therapies tend to focus on the here-and-now and the future, rather than delving into the past and trying to analyse unconscious conflicts, etc.
There might be an obvious reason why your friend feels as he does about his looks, but if not, rather than spending hours and hours trying to work out the: ‘why,’ cognitive therapy might involve looking at how the way he thinks and feels affects his life. So if he says he doesn’t go out because he’s: “so ugly”, the first question might be: “Do you want to go out?” He’s probably going to say: “Of course I do, but I’m too ugly!” Assuming that the cognitive distortion of “I’m ugly” has been worked on, but not resolved, then the focus might be switched to going out, and what consequences the client might feel will follow if he risks venturing out.
The act of ‘going out’ becomes an “experiment” involving testing out the client’s expectations and anticipated consequences of such an activity. The objectives are expressed in behavioural terms, and the cognitive process involves modifying thinking in order to meet such objectives.
So for example, a client might say: “I won’t be able to speak to anyone because I’ll be too embarrassed!” In which case, the cognitive side of the therapy could focus on managing the thinking that produces the embarrassment so that the behavioural objective (going out) becomes more achievable.
The first few trips out might be based on avoiding any social contact, but then gradually building up contacts as described earlier.
Turning things around and dealing with the consequences of the problem can often neutralise “the problem”, e.g. having dealt with the practical consequences of the problem your friend may well conclude that: “it doesn’t matter what he looks like because people mix freely and like him anyway”.
Relaxation training is very useful when dealing with anxiety, so take a look at this link as well…
http://mbct.co.uk/
I recommend you don’t attempt to become his therapist, but perhaps knowing more about what to expect will encourage him to seek some professional help. Hopefully, the above will also help you both with supporting each other, and perhaps with the occasional challenge becoming incorporated, i.e. the B in CBT. Knowing when to provide support, and when to challenge, is all part of good therapy.
You sound very caring and level headed, and he’s lucky to have a friend like you.
Cynical I know, but I'd expect at some point for the cost of his treatment to come up, sorry
Yeah, me too. Also wondering about diagnosing someone with a psychiatric disorder when you've never even met them.
Wondering if I can PM someone individually about this? I need some extra advice and need someone to basically tell me if I'm doing the right thing or not with my current support...
Whilst I understand how debilitating depression is and so difficult to overcome, I think you need to be aware that this guy could be a scammer. I am not saying he is, I don't know him - neither do you - and he could be a totally genuine guy. Just be careful, and don't feel guilty if you do question his motives. Did you meet on a site specific to people with these medical problems? If so, it is an ideal opportunity for con artists to trawl, looking for people who are suffering themselves, and may be rather more susceptible to his story and, consequently, willing to assist him financially, as they think they are helping .
If we assume he is being totally honest, you have provided him with the necessary information to get help for himself. You cannot do it for him, I would have thought his first step, would be a visit to his GP - has he not mentioned this?
btw, has he invited you over to his country yet? If he does, don't go. Please.
It's nothing like that at all. We've now been talking almost daily for over six months now, have eachother on Facebook and been on webcam to eachother. We talk about all sorts of things like normal young guys do, but it's still pretty obvious he is suffering from BDD. I've already tried to get him to see a therapist and he refuses (social anxiety) and he often comes to me for support and encouragement whenever he's feeling depressed about the way he looks. I am always honest with him and try be very careful with how I word things and what I say to him, but I'm now concerned that I'm doing more harm than good and that he's became too dependant on me to say the right things and re-assure him about his looks. I've read that seeking constant re-assurance is something that's common with BDD sufferers and that it only helps temporarily. Should I keep re-assuring him? He looks alot like a famous model and there's two extremes where one day he will be slightly overconfident and become almost bragging about how much he looks like him, and other times he will be really low and depressed and say he looks nothing like him and that the model is much better looking than him. I wouldn't say it's an obsession but it's obviously always on his mind. Maybe I'm being too nice to him? Or I'm encouraging his behaviour? I don't know, I just want to help but so limited with what I can do and say.
I think he can only get help from a professional - e.g. therapist, doctor, whatever. I understand social anxiety however he will need to work on his BDD or whatever it is either in conjunction with his SA or as another issue.
Self esteem is at the heart of this, as well as often being at the heart of SA. However personally I think it's nearly impossible to simply 'improve' your self esteem or to have anyone else help you. I think, in my experience, it's only ever through personal experience/time/changes that my confidence and esteem has improved.
So I think you need to encourage him to work towards dealing with his self esteem. You can't base your friendship on what to say all the time, or whether he looks like a model or providing reassurance.
I say this as someone who has a close male friend in real life who needs reassurance and is convinced he is ugly and unattractive. I don't think he has BDD, just severe self esteem issues. He takes everything the wrong way and sounds a bit like your friend. I've encouraged him to see a therapist and in the meantime he's bought himself a book on confidence, and we chat about it. But I couldn't spend the whole time reassuring him - I think that's quite a self-absorbed situation and it's not good for you as a friend. You can only really help him by getting him to take some steps on his own.
Please don't allow him to become dependent on you. Especially as an online friendship where you don't know the guy. If you met him in person you might not even be friends with him, so don't let this online friendship zap too much of your time or energy.
There's a bit of an obsession about his features. He's talked about surgery for his ears, spoken about how he hates his eyes and facial length, his mouth etc. He has one picture on Facebook and used to frequently turn off his camera because he couldn't stand looking at himself on the screen. He's also told me he can spend hours obsessing over his appearance in the mirror, is frantically worrying about hair loss and things like that. Maybe it's not BDD, I just assumed these were all possible symptoms or something similar to it?
I had various friends who would tell me all of their woes and problems and I would hardly ever do the same back, I became a sort of magnet for these type of people and unfortunately it lead me to a place were no matter how good advice I gave they never took it after years of knowing some of these people.
Then something happened to me in my personal life, someone important to be died and that was my sort of wake up call and I realized I'd been spending way too much time helping the unhelpable. And yup fast forward to now I don't talk to a single one of these people now and instead I focus on people I can actually make a difference to.
It's good you want to help this guy, with the Internet and the country/distance thing you will not be able to physically help this guy, and that is what he needs he needs to sort out his own thoughts, which you can't do as it's a personal thing for him and he needs to get physical help.
Sounds a lot like what you're doing is just giving him an 'audience' to vent all his insecurities out on and because you so want to with all your heart, in a really good place help him, from his POV he'll just feel you'll always be there ready to listen...but because it's the Internet it's safe and it's not real or physical life then I don't think there's anything you can actually do to help this guy that will make a big difference.
There are a lot of people in the World who when they have a problem just want somewhere to vent and someone to listen to it, the Internet is perfect for that and there's a lot of people who would go to doctors over any little thing to just moan how terrible their life is but doctors wont let them and professional therapists charge for this service...fiends and relatives will ignore your calls or tell you to get lost so they turn to the Internet.
It's a free way for someone to moan about their problems and that's what he's doing. Ask yourself what you are getting out of it. Do you see a future with this guy? Is it a potential for love? If someone with all of these issues really a stable relationship in your life that gives you love and affection that is worth it?
Everyone deserves help but I do beleive there is a limit to how long you can go around in the same circle with someone & if things don't change and stay the same you'll end up feeling miserable too. You seem like you're already figuring out how useless this can be at times, so that's enough to show you that it's unlikely to improve.
I'm not saying cut him out of your life, just back off a little, refuse to talk about that subject with him and a lot of the time leaving someone to their own devices gives them what they need to get help.
Well like I said, it is a good friendship. We talk alot about football and day to day things and have mentioned a couple of times about meeting up in the future so there is alot more than just the "looks" topic, but it's just sad for me when I recognize he's in one of his self-hating moods and I can't do anything.
Thanks for the long reply. I appreciate it, and certainly made me re-evaluate things a little. And thanks to everyone else who replied.